title: Incremental shuttle and six-minute walking tests in the assessment of functional capacity in chronic heart failure.
abstract: BACKGROUND
  The incremental shuttle test presents some theoretical advantages over the six-minute walk test in chronic heart failure (CHF), including better standardization and less dependency on collaboration.
  
  
  OBJECTIVE
  The present study evaluated test-retest repeatability, test accuracy in predicting a peak oxygen consumption (VO(2)) of 14 mL/kg/min or less, as well as the prognostic value of both walking tests in stable CHF patients.
  
  
  METHODS
  Sixty-three patients (44 men; New York Heart Association functional class II to IV) underwent an incremental treadmill exercise test and, on another day, the walk test in duplicate.
  
  
  RESULTS
  Patients showed well-preserved functional capacity according to the distance walked in both tests (six-minute walk test 491+/-94 m versus incremental shuttle walk test 422+/-119 m; P<0.001). Interestingly, the six-minute and incremental shuttle walk test differences in distance walked were higher in more disabled patients. The mean bias +/-95% CI of the within-test differences were similar (7+/-40 m and 8+/-45 m, respectively). Peak VO(2), but not distance walked in either test, was associated with survival (P<0.05).
  
  
  CONCLUSIONS
  The incremental shuttle walk test showed similar repeatability and accuracy in estimating peak VO(2) compared with the six-minute walk test in CHF patients. Direct measurement of peak VO(2), however, remains superior to either walking test in predicting survival--at least in patients with well-preserved functional capacity.
authors.affiliation: Department of Medicine, Federal University of São Paulo, São Paulo, Brazil. cris1801@yahoo.com
authors.forename: Cristiane
authors.initials: C
authors.lastname: Pulz
authors.forename: Rosiane V
authors.initials: RV
authors.lastname: Diniz
authors.forename: Alexandre N F
authors.initials: AN
authors.lastname: Alves
authors.forename: Antônio S
authors.initials: AS
authors.lastname: Tebexreni
authors.forename: Antônio C
authors.initials: AC
authors.lastname: Carvalho
authors.forename: Angelo A V
authors.initials: AA
authors.lastname: de Paola
authors.forename: Dirceu R
authors.initials: DR
authors.lastname: Almeida
mesh_terms: D002908:Chronic Disease; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016138:Walking