Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, São Paulo, Brazil.
Pediatric Department of Federal University of São Paulo-UNIFESP, São Paulo, São Paulo, Brazil.
Pediatr Pulmonol. 2022 Jan;57(1):75-80. doi: 10.1002/ppul.25706. Epub 2021 Oct 12.
Whether the modified shuttle test (MST) achieves maximal effort in children and adolescents with asthma is unclear. The aim was to compare the physiological responses of MST to the cardiopulmonary exercise test (CPET) in pediatric patients with asthma, to observe its convergent validity.
A cross-sectional study with volunteers with asthma (6-17 years of age) under regular treatment. The MST is an external-paced test, and the participants were allowed to walk/run. CPET was performed on a cycle ergometer to compare with MST. Gas exchange (VO , VCO , and VE) and heart rate (HR) were the outcomes and were continuously assessed in both tests.
Forty-seven volunteers were included, normal lung function expiratory forced volume at 1st second/forced vital capacity (FEV /FVC) 88.6 (7.7). VO was higher at MST (2.0 ± 0.6 L/min) compared to CPET (1.6 ± 0.5 L/min), p < 0.001. Similar results was observed to VE at MST (50 ± 16 L/min) versus VE at CPET (40 ± 13 L/min), and to VCO at MST (2.1 ± 0.8 L/min) versus VCO at CPET (1.7 ± 0.6 L/min), p < 0.001. HR was also higher at MST (94 ± 6%pred) versus CPET (87 ± 8%pred), p = 0.002. VO in MST correlated to the CPET (r = 0.78, p < 0.001). The ICC of VO between tests was 0.73 (0.06-0.89), p < 0.001, and VO Bland-Altman analysis showed a bias of 0.46 L/min.
The MST showed a maximal physiologic response in children and adolescents with asthma. It is a valid test and can be used as an alternative to evaluating exercise capacity.
改良 shuttle 测试（MST）是否能让哮喘患儿达到最大运动强度尚不清楚。本研究旨在比较哮喘患儿 MST 和心肺运动测试（CPET）的生理反应，观察其收敛效度。
这是一项纳入经规律治疗的哮喘患儿志愿者的横断面研究。MST 为外部节拍测试，允许参与者步行/跑步。CPET 在功率自行车上进行，以与 MST 进行比较。比较两种测试的气体交换（VO 、VCO 和 VE）和心率（HR）。
共纳入 47 名志愿者，正常肺功能第一秒呼气量/用力肺活量（FEV/FVC）88.6（7.7）。MST 的 VO （2.0±0.6 L/min）高于 CPET（1.6±0.5 L/min），p<0.001。MST 的 VE（50±16 L/min）和 VCO（2.1±0.8 L/min）也高于 CPET（40±13 L/min）和 VCO（1.7±0.6 L/min），p<0.001。MST 的 HR（94±6%pred）也高于 CPET（87±8%pred），p=0.002。MST 的 VO 与 CPET 相关（r=0.78，p<0.001）。两种测试间 VO 的 ICC 为 0.73（0.06-0.89），p<0.001，VO 的 Bland-Altman 分析显示偏倚为 0.46 L/min。
MST 可使哮喘患儿达到最大生理反应，是一种有效的测试方法，可用于评估运动能力。
