Zatloukal Jakub, Houchen-Wolloff Linzy, Ward Sarah, Khan Fasihul, Singh Sally J
Pulmonary Rehabilitation Department, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
Centre for Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
ERJ Open Res. 2025 Apr 22;11(2). doi: 10.1183/23120541.00601-2024. eCollection 2025 Mar.
Pulmonary rehabilitation (PR) is recommended for patients with interstitial lung disease (ILD). The impact of PR on exercise capacity, symptom management and mortality risk in ILD is well established; however, there are limited studies reporting on the minimal important difference (MID) for shuttle walk tests (SWTs) in the ILD population. The aim of this study was to establish the MID for both the incremental and endurance shuttle walking tests (ISWT/ESWT) in the ILD population and to evaluate the association with survival.
The study includes 207 participants with ILD (mean±sd age 71.1±9.5 years, forced vital capacity 2.32±0.79 L) who completed PR.
The baseline ISWT was 251.4±153.3 m and ESWT was 217.7±136.3 s. There were significant improvements for both the ISWT and ESWT following the PR programme (44.5±77.0 m (p<0.001) and 312.3±338.6 s (p<0.001)). MID was calculated through a combination of distribution (0.5×sd) and anchor-based techniques (global rating of change (GROC) and receiver operating characteristic (ROC) analysis). The distribution-based technique yielded an MID of 38.5 m for ISWT and 169.3 s for ESWT. ROC analyses yielded an MID of 35 m for ISWT and 200 s for ESWT; and the GROC yielded an MID of 58.5 m for ISWT and 209.0 s for ESWT. Survival analysis showed that improvements in exercise tolerance are associated with improved survival.
Our data suggest an MID of 35.0-38.5 m for ISWT and 170-209 s for ESWT for patients with ILD. The size of improvements in SWT is associated with a survival advantage in ILD individuals who attend and complete PR.
对于间质性肺疾病（ILD）患者，推荐进行肺康复（PR）。PR对ILD患者运动能力、症状管理及死亡风险的影响已得到充分证实；然而，关于ILD人群往返步行试验（SWT）最小重要差异（MID）的研究报道有限。本研究的目的是确定ILD人群递增式和耐力往返步行试验（ISWT/ESWT）的MID，并评估其与生存的相关性。
本研究纳入了207例完成PR的ILD患者（平均年龄±标准差71.1±9.5岁，用力肺活量2.32±0.79L）。
基线ISWT为251.4±153.3m，ESWT为217.7±136.3s。PR方案实施后，ISWT和ESWT均有显著改善（分别为44.5±77.0m（p<0.001）和312.3±338.6s（p<0.001））。通过分布（0.5×标准差）和基于锚定的技术（整体变化评分（GROC）和受试者工作特征（ROC）分析）相结合来计算MID。基于分布的技术得出ISWT的MID为38.5m，ESWT的MID为169.3s。ROC分析得出ISWT的MID为35m，ESWT的MID为200s；GROC得出ISWT的MID为58.5m，ESWT的MID为209.0s。生存分析表明运动耐量的改善与生存改善相关。
我们的数据表明，ILD患者ISWT的MID为35.0 - 38.5m，ESWT的MID为170 - 209s。SWT改善的幅度与参加并完成PR的ILD个体的生存优势相关。
