title: Speed of ascent during stair climbing identifies operable lung resection candidates.
abstract: BACKGROUND
  Preoperative evaluation of lung resection candidates with impaired pulmonary reserves includes measurement of aerobic capacity. Stair climbing is an attractive low-cost alternative to treadmill exercise testing but it lacks standardisation.
  
  
  OBJECTIVE
  To directly compare stair climbing and treadmill exercise testing with respect to an established cut-off value for lung resection.
  
  
  METHODS
  We subjected 56 lung resection candidates to both symptom-limited treadmill exercise testing and stair climbing to a maximum of 20 m. Both exercise tests were monitored with the same portable spiroergometer. Subjects were on average 46.6 years old, 61% were male and 54% had FEV(1)/FVC < 70%. Mean FEV(1) and DLCO(c) were 51.6 and 57.1%, respectively.
  
  
  RESULTS
  Mean altitude reached, exercise time, speed of ascent and peak VO(2) were 16.9 m, 74 s, 14.7 m/min and 22.4 ml/min/kg, respectively, in 54 subjects completing stair climbing. Thirty-one subjects (58%) reached 20 m without stopping. Treadmill tests were completed by 51 subjects and lasted longer (432 s; p < 0.001), but VO(2max) was not different compared to stair climbing (22.7 ml/min/kg; p = 0.673). Speed of ascent was significantly correlated to both stair climbing peak VO(2) (r = 0.63) and treadmill VO(2max) (r = 0.67). All 19 subjects (34%) who reached 20 m in 80 s or less (≥15 m/min) had a VO(2max) of ≥20 ml/min/kg.
  
  
  CONCLUSIONS
  We found a clinically useful correlation between speed of ascent during stair climbing and VO(2max) during treadmill exercise testing. Climbing to 20 m with an average speed of ascent of ≥15 m/min accurately identified subjects qualifying for pneumonectomy according to established criteria.
authors.affiliation: Division of Pulmonology, Department of Medicine, Tygerberg Academic Hospital, Stellenbosch University, Cape Town, South Africa. mauribernasconi@gmail.com
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bernasconi
authors.forename: Coenraad F N
authors.initials: CF
authors.lastname: Koegelenberg
authors.forename: Florian
authors.initials: F
authors.lastname: von Groote-Bidlingmaier
authors.forename: David
authors.initials: D
authors.lastname: Maree
authors.forename: Barend J
authors.initials: BJ
authors.lastname: Barnard
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Diacon
authors.forename: Chris T
authors.initials: CT
authors.lastname: Bolliger
mesh_terms: D057186:Comparative Effectiveness Research; D005080:Exercise Test / Q000379:methods / Q000592:standards; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D018579:Patient Selection; D011013:Pneumonectomy / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011379:Prognosis