Introduction Several baseline factors influence the response to Pulmonary Rehabilitation (PR). The Incremental and Endurance shuttle walk test is used to prescribe an exercise walking speed for patients with a chronic respiratory disease as part of a PR programme. We wished to explore the speed and duration of baseline endurance performance and observe how this impacted upon changes post rehabilitation particularly around the higher speeds of the endurance shuttle walk test (ESWT).
Methods Patients completed a 7 week outpatient PR programme comprising of both endurance and strength training. The endurance training is based on the ESWT speed which is 85% of the individual maximal capacity derived from the incremental shuttle walk test (ISWT). The ISWT and subsequent ESWT were performed at baseline and discharge. Patients were categorised into low (<3.6 km/hr) or high (>3.6 km/hr) speed walkers based on their baseline ESWT performance.
Results 990 patients completed the SWT: 567 low speed walkers (mean age 70.9 ± 9.7 years; FEV1 1.5 L ± 4.9; BMI 27.6 ± 9.0 kg/m2; MRC 4 (IQR 3–4); ISWT pre 128.4 ± 61.6 m; ESWT pre 166.3 ± 161.5 secs) and 423 high speed walkers (mean age 67.8 ± 9.2 years; FEV1 1.62 L ± 3.8; BMI 27.1 ± 14.0 kg/m2; MRC 3(IQR 2–3); ISWT pre 373.4 ± 103.3 m; ESWT pre 262.4 ± 147.6 secs). Those walking at a higher speed had a significantly higher pre ESWT (p ≤ 0.001). A statistically significant improvement was observed in the ESWT within each group (low: mean change 344.2 ± 401.5 p ≤ 0.001; high: mean change 369.3 secs p ≤ 0.001). However the change in ESWT was not significantly different between the groups (p = 0.3).
Conclusion Interestingly, those patients who walk at a faster speed have a greater baseline ESWT performance compared to those patients who walk at a slower endurance speed. However both groups made comparable changes in the ESWT following PR.
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