A L Lee1, C J Hill2, N Cecins3, S Jenkins4, C F McDonald5, A T Burge6, L Rautela7, R G Stirling8, P J Thompson9, A E Holland10. 1. Alfred Health, Commercial Road, Melbourne 3004, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia; Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton 3010, Victoria, Australia. Electronic address: Annemarie.Lee@alfred.org.au. 2. Institute for Breathing and Sleep, Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia; Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia. Electronic address: Catherine.Hill@austin.org.au. 3. Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth 6009, Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Hospital Avenue, Nedlands, Perth 6009, Australia. Electronic address: Nola.Cecins@health.wa.gov.au. 4. Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth 6009, Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Hospital Avenue, Nedlands, Perth 6009, Australia; Curtin University, Kent Street, Bentley, Perth 6102, Australia. Electronic address: S.Jenkins@curtin.edu.au. 5. Institute for Breathing and Sleep, Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia; Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia. Electronic address: Christine.McDonald@austin.org.au. 6. Alfred Health, Commercial Road, Melbourne 3004, Victoria, Australia. Electronic address: A.Burge@alfred.org.au. 7. Institute for Breathing and Sleep, Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia; Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia. Electronic address: Linda.Rautela@austin.org.au. 8. Alfred Health, Commercial Road, Melbourne 3004, Victoria, Australia; Department of Medicine, Monash University, Melbourne 3800, Australia. Electronic address: R.Stirling@alfred.org.au. 9. Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth 6009, Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, Hospital Avenue, Nedlands, Perth 6009, Australia; Curtin University, Kent Street, Bentley, Perth 6102, Australia. Electronic address: P.Thompson@liwa.uwa.gov.au. 10. Alfred Health, Commercial Road, Melbourne 3004, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia; Physiotherapy, La Trobe University, 99 Commercial Road, Melbourne 3004, Victoria, Australia. Electronic address: A.Holland@alfred.org.au.
Abstract
BACKGROUND: The 6-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) are clinically meaningful measures of exercise capacity in people with non-cystic fibrosis (CF) bronchiectasis, but the change in walking distance which constitutes clinical benefit is undefined. This study aimed to determine the minimal important difference for the 6MWD and ISWD in non-CF bronchiectasis. METHODS: Thirty-seven participants with mean FEV1 70% predicted completed both field walking tests before and after an 8-week exercise program. The minimal important difference was calculated using a distribution-based and anchor-based method, with the global rating of change scale used. RESULTS: The mean change in 6MWD in participants who reported themselves to be unchanged was 10 m, compared to 36 m (small change) and 45 m (substantial change) (p = 0.01). For the ISWD, the mean change in participants who reported themselves to be unchanged was 33 m, compared to 54 m (small change) and 73 m (substantial change) (p = 0.04). The anchor-based method defined the minimal important difference for 6MWD as 24.5 m (AUC 0.76, 95% CI 0.61-0.91) and for ISWD as 35 m (AUC 0.88, 95% CI 0.73-0.99), based on participant's global rating of change. The distribution-based method indicated a value of 22.3 m for the 6MWD and 37 m for the ISWD. There was excellent agreement between the two methods for the 6MWD (kappa = 0.91) and the ISWD (kappa = 0.92). CONCLUSIONS: Small changes in 6MWD and ISWD may represent clinically important benefits in people with non-CF bronchiectasis. These data are likely to assist in the interpretation of change in exercise capacity following intervention.
BACKGROUND: The 6-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) are clinically meaningful measures of exercise capacity in people with non-cystic fibrosis (CF) bronchiectasis, but the change in walking distance which constitutes clinical benefit is undefined. This study aimed to determine the minimal important difference for the 6MWD and ISWD in non-CF bronchiectasis. METHODS: Thirty-seven participants with mean FEV1 70% predicted completed both field walking tests before and after an 8-week exercise program. The minimal important difference was calculated using a distribution-based and anchor-based method, with the global rating of change scale used. RESULTS: The mean change in 6MWD in participants who reported themselves to be unchanged was 10 m, compared to 36 m (small change) and 45 m (substantial change) (p = 0.01). For the ISWD, the mean change in participants who reported themselves to be unchanged was 33 m, compared to 54 m (small change) and 73 m (substantial change) (p = 0.04). The anchor-based method defined the minimal important difference for 6MWD as 24.5 m (AUC 0.76, 95% CI 0.61-0.91) and for ISWD as 35 m (AUC 0.88, 95% CI 0.73-0.99), based on participant's global rating of change. The distribution-based method indicated a value of 22.3 m for the 6MWD and 37 m for the ISWD. There was excellent agreement between the two methods for the 6MWD (kappa = 0.91) and the ISWD (kappa = 0.92). CONCLUSIONS: Small changes in 6MWD and ISWD may represent clinically important benefits in people with non-CF bronchiectasis. These data are likely to assist in the interpretation of change in exercise capacity following intervention.
Authors: Jessica A Walsh; Suhani Patel; Ruth E Barker; Sarah E Jones; Stephanie C Wynne; Samantha S C Kon; Julius Cairn; Michael R Loebinger; Robert Wilson; William D-C Man; Claire M Nolan Journal: Ann Am Thorac Soc Date: 2020-03
Authors: Anderson José; Anne E Holland; Jessyca P R Selman; Cristiane Oliveira de Camargo; Diogo Simões Fonseca; Rodrigo A Athanazio; Samia Z Rached; Alberto Cukier; Rafael Stelmach; Simone Dal Corso Journal: ERJ Open Res Date: 2021-05-31
Authors: Mônica Corso Pereira; Rodrigo Abensur Athanazio; Paulo de Tarso Roth Dalcin; Mara Rúbia Fernandes de Figueiredo; Mauro Gomes; Clarice Guimarães de Freitas; Fernando Ludgren; Ilma Aparecida Paschoal; Samia Zahi Rached; Rosemeri Maurici Journal: J Bras Pneumol Date: 2019-08-12 Impact factor: 2.624
Authors: Carlos H Martinez; Yuka Okajima; Andrew Yen; Diego J Maselli; Pietro Nardelli; Farbord Rahaghi; Kendra Young; Gregory Kinney; Charles Hatt; Craig Galban; George R Washko; MeiLan Han; Raúl San José Estépar; Alejandro A Diaz Journal: Acad Radiol Date: 2020-03-23 Impact factor: 3.173