Article Text

Download PDFPDF
Validity, responsiveness and minimum clinically important difference of the incremental shuttle walk in idiopathic pulmonary fibrosis: a prospective study
  1. Claire M Nolan1,2,
  2. Veronica Delogu1,
  3. Matthew Maddocks3,
  4. Suhani Patel1,
  5. Ruth E Barker1,
  6. Sarah E Jones1,
  7. Samantha S C Kon1,4,
  8. Toby M Maher2,5,
  9. Paul Cullinan2,
  10. William D-C Man1,2
  1. 1 Harefield Pulmonary Rehabilitation and Muscle Research Laboratory, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
  2. 2 National Heart and Lung Institute, Imperial College, London, UK
  3. 3 Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
  4. 4 Department of Respiratory Medicine, The Hillingdon Hospitals NHS Foundation Trust, London, UK
  5. 5 Department of Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
  1. Correspondence to Claire M Nolan, Pulmonary Rehabilitation, Department of Respiratory Medicine, Harefield Hospital, Harefield, Middlesex UB9 6JH, UK; c.nolan{at}


The incremental shuttle walk (ISW) is well validated in COPD but limited psychometric data restrict its use in idiopathic pulmonary fibrosis (IPF). Study 1: 50 patients performed the ISW and 6 min walk test (6MWT). Study 2: 72 patients completed the ISW before and after pulmonary rehabilitation (PR). The ISW correlated strongly with 6MWT distance (r=0.81,p<0.0001). Mean (95% confidence interval) improvement in ISW with PR was 54 (38 to 70) m with an effect size of 0.29. Distribution-based and anchor-based minimum clinically important difference (MCID) estimates ranged from 31 to 46 m. The ISW is valid and responsive in IPF, with an anchor-based MCID estimate similar to that observed in chronic obstructive pulmonary disease.

Trial registration number Pre-results; NCT02530736, NCT02436278.

  • incremental shuttle walk test
  • IPF
View Full Text

Statistics from


  • Contributors CMN and VD contributed equally to this study. CMN and WDCM substantially contributed to the conception and design of the study, prepared the first draft of the manuscript and agreed to be accountable for all aspects of the work. CMN, VD, SP, REB and SEJ contributed equally to the acquisition of data. CMN, VD and WDCM were responsible for the analysis and interpretation of the data. All authors equally contributed to the revision of the manuscript critically for important intellectual content and approval of the final manuscript.

  • Funding This work was supported by a National Institute for Health Research Doctoral Research Fellowship (DRF-2017-07-089) awarded to CMN.

  • Competing interests VD, SP and REB are funded by the NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College. VD is funded by NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London. MM is supported by Cicely Saunders International and CLAHRC for South London. SSCK is funded by The Hillingdon Hospital and The Royal Brompton and Harefield NHS Foundation Trust. TMM is supported by an NIHR Clinician Scientist Fellowship (NIHR Ref: CS-2013-13-017). WDCM is partly funded by the NIHR CLAHRC for NW London. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. All other author have no competing interest to declare.

  • Patient consent Obtained.

  • Ethics approval London Riverside Research Ethics Committee: 14/LO/2247, 15/LO/0015.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.