RESUMO
The purpose of the study was to evaluate the association of field test outcomes with peak oxygen uptake (VO2peak) in patients with cystic fibrosis (CF) and to describe the main prediction equations available. Data searches were performed in five databases (Pubmed, Embase, LILACs, Scopus and Web of Science) and also in the reference lists of articles included. The following inclusion criteria were used: studies including individuals with CF, presenting both a field test and a cardiopulmonary exercise testing (CPET), and describing a predictive equation or coefficient of correlation/determination. Case studies, abstracts, letters of reply, editorials and duplicate publications were excluded. The methodological quality analysis was performed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies scale. Protocol registration number: CRD42020148363. Ten studies were eligible. Five equations were found to predict VO2peak. Equations derived from the shuttle tests (ST) showed strong correlations with VO2peak (r = 0.79 to 0.95). The six-minute walk test (6MWT) showed moderate associations with VO2peak in participants with moderate disease severity (r = 0.53 to 0.65). Furthermore, patients with lower maximum heart rate on the three-minute step test tended to have a higher percent predicted VO2peak (r = -0.40), and the one-minute sit-to-stand test demonstrated moderate correlations between VO2peak and the number of repetitions (r = 0.52 to 0.66). In conclusion, field test outcomes correlate with oxygen consumption assessed through CPET, although only the ST seems to be valid as a predictor of VO2peak in patients with CF.
RESUMO
BACKGROUND: Several tests may be used to assess exercise intolerance in cystic fibrosis (CF), including the gold standard cardiopulmonary exercise test (CPET) and the Modified Shuttle Test (MST). OBJECTIVE: To evaluate the use of the MST as a predictor of peak oxygen uptake (VO2 peak) and to compare VO2 peak and maximal heart rate (HRmax) obtained in both tests. METHODS: Cross-sectional study including individuals with CF aged between 6 and 20 years old. Participants who were unable to perform the tests and/or presented signs of pulmonary exacerbation were excluded. Demographic, anthropometric, clinical and spirometric values ââwere collected. CPET and the MST were performed in two consecutive outpatient visits. HRmax, peripheral oxygen saturation, dyspnea, and VO2 peak measured and estimated were compared. RESULTS: Twenty-four patients, mean age 15.7 ± 4.2 years and FEV1 (% predicted) 76.4 ± 23.8, were included. Mean values ââof HRmax (bpm) and HRmax in percent of predicted (HRmax%) were lower (P = 0.01) in the MST (171.6 ± 14.5 and 87.1 ± 7.5) compared to CPET (180.9 ± 10.0 and 91.9 ± 5.4). However, there was no significant differences between tests in the variation (delta) for HRmax and HRmax% (P = 0.17). A strong correlation (r = 0.79; P < 0.0001) was found between distance achieved (MST) and VO2 peak (CPET). The regression model to estimate VO2 peak resulted in the following equation: VO2 (mL · kg-1 · min-1 ) = 20.301 + 0.019 × MST distance (meters). There was no difference (P = 0.50) between VO2 peak measured (CPET) and estimated by the equation. CONCLUSION: The MST may be an alternative method to evaluate exercise capacity and to predict VO2 peak in children and adolescents with CF.
