title: 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.
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.
  
  
  CONCLUSIONS
  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.
authors: Explorations Fonctionnelles Respiratoires, l'institut du thorax, CHU de Nantes; Université de Poitiers, Laboratoire MOVE EA 6314, F-86000 Poitiers.
authors: Trija
authors: T
authors: Vaidya
authors: Université de Poitiers, Laboratoire MOVE EA 6314, F-86000 Poitiers.
authors: Claire
authors: C
authors: de Bisschop
authors: Pulmonary Rehabilitation Unit, Morlaix Hospital Centre; European University of Occidental Brittany, EA3878, Brest.
authors: Marc
authors: M
authors: Beaumont
authors: Service de Pneumologie, CHU d'Angers, Angers.
authors: Hakima
authors: H
authors: Ouksel
authors: Service de Réhabilitation Respiratoire, Soins de Suite et Rééducation, CHU de Nantes.
authors: Véronique
authors: V
authors: Jean
authors: Service de Réhabilitation Respiratoire, la Tourmaline, UGECAM.
authors: François
authors: F
authors: Dessables
authors: Explorations Fonctionnelles Respiratoires, l'institut du thorax, CHU de Nantes; Université de Nantes, Laboratory EA 4334 "Mouvement, Interactions, Performance," Nantes, France.
authors: Arnaud
authors: A
authors: Chambellan
mesh_terms: D000368:Aged; D019540:Area Under Curve; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D005602:France; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D000071081:Minimal Clinically Important Difference; D015999:Multivariate Analysis; D009119:Muscle Contraction; D053580:Muscle Strength; D010102:Oxygen Inhalation Therapy; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D052097:Quadriceps Muscle / Q000503:physiopathology; D012372:ROC Curve; D020127:Recovery of Function; D012138:Respiratory Therapy / Q000379:methods; D016896:Treatment Outcome; D000070857:Walk Test
keywords: 6-minute walk test; COPD; exercise tolerance; pulmonary rehabilitation; sit-to-stand test