title: Reliability and responsiveness of cardiopulmonary exercise testing in fatigued persons with multiple sclerosis and low to mild disability.
abstract: BACKGROUND
  Peak oxygen uptake (VO2peak) via cardiopulmonary exercise testing is considered the gold standard for testing aerobic capacity in healthy participants and people with various medical conditions. The reliability and responsiveness of cardiopulmonary exercise testing outcomes in persons with MS (PwMS) have not been extensively studied.
  
  
  OBJECTIVE
  (1) to investigate the reliability of cardiopulmonary exercise parameters in PwMS; (2) to determine the responsiveness, in terms of the smallest detectable change (SDC), for each parameter.
  
  
  METHODS
  Two repeated measurements of cardiopulmonary exercise outcomes were obtained, with a median time interval of 16 days.
  
  
  METHODS
  Thirty-two PwMS suffering from subjective fatigue performed cardiopulmonary exercise tests on a cycle ergometer, to voluntary exhaustion. We calculated the reliability, in terms of the intra-class correlation coefficient (ICC [2,k]; absolute agreement), and the measurement error, in terms of standard error of measurement (SEM) and SDC at individual (SDCindividual) and group level (SDCgroup).
  
  
  RESULTS
  The ICC for VO2peak was 0.951, with an SEM of 0.131 L∙min(-1) and an SDCindividual of 0.364 L∙min(-1). When corrected for bodyweight, the ICC of VO2peak was 0.933, with an SEM of 1.7 mL∙kg(-1)∙min(-1) and in an SDCindividual of 4.6 mL∙kg(-1)∙min(-1).
  
  
  CONCLUSIONS
  Generalization of our study results is restricted to fatigued PwMS with a low to mild level of disability.
  
  
  CONCLUSIONS
  At individual level, cardiopulmonary exercise testing can be used reliably to assess physical fitness in terms of VO2peak, but less so to determine significant changes. At group level, VO2peak can be reliably used to determine physical fitness status and establish change over time.
authors: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Rembrandtkade 10, 3583 TM, Utrecht, The Netherlands.
authors: Martin
authors: M
authors: Heine
authors: Department of Rehabilitation Medicine & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors: Lizanne Eva
authors: LE
authors: van den Akker
authors: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Rembrandtkade 10, 3583 TM, Utrecht, The Netherlands.
authors: Olaf
authors: O
authors: Verschuren
authors: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Rembrandtkade 10, 3583 TM, Utrecht, The Netherlands.
authors: Anne
authors: A
authors: Visser-Meily
authors: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Neurorehabilitation, Centre of Rehabilitation and Rheumatology READE, Amsterdam, The Netherlands.
authors: Gert
authors: G
authors: Kwakkel
mesh_terms: D006233:Persons with Disabilities; D005080:Exercise Test / Q000379:methods*; D005221:Fatigue / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D010100:Oxygen / Q000378:metabolism; D015203:Reproducibility of Results
chemical_list: D010100:Oxygen