Highlights
- •The incremental shuttle walk test is a valid and reliable test in multiple sclerosis.
- •The test has the advantage of being cost-effective and practical.
- •The test may be an alternative for the routine functional exercise capacity assessment.
Abstract
Background
Functional exercise capacity evaluation is crucial to monitor treatment effects and
disease progression in people with multiple sclerosis (pwMS). Compared to other tests,
the incremental shuttle walking test (ISWT), which more accurately reflects cardiovascular
responses, may be more useful for assessing exercise capacity. The aim of the study
is to investigate the reliability and validity of the ISWT.
Methods
Thirty-six pwMS with an Expanded Disability Status Scale (EDSS) score<4.5 between
the ages of 25 and 65 were included in the study. The subjects underwent practice
(ISWT-p) before undergoing the test-retest protocol in order to rule out the ISWT
learning effect (ISWT-1 – ISWT-2). ISWT-1 and ISWT-2 were administered with a 3–7
day interval for test-retest reliability. Six-minutes walking test (6MWT) were applied
for concurrent validity. The EDSS, pulmonary function tests, Fatigue Impact Scale
(FIS), respiratory muscle strength [maximum inspiratory and expiratory pressure (MIP-MEP)]
measurements were made for convergent validity.
Results
ISWT was found to have excellent test-retest reliability with an ICC value of 0.97.
The area under the curve value was 0.904 indicating that ISWT has a good performance
for predicting disease severity. The moderate correlation between ISWT and 6MWT (rho:
0.68, p<0,001) proved concurrent validity. It was also moderately correlated with EDSS, MEP
(rho: -0.58 and 0.47 respectively), weakly correlated with MIP and FIS (rho:0.37 and
-0.36, respectively) while not correlated with pulmonary function tests.
Conclusion
The ISWT had excellent test-retest reliability, acceptable criterion and construct
validity in ambulatory MS patients.
Keywords
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Article info
Publication history
Published online: January 14, 2023
Accepted:
January 13,
2023
Received in revised form:
December 28,
2022
Received:
November 28,
2022
Identification
Copyright
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