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Original Research: Pulmonary Physiology |

Measurement Properties of the Incremental Shuttle Walk TestProperties of the Incremental Shuttle Walk Test: A Systematic Review

Verônica F. Parreira, PhD; Tania Janaudis-Ferreira, PhD; Rachel A. Evans, PhD; Sunita Mathur, PhD; Roger S. Goldstein, PhD, FCCP; Dina Brooks, PhD
Author and Funding Information

From the Department of Physical Therapy (Dr Parreira), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; CAPES Brazil (Dr Parreira), West Park Healthcare Centre (Respiratory Medicine), and Department of Physical Therapy (Dr Parreira), University of Toronto, Toronto, ON, Canada; Department of Respiratory Medicine (Drs Parreira, Janaudis-Ferreira, Mathur, Goldstein, and Brooks), West Park Healthcare Centre, Toronto, ON, Canada; Sunnybrook Health Sciences Centre (Dr Janaudis-Ferreira), St. John’s Rehabilitation Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Physical Therapy (Drs Janaudis-Ferreira, Mathur, Goldstein, and Brooks), University of Toronto, Toronto, ON, Canada; Department of Infection, Immunity and Inflammation (Dr Evans), School of Medicine, University of Leicester, Leicester, England; and Department of Medicine (Dr Goldstein), University of Toronto, Toronto, ON, Canada.

Correspondence to: Dina Brooks, PhD, Department of Physical Therapy, University of Toronto, 160-500 University Ave, Toronto, ON, M5G 1V7, Canada; e-mail: dina.brooks@utoronto.ca


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(6):1357-1369. doi:10.1378/chest.13-2071
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Background:  The incremental shuttle walk test (ISWT) was developed > 20 years ago and has been used to assess peak exercise capacity in a variety of chronic diseases. The aim of this systematic review is to describe the measurement properties of the ISWT in a clinical population.

Methods:  Of 800 articles identified by electronic and hand searches, 35 were included. Twenty-one articles included data on the validity of the ISWT, 18 on the reliability, four on the responsiveness, and four on the interpretability.

Results:  Most of the studies were conducted in patients with COPD (n = 13) or cardiac disease (n = 8). For criterion validity, comparisons between distance covered during the ISWT and peak oxygen consumption reported correlations ranging from 0.67 to 0.95 (P < .01). Intraclass correlation coefficients for test-retest reliability ranged from 0.76 to 0.99. The ISWT was shown to be responsive to pulmonary rehabilitation and bronchodilator administration. The minimal clinically important difference (MCID) in patients with COPD was 48 m. Predictive equations for the distance in the ISWT are available for healthy individuals.

Conclusions:  The ISWT can be considered a valid and reliable test to assess maximal exercise capacity in individuals with chronic respiratory diseases. The ISWT has been shown to be responsive to pulmonary rehabilitation and bronchodilator use in individuals with COPD, cystic fibrosis, and asthma. Further studies examining responsiveness and the MCID of the ISWT in patients with conditions other than lung diseases are required for the interpretation of interventions in other populations.

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