The 1-minute sit-to-stand test to detect exercise-induced oxygen desaturation in patients with interstitial lung disease

Justine Briand, Hélène Behal, Cécile Chenivesse, Lidwine Wémeau-Stervinou, Benoit Wallaert, Justine Briand, Hélène Behal, Cécile Chenivesse, Lidwine Wémeau-Stervinou, Benoit Wallaert

Abstract

Background: Although the 6-min walk test (6MWT) is the gold standard for assessing exercise-induced impairment of gas exchange, it cannot easily be performed in a clinical office environment. The aim of this study was to compare the 1-min sit-to-stand test (1STST) with the 6MWT for the ability to assess exercise-induced oxygen desaturation in patients with interstitial lung diseases (ILDs).

Methods: A total of 107 patients were enrolled and classified into three groups: sarcoidosis, fibrotic idiopathic interstitial pneumonia (f-IIP), and other forms of ILD. The 6MWT and 1STST were performed on the same day, and pulmonary function tests, pulse oxygen saturation (SpO2), and dyspnea and fatigue (modified Borg scale) were assessed. SpO2 desaturation was evaluated by intraclass correlation coefficient (ICC), Bland-Altman analysis, and kappa (κ) coefficient in the whole population and the patient subgroups.

Results: The SpO2 nadir during the 1STST and 6MWT showed good consistency [mean ± standard deviation: 92.5% ± 5% and 90% ± 7%, respectively; ICC 0.77, 95% confidence interval (CI) 0.71-0.83] and correlated strongly ( r = 0.9, p < 0.0001). The frequency of patients with oxygen desaturation ⩾4% was also consistent for the two exercise tests ( κ = 0.68, 95% CI 0.54-0.82). The number of repetitions in the 1STST correlated with the 6MWT distance ( r = 0.5, p < 0.0001), but the dyspnea scores were higher during the 1STST than the 6MWT ( p < 0.0001). These findings did not differ for the three patient subgroups.

Conclusion: The 1STST can measure exercise-induced desaturation in ILD patients and could be used as an alternative test to the 6MWT in office practice.

Keywords: 1-min sit-to-stand test; 6-min walk test; exercise; functional tests; interstitial lung disease.

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Correlation between aspects of the 6MWT and 1STST. Left: SpO2 nadir values during the 6MWT and 1STST. Right: Distance walked in the 6MWT and number of repetitions in the 1STST. 1STST, 1-min sit-to-stand test; 6MWT, 6-min walk test; SpO2, oxygen saturation.
Figure 2.
Figure 2.
Bland–Altman plot of the difference in SpO2 nadir between the 6MWT and 1STST as a function of the mean SpO2 nadir in both tests. Solid black line represents the mean difference and the dotted lines define the limits of the 95% confidence interval. 1STST, 1-min sit-to-stand test; 6MWT, 6-min walk test; SpO2, oxygen saturation.

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