Johnston Kylie N, Potter Adrian J, Phillips Anna
School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
Sansom Institute for Health Research, Division of Health Sciences, University of South Australia.
Phys Ther. 2017 Sep 1;97(9):926-943. doi: 10.1093/ptj/pzx063.
An increasing variety of short functional exercise tests are reported in people with chronic obstructive pulmonary disease (COPD). Systematic review of the psychometric properties of these exercise tests is indicated.
The aim of this study was to determine the reliability, validity, and responsiveness of short (duration < 6 min) lower extremity functional exercise tests in people with COPD.
Five databases were searched: MEDLINE, Embase, Scopus, AMED, and CINAHL.
Studies reporting psychometric properties of short functional exercise tests in people with COPD were included.
Two reviewers independently extracted data and rated the quality of each measurement property using the COnsensus-based Standards for the Selection of Health Measurement INstrument (COSMIN).
Twenty-nine studies were identified reporting properties of 11 different tests. Four-meter gait speed [4MGS] and 5 repetition sit-to-stand [5STS] demonstrated high reliability (ICC = .95-.99; .97) with no learning effect (COSMIN study ratings = good--excellent). Their validity for use as a stratification tool anchored against an established prognostic indicator (area under receiver operator characteristics curve [AUC] = 0.72-0.87; 0.82) and responsiveness to change after pulmonary rehabilitation was greatest in more frail people with COPD. Studies of the Timed "Up and Go" [TUG] test support use of a practice test and show discriminative ability to detect falls history and low six-minute walk distance (AUC = 0.77; 0.82, COSMIN ratings = fair-excellent).
Earlier studies were limited by small sample size. Limited data of lower study quality was identified for step tests and the Two-Minute Walk Test.
Selected short functional exercise tests can complement established exercise capacity measures, in stratification and measuring responsiveness to change especially in people with COPD and lower functional ability.
慢性阻塞性肺疾病（COPD）患者中报道的短功能运动测试种类日益增多。有必要对这些运动测试的心理测量特性进行系统评价。
本研究旨在确定COPD患者短（持续时间<6分钟）下肢功能运动测试的可靠性、有效性和反应性。
检索了五个数据库：MEDLINE、Embase、Scopus、AMED和CINAHL。
纳入报告COPD患者短功能运动测试心理测量特性的研究。
两名研究者独立提取数据，并使用基于共识的健康测量工具选择标准（COSMIN）对每个测量特性的质量进行评分。
确定了29项报告11种不同测试特性的研究。四米步速[4MGS]和五次坐立试验[5STS]显示出高可靠性（组内相关系数ICC = 0.95 - 0.99；0.97）且无学习效应（COSMIN研究评分 = 良好 - 优秀）。它们作为分层工具的有效性以既定的预后指标为锚定（受试者操作特征曲线下面积[AUC] = 0.72 - 0.87；0.82），并且在功能更差的COPD患者中，对肺康复后变化的反应性最大。定时起立行走试验[TUG]的研究支持使用预测试验，并显示出检测跌倒史和低六分钟步行距离的判别能力（AUC = 0.77；0.82，COSMIN评分 = 中等 - 优秀）。
早期研究受样本量小的限制。针对台阶试验和两分钟步行试验，识别出的低质量研究数据有限。
选定的短功能运动测试可以补充既定的运动能力测量方法，用于分层以及测量对变化的反应性，特别是在COPD患者和功能能力较低的人群中。
