title: Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review.
abstract: OBJECTIVE
  Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders?
  
  
  METHODS
  Systematic review of studies of the psychometric properties of exercise tests.
  
  
  METHODS
  People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders.
  
  
  METHODS
  Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included.
  
  
  METHODS
  Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates.
  
  
  RESULTS
  Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias. The included studies evaluated: Åstrand test; modified Åstrand test; Lean body mass-based Åstrand test; submaximal bicycle ergometer test following another protocol other than Åstrand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test. None of the studies assessed maximal exercise tests. Where they had been tested, reliability and validity were generally high. Dropout rates were generally acceptable. The 2-km walk test was not recommended in fibromyalgia.
  
  
  CONCLUSIONS
  Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue. There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue.
authors.affiliation: Hospital Rivierenland Tiel, The Netherlands.
authors.forename: Julia
authors.initials: J
authors.lastname: Ratter
authors.affiliation: Applied Research and Development Physiotherapy, Health Division, Bern University of Applied Sciences, Switzerland.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Radlinger
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Lucas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000628:therapy*; D005080:Exercise Test / Q000379:methods*; D015673:Fatigue Syndrome, Chronic / Q000628:therapy*; D005260:Female; D005356:Fibromyalgia / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D016896:Treatment Outcome; D016138:Walking
keywords: Chronic pain; Exercise test; Fatigue syndrome (chronic); Fibromyalgia; Psychometrics; Review (publication type)