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Clinical Investigations: CYSTIC FIBROSIS |

Reliability, Repeatability, and Sensitivity of the Modified Shuttle Test in Adult Cystic Fibrosis*

Judy Bradley, DPhil; Jennifer Howard, BSc; Eric Wallace, DPhil; Stuart Elborn, MD
Author and Funding Information

*From the Adult Cystic Fibrosis Unit (Drs. Bradley and Elborn and Ms. Howard), Belfast City Hospital, Belfast; University of Ulster (Dr. Bradley and Mr. Wallace), Ulster, Northern Ireland.

Correspondence to: Stuart Elborn, MD, Adult Cystic Fibrosis Unit, Belfast City Hospital, Lisburn Rd, County Antrim, Northern Ireland, BT9 7AB; e-mail: stuart.elborn@bch.n-i.nhs.uk



Chest. 2000;117(6):1666-1671. doi:10.1378/chest.117.6.1666
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Study objectives: The purpose of this study was to investigate the test-retest reliability, repeatability, and sensitivity of the modified shuttle test (MST) in adult patients with cystic fibrosis (CF).

Design: Prospective study.

Setting: Adult CF Unit, Belfast City Hospital.

Patients: Adult patients with CF.

Interventions: Test-retest reliability—none; sensitivity—inpatient IV antibiotic therapy for an acute exacerbation of respiratory disease.

Measurements: The test-retest reliability and repeatability of the MST was assessed by comparing performance on two consecutive MSTs performed in 12 patients with CF and stable disease. The sensitivity of the MST was assessed by measuring the change in MST performance after 2 weeks of IV antibiotic therapy in 24 patients admitted to hospital with acute exacerbations of their respiratory disease.

Results: In the assessment of test-retest reliability and repeatability (n = 12), there was a significant and strong correlation between trials for distance completed (Pearson’s r = 0.99; p < 0.01), peak heart rate (Pearson’s r = 0.99; p < 0.01), peak arterial oxygen saturation (Sao2; Pearson’s r = 0.99; p < 0.01), and peak Borg rating of perceived breathlessness (Pearson’s r = 0.99; p < 0.01). The coefficients of repeatability for these variables were small (coefficient of repeatability: distance completed, 4 shuttles; peak heart rate, 6 beats/min; peak Sao2, 4%; and peak Borg rating of perceived breathlessness, 0.9). In the assessment of sensitivity (n = 24), the standardized response mean (SRM) for distance completed on MST (SRM = 1.18) was the SRMs for spirometric measures of lung function (FEV1, SRM = 0.96; FEV1 percent predicted, SRM = 0.88).

Conclusions: This study demonstrates that the MST is a reliable, repeatable, and sensitive measure of exercise capacity in adult CF. The MST may be of value in determining prognosis, evaluation for lung transplantation, exercise prescription, and establishing the impact of new treatments on the disability associated with CF.

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