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Minimum important difference of the incremental shuttle walk test distance in patients with COPD
  1. Rachael A Evans1,2,3,
  2. Sally J Singh1,2,4
  1. 1 Respiratory Sciences, University of Leicester, Leicester, UK
  2. 2 NIHR Leicester Biomedical Research Centre–Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
  3. 3 Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, UK
  4. 4 Cardiac/Pulmonary Rehabilitation, University Hospitals of Leicester NHS Trust, Leicester, UK
  1. Correspondence to Dr Rachael A Evans, Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK; re66{at}


We aimed to describe the minimum important difference (MID) of the incremental shuttle walk test (ISWT) in patients with COPD using both distribution and anchor-based methods. Two cohorts were used (n=613) with eligibility criteria of a clinical diagnosis of COPD, an FEV1/FVC <70% and an ISWT (after familiarisation) before and after a 7-week course of pulmonary rehabilitation (PR). The MID of the ISWT using the distribution method was 36.1 m. The area under the curve to discriminate between perceived ‘improvement’ and ‘no improvement’ after PR for a change in ISWT of 35 m was 0.66 (0.58–0.73). The MID of the ISWT is therefore between 35.0 and 36.1 m.

  • pulmonary rehabilitation
  • exercise
  • COPD ÀÜ mechanisms

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  • Contributors RAE and SJS conceived the idea. RAE performed the data analysis. RAE and SJS were involved in data interpretation. RAE drafted the manuscript and both authors approved the final manuscript.

  • Funding RAE is funded by a National Institute for Health Research (NIHR) Clinician Scientist Fellowship (CS-2016-16-020). This research was supported by the NIHR Leicester Biomedical Research Centre - Respiratory Theme.

  • Disclaimer The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Local ethical committee (Leicestershire REC) approval was granted to collect the additional data at the time of the follow-up assessment.

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

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