Impact of Chair Seat Height on the 1-Minute Sit to Stand Test Performance in Chronic Obstructive Pulmonary Disease

The Impact of Chair Seat Height on the 1-Minute Sit to Stand Test Performance in Chronic Obstructive Pulmonary Disease: a Randomized Cross-over Study

The 1-minute sit to stand (1-min STS) test is a standardized test which is used to examine exercise capacity in patients with chronic obstructive pulmonary disease (COPD). The chair seat height used is standardized to 46-48 cm. Using a standard seat height for all patients - irrespective of their body height - may lead to invalid estimates of functional exercise capacity. The objective of this study is to assess whether there is a difference in repetitions during the 1-min STS test if the seat height is adjusted to 90° knee joint angle or the standard height chair of 46 cm is used.

Study Overview

• Status: Completed
• Conditions: Chronic Obstructive Pulmonary Disease; COPD
• Intervention / Treatment: Other: 1-min STS test: adjusted; Other: 1-min STS test: standardized

Detailed Description

In a single-center, randomized crossover study, the investigators aim to elucidate whether there is a difference in repetitions during the 1-min STS test if the seat height is adjusted to 90° knee joint angle or the standard height chair of 46 cm is used.

Patients with COPD referred for pulmonary rehabilitation will be invited to perform one standardised- (chair seat height 46cm) and one individualized (chair seat height adapted to 90° knee flexion) 1-min STS test on two different days in random order.

The tests will be performed after patients are familiarised with the 1-min STS testing procedure and learning effects can be excluded.

• Study Type: Interventional
• Enrollment (Actual): 55
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Bern
    • Heiligenschwendi, Bern, Switzerland, 3625
      • Berner Reha Zentrum

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Patients with diagnosed COPD according to a forced expiratory volume in 1s (FEV1) / forced vital capacity (FVC) ratio below the lower limit of normal

Exclusion Criteria:

• Patients who are not able to bend their knees while sitting on a standard chair (i.e., knee flexion less than 90°)
• Patients who are not able to understand the instructions of the 1-min STS test, either of language or cognitive reasons
• Patients who are unable to perform the STS test due to functional disability (i.e., being not able to rise from a chair without hand support), previous surgery, or pain according to the judgement of the responsible physician.
• Patients who did not sign the informed consent form

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1-min STS test: chair seat height adjusted to 90° knee flexion; In this experimental condition, the patient performs the 1-minute sit to stand test on an individually adjusted seat height of 90° knee joint flexion.	Other: 1-min STS test: adjusted; Individually adjusted chair seat height of 90° knee joint flexion
Active Comparator: 1-min STS test: chair seat height standardized of 46cm; In this experimental condition, the patient performs the 1-minute sit to stand test on a standard height chair of 46cm.	Other: 1-min STS test: standardized; Standardized chair seat height of 46 cm

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of repetitions in the 1-min STS test	difference in the amount of sit to stand repetitions in the 1-min STS test from a standard chair (46cm) or an individualized seat height chair of 90° knee joint angle	During pulmonary rehabilitation, approximately 14 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sit to stand power index	The sit to stand power index is used to calculate the force-generating capacity (in watt) of the knee extensor muscles and is defined as: (leg length (in m) - seat height (in m)) x body mass x acceleration of gravity x sit to stand repetitions / time (sit-stand) (in sec.)	During pulmonary rehabilitation, approximately 14 days

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Oxygen saturation	Difference in oxygen saturation profiles between the two experimental conditions	During pulmonary rehabilitation, approximately 14 days
Heart rate	Difference in heart rate profiles between the two experimental conditions	During pulmonary rehabilitation, approximately 14 days
Ratings of perceived exertion	Difference in perceived exertion profiles between the two experimental conditions measured with the category ratio - 10 Borg scale (0-10)	During pulmonary rehabilitation, approximately 14 days
Ratings of perceived breathlessness	Difference in perceived breathlessness profiles between the two experimental conditions measured with the category ratio - 10 Borg scale (0-10)	During pulmonary rehabilitation, approximately 14 days
Incorrectly performed repetitions during the 1-min STS test	The number of incorrectly performed repetitions during th 1-min STS test	During pulmonary rehabilitation, approximately 14 days
Questionnaire about the patient's preferences during the 1-min sit to stand test	Multiple choice questions about patient reported perception concerning sitting position, chair height, perceived difficulties during the 1-min sit to stand test.	During pulmonary rehabilitation, approximately 14 days

Collaborators and Investigators

• Sponsor: Thomas Riegler
• Collaborators: University of Zurich
• Investigators: Principal Investigator: Thomas Riegler, MSc, Berner Reha Zentrum, Heiligenschwendi; Principal Investigator: Thomas Radtke, PD, Dr phil, University of Zurich

Publications and helpful links

General Publications

• Crook S, Busching G, Schultz K, Lehbert N, Jelusic D, Keusch S, Wittmann M, Schuler M, Radtke T, Frey M, Turk A, Puhan MA, Frei A. A multicentre validation of the 1-min sit-to-stand test in patients with COPD. Eur Respir J. 2017 Mar 2;49(3):1601871. doi: 10.1183/13993003.01871-2016. Print 2017 Mar.
• Yoshioka S, Nagano A, Hay DC, Fukashiro S. Peak hip and knee joint moments during a sit-to-stand movement are invariant to the change of seat height within the range of low to normal seat height. Biomed Eng Online. 2014 Mar 12;13(1):27. doi: 10.1186/1475-925X-13-27.
• Reychler G, Boucard E, Peran L, Pichon R, Le Ber-Moy C, Ouksel H, Liistro G, Chambellan A, Beaumont M. One minute sit-to-stand test is an alternative to 6MWT to measure functional exercise performance in COPD patients. Clin Respir J. 2018 Mar;12(3):1247-1256. doi: 10.1111/crj.12658. Epub 2017 Jun 15.
• Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, Enright PL, Hankinson JL, Ip MS, Zheng J, Stocks J; ERS Global Lung Function Initiative. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012 Dec;40(6):1324-43. doi: 10.1183/09031936.00080312. Epub 2012 Jun 27.
• Miller MR, Quanjer PH, Swanney MP, Ruppel G, Enright PL. Interpreting lung function data using 80% predicted and fixed thresholds misclassifies more than 20% of patients. Chest. 2011 Jan;139(1):52-9. doi: 10.1378/chest.10-0189. Epub 2010 Jun 3. Erratum In: Chest. 2011 Mar;139(3):733.

Study record dates

Study Major Dates

• Study Start (Actual): September 16, 2020
• Primary Completion (Actual): March 25, 2021
• Study Completion (Actual): March 30, 2021

Study Registration Dates

• First Submitted: October 1, 2020
• First Submitted That Met QC Criteria: October 1, 2020
• First Posted (Actual): October 8, 2020

Study Record Updates

• Last Update Posted (Actual): July 21, 2021
• Last Update Submitted That Met QC Criteria: July 20, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: 1-minute Sit to Stand Test; chair seat height
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
• Other Study ID Numbers: 2020-01677

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No