Julia Ratter1, Lorenz Radlinger2, Cees Lucas3. 1. Hospital Rivierenland Tiel, The Netherlands. 2. Applied Research and Development Physiotherapy, Health Division, Bern University of Applied Sciences, Switzerland. 3. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands.
Abstract
QUESTION: Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders? DESIGN: Systematic review of studies of the psychometric properties of exercise tests. PARTICIPANTS: People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders. INTERVENTION: Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included. OUTCOME MEASURES: Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates. RESULTS: Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias. The included studies evaluated: Åstrand test; modified Åstrand test; Lean body mass-based Åstrand test; submaximal bicycle ergometer test following another protocol other than Åstrand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test. None of the studies assessed maximal exercise tests. Where they had been tested, reliability and validity were generally high. Dropout rates were generally acceptable. The 2-km walk test was not recommended in fibromyalgia. CONCLUSION: Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue. There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue.
QUESTION: Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders? DESIGN: Systematic review of studies of the psychometric properties of exercise tests. PARTICIPANTS: People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders. INTERVENTION: Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included. OUTCOME MEASURES: Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates. RESULTS: Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias. The included studies evaluated: Åstrand test; modified Åstrand test; Lean body mass-based Åstrand test; submaximal bicycle ergometer test following another protocol other than Åstrand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test. None of the studies assessed maximal exercise tests. Where they had been tested, reliability and validity were generally high. Dropout rates were generally acceptable. The 2-km walk test was not recommended in fibromyalgia. CONCLUSION: Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue. There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue.
Authors: Jone Ansuategui Echeita; Matthias Bethge; Berry J van Holland; Douglas P Gross; Jan Kool; Peter Oesch; Maurizio A Trippolini; Elizabeth Chapman; Andy S K Cheng; Robert Sellars; Megan Spavins; Marco Streibelt; Peter van der Wurff; Michiel F Reneman Journal: J Occup Rehabil Date: 2019-03
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