Yann Combret1,2,3, Fairuz Boujibar4, Charlotte Gennari5, Clément Medrinal3,6,7, Sophie Sicinski8, Tristan Bonnevie9,10, Francis-Edouard Gravier9,10, Muriel Laurans5, Christophe Marguet8,11, Pascal Le Roux1, Bouchra Lamia3,10,12, Guillaume Prieur2,3,10, Grégory Reychler2,13. 1. Pediatric Department, Le Havre Hospital, Le Havre, Normandie, France. 2. Research and Clinical Experimentation Institute (IREC), Pulmonology, ORL and Dermatology, Louvain Catholic University, Brussels, Brussels Capital Region, Belgium. 3. Pulmonology Department, Le Havre Hospital, Le Havre, Normandie, France. 4. INSERM U1096, UNIROUEN, Normandie Univ, Rouen University Hospital, Rouen, Normandie, France. 5. Cystic Fibrosis Department, Pediatric Section, Caen University Hospital, Caen, Normandie, France. 6. Erphan Department, UVSQ, Paris-Saclay University, Versailles, Île-de-France, France. 7. Saint Michel School of Physiotherapy, Paris-Saclay University, Paris, Île-de-France, France. 8. Pediatric Cystic Fibrosis Department, Pediatric Section, Rouen University Hospital, Rouen, Normandie, France. 9. ADIR Association, Rouen University Hospital, Rouen, Normandie, France. 10. UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Rouen University Hospital, Rouen, Normandie, France. 11. Pediatric Respiratory Disease and Allergy Unit, UNIROUEN, Inserm EA 2656, Rouen University Hospital, Rouen, Normandie, France. 12. Intensive Care Unit, Respiratory Section, Rouen University Hospital, Rouen, Normandie, France. 13. Department of Physical Medicine and Rehabilitation, Saint-Luc University Clinics, Brussels, Brussels Capital Region, Belgium.
Abstract
BACKGROUND:Functional exercise capacity assessment is recommended in children with cystic fibrosis (CF). The six-minute walk test (6MWT) is a valid evaluation of exercise capacity but can be technically complex. Inversely, the sit-to-stand test (STST) is a simple method to evaluate exercise capacity, and is validated in healthy children and adults with CF. This study aimed to evaluate STST measurement properties in children and adolescents with CF. METHODS: In this multicenter study, children with CF (6 to 18 years) performed two iterations of both the STST and the 6MWT in a randomized order. Criterion validity was determined by assessing correlations between STST repetitions and 6MWT distance (6MWD). Intra-rater reliability, test-retest repeatability, mean bias and limits of agreement were also assessed. Relationships with other outcomes (i.e. respiratory and quadriceps muscle strength) and cardio-respiratory responses were analysed for both tests. RESULTS:Thirty-six children with CF were included (mean age 12.0 ±3.5 years and FEV1 95.8 ±25.0%). On average, 39.6 ±10.5 repetitions were performed during the STST and mean 6MWD was 596.0 ±102.6 meters. STST number of repetitions was significantly correlated with 6MWD (r = 0.48; p<0.01). Both tests had very good intra-rater reliability (ICCSTST = 0.91 (95%CI 0.76-0.96) and ICC6MWT = 0.94 (95%CI 0.85-0.97)), and a significant test-retest learning effect. The number of STST repetitions was not correlated with quadriceps or respiratory muscle strength test, and the STST induced fewer cardio-respiratory responses than the 6MWT. CONCLUSIONS: The STST is an easy-to-use functional test with moderate criterion validity when compared to the 6MWT in children with CF, probably because both tests measure different components of functional exercise capacity. The STST is useful when the 6MWT is unfeasible, however further investigations are required to explore the clinical implications of STST results in children with CF. CLINICAL TRIAL REGISTRATION: NCT03069625.
RCT Entities:
BACKGROUND: Functional exercise capacity assessment is recommended in children with cystic fibrosis (CF). The six-minute walk test (6MWT) is a valid evaluation of exercise capacity but can be technically complex. Inversely, the sit-to-stand test (STST) is a simple method to evaluate exercise capacity, and is validated in healthy children and adults with CF. This study aimed to evaluate STST measurement properties in children and adolescents with CF. METHODS: In this multicenter study, children with CF (6 to 18 years) performed two iterations of both the STST and the 6MWT in a randomized order. Criterion validity was determined by assessing correlations between STST repetitions and 6MWT distance (6MWD). Intra-rater reliability, test-retest repeatability, mean bias and limits of agreement were also assessed. Relationships with other outcomes (i.e. respiratory and quadriceps muscle strength) and cardio-respiratory responses were analysed for both tests. RESULTS: Thirty-six children with CF were included (mean age 12.0 ±3.5 years and FEV1 95.8 ±25.0%). On average, 39.6 ±10.5 repetitions were performed during the STST and mean 6MWD was 596.0 ±102.6 meters. STST number of repetitions was significantly correlated with 6MWD (r = 0.48; p<0.01). Both tests had very good intra-rater reliability (ICCSTST = 0.91 (95%CI 0.76-0.96) and ICC6MWT = 0.94 (95%CI 0.85-0.97)), and a significant test-retest learning effect. The number of STST repetitions was not correlated with quadriceps or respiratory muscle strength test, and the STST induced fewer cardio-respiratory responses than the 6MWT. CONCLUSIONS: The STST is an easy-to-use functional test with moderate criterion validity when compared to the 6MWT in children with CF, probably because both tests measure different components of functional exercise capacity. The STST is useful when the 6MWT is unfeasible, however further investigations are required to explore the clinical implications of STST results in children with CF. CLINICAL TRIAL REGISTRATION: NCT03069625.
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