Measurement properties and physiological response types of Step-tests in different clinical populations - a systematic review

• Autor(a) principal: Laranjeira, Inês Sofia Neves
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.22/19730
• topic: Exercise testing; Validity; Reliability; Responsiveness; Cardiorespiratory responses

Exercise capacity assessment is na importante clinical measure. VO2max is the gold standard, measured by cardiopulmonary exercise testing. Nonetheless, it can be difficult to apply, especially in home-based settings. Step tests are a field test type with significant correlation with gold standard, being quick, low cost and easy to learn, however there are multiple protocols, difficulting the choice process in each clinical population. To determine the diferente step tests, corresponding level of evidence of their measurement properties (validaty, reliability and responsiveness) and assess the physiologicalmaximal responses and exercise limitations in any clinical group. The data sources PubMed, MEDLINE, Cochrane Central, PEDRo, LILACS, Web of Science were searched up between 10th and 30th of July, 2021. Studies of any design that reported any measurements properties of the step test and corresponding physiological responses while assessing exercise capacity in any clinical group were selected. One reviewer collected the data and rated the level of quality by COSMIN and study desing quality by QATAS and was posteriorly reviewed by two other reviewers. Forty-three studies were included. 2MST, 3MST, 6MST, 6MSrT, aCST, CST, IST, MIST, PST, SST, SFRST, 3ST×1, STEP, YMCA+1mHRC were identified. Level of evidence was mostly “Low” and “Very low”. Best level of evidence was “Moderate” for criterion validity and reliability of the 6-Minute Stepper Test in COPD patients (r=0.48 – 0.63; ICC = 0.92 – 0.95, respectively) and measurement error on the Adapted Chester Step Test on healthy subjects (SEM = 12,8). Study design quality varied between “Weak” and “Moderate”. Only five studies presented all the physiological variables for maximal response assessment. Only one study documented VO2max plateau. Heart rate and rating of perceivd exertion were the most commonly evaluated physiological variables. Step tests show a ventilatory limitation on respiratory clinical groups, a cardiac limitation on cardiac and metabolic groups and tend to be more symptom limitd on healthy groups. The level of evidence of the measurement properties of the step test is “low” to “very low” while assessing exercise capacity, limiting their applicability on clinical practice. Self-paced step teststend to have submaximal responses while assessing exercise capacity. The 6-Minute stepper Test and 6-Minute Step test are currently the most frequente and investigated tests.