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Original Research: Sleep Disorders |

Do Field Walking Tests Produce Similar Cardiopulmonary Demands to an Incremental Treadmill Test in Obese Individuals With Treated OSA?Walking Test Demands in Obese Individuals With OSA

Rachael A. Evans, PhD; Thomas E. Dolmage, MSc; Priscila G. Robles, MSc; Roger S. Goldstein, MD, FCCP; Dina Brooks, PhD
Author and Funding Information

From the Department of Respiratory Medicine (Drs Evansand Goldstein, Mr Dolmage, Ms Robles, and Prof Brooks) and Department of Respiratory Diagnostic & Evaluation Services (Mr Dolmage and Dr Goldstein), West Park Healthcare Centre, Toronto, ON, Canada; Department of Infection, Immunity and Inflammation (Dr Evans), University of Leicester, Leicester, England; and Department of Medicine (Drs Evans and Goldstein) and Department of Physical Therapy (Ms Robles, Dr Goldstein, and Prof Brooks), University of Toronto,Toronto, ON, Canada.

CORRESPONDENCE TO: Rachael A. Evans, PhD, Department of Respiratory Medicine, Glenfield Hospital, Groby Rd, Leicester, LE3 9QP, England; e-mail: rachael.evans@uhl-tr.nhs.uk


FUNDING/SUPPORT: Dr Evans was supported by a postdoctoral fellowship for exercise rehabilitation supported by West Park Foundation and a National Institute for Health Research Clinical Lectureship in Respiratory Medicine (UK). Dr Goldstein is supported by the University of Toronto National Sanatorium Association Chair for Respiratory Rehabilitation Research, and Prof Brooks holds a Canada Research Chair for Pulmonary Rehabilitation.

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


Chest. 2014;146(1):81-87. doi:10.1378/chest.13-2060
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BACKGROUND:  Cardiorespiratory fitness, assessed during cardiopulmonary exercise tests by peak oxygen uptake (V˙ o2pk), is an independent predictor of mortality in obesity. We investigated whether V˙ o2pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test (ITMT) in obese individuals with treated OSA.

METHODS:  Individuals with treated OSA and a BMI > 30 kg/m2 were recruited. Participants completed an ITMT, two 6-min walk tests (6MWTs), and two incremental shuttle walk tests (ISWTs) on three separate days in a randomized order. Expired gas analysis was performed during all tests.

RESULTS:  The study was completed by 16 patients (nine men) (mean [SD] age, 58 [12] y; BMI, 36.1 [7.6] kg/m2). There was no difference (P = .27) in V˙ o2pk assessed by the ITMT and the ISWT (2,266 [478] and 2,017 [561] mL/min, respectively). The V˙ o2pk measured by the 6MWT (1,778 [360] mL/min) was lower than that measured by the ITMT (P < .01). The limits of agreement for V˙ o2pk between the ISWT and the ITM were ± 730 mL/min. Cardiorespiratory responses during the ISWT and the ITMT reflected a graded response to a peak, whereas the 6MWT demonstrated a rapid rise to a plateau.

CONCLUSIONS:  The ISWT can be used instead of an ITMT and in preference to the 6MWT to assess cardiorespiratory fitness for a cohort of obese people with treated OSA. However, the imprecision of the agreement in V˙ o2pk between the ITMT and ISWT means they cannot be used interchangeably in an individual.

TRIAL REGISTRY:  ClinicalTrials.gov; No.: NCT01930513; www.clinicaltrials.gov

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