Is the 1-minute sit-to-stand test a good tool for the evaluation of the impact of pulmonary rehabilitation? Determination of the minimal important difference in COPD

Trija Vaidya, Claire de Bisschop, Marc Beaumont, Hakima Ouksel, Véronique Jean, François Dessables, Arnaud Chambellan, Trija Vaidya, Claire de Bisschop, Marc Beaumont, Hakima Ouksel, Véronique Jean, François Dessables, Arnaud Chambellan

Abstract

Background: The 1-minute sit-to-stand (STS) test could be valuable to assess the level of exercise tolerance in chronic obstructive pulmonary disease (COPD). There is a need to provide the minimal important difference (MID) of this test in pulmonary rehabilitation (PR).

Methods: COPD patients undergoing the 1-minute STS test before PR were included. The test was performed at baseline and the end of PR, as well as the 6-minute walk test, and the quadriceps maximum voluntary contraction (QMVC). Home and community-based programs were conducted as recommended. Responsiveness to PR was determined by the difference in the 1-minute STS test between baseline and the end of PR. The MID was evaluated using distribution and anchor-based methods.

Results: Forty-eight COPD patients were included. At baseline, the significant predictors of the number of 1-minute STS repetitions were the 6-minute walk distance (6MWD) (r=0.574; P<10-3), age (r=-0.453; P=0.001), being on long-term oxygen treatment (r=-0.454; P=0.017), and the QMVC (r=0.424; P=0.031). The multivariate analysis explained 75.8% of the variance of 1-minute STS repetitions. The improvement of the 1-minute STS repetitions at the end of PR was 3.8±4.2 (P<10-3). It was mainly correlated with the change in QMVC (r=0.572; P=0.004) and 6MWD (r=0.428; P=0.006). Using the distribution-based analysis, an MID of 1.9 (standard error of measurement method) or 3.1 (standard deviation method) was found. With the 6MWD as anchor, the receiver operating characteristic curve identified the MID for the change in 1-minute STS repetitions at 2.5 (sensibility: 80%, specificity: 60%) with area under curve of 0.716.

Conclusion: The 1-minute STS test is simple and sensitive to measure the efficiency of PR. An improvement of at least three repetitions is consistent with physical benefits after PR.

Keywords: 6-minute walk test; COPD; exercise tolerance; pulmonary rehabilitation; sit-to-stand test.

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Association between change in 1-minute STS test and change in (A) 6-minute walk distance (6MWD) and (B) quadriceps maximal voluntary contraction (QMVC) with pulmonary rehabilitation. Note: (A and B) The black dotted line is the linear regression of the relation between the two variables. Abbreviations: 6MWD, 6-minute walk distance; QMVC, quadriceps maximal voluntary contraction; STS, sit-to-stand.
Figure 2
Figure 2
Receiver operating characteristic curve for the identification of the minimal important difference of the 1-minute STS test using a 30 m improvement in 6-minute walk test as anchor. Abbreviations: STS, sit-to-stand; AUC, area under curve.

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Source: PubMed

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