Home-based and remote exercise testing in chronic respiratory disease, during the COVID-19 pandemic and beyond: a rapid review
This article has been Reviewed by the following groups
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
- Evaluated articles (ScreenIT)
Abstract
Objectives
To identify exercise tests that are suitable for home-based or remote administration in people with chronic lung disease.
Methods
Rapid review of studies that reported home-based or remote administration of an exercise test in people with chronic lung disease, and studies reporting their clinimetric properties.
Results
84 studies were included. Tests used at home were the 6-minute walk test (6MWT, 2 studies), sit-to-stand tests (STS, 5 studies), Timed Up and Go (TUG, 4 studies) and step tests (2 studies). Exercise tests administered remotely were the 6MWT (2 studies) and step test (1 study). Compared to centre-based testing the 6MWT distance was similar when performed outdoors but shorter when performed at home (2 studies). The STS, TUG and step tests were feasible, reliable (intra-class correlation coefficients >0.80), valid (concurrent and known groups validity) and moderately responsive to pulmonary rehabilitation (medium effect sizes). These tests elicited less desaturation than the 6MWT, and validated methods to prescribe exercise were not reported.
Discussion
The STS, step and TUG tests can be performed at home, but do not accurately document desaturation with walking or allow exercise prescription. Patients at risk of desaturation should be prioritised for centre-based exercise testing when this is available.
Article activity feed
-
SciScore for 10.1101/2020.07.15.20154930: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The search strategy for MEDLINE is in supplementary Table 1. MEDLINEsuggested: (MEDLINE, RRID:SCR_002185)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations to this review relate to both the body of evidence and the review process. The included studies …
SciScore for 10.1101/2020.07.15.20154930: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The search strategy for MEDLINE is in supplementary Table 1. MEDLINEsuggested: (MEDLINE, RRID:SCR_002185)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations to this review relate to both the body of evidence and the review process. The included studies often included a small number of participants and used a wide variety of testing protocols, which limited data synthesis. Feasibility of the tests was poorly documented and key patient groups were often excluded from studies (e.g. those using oxygen therapy or those who could not perform the test. Clinimetric properties of tests were rarely assessed in the home setting, but given the nature of the tests (STS, step and TUG) and the use of face-to-face supervision, these seem unlikely to vary substantially from those properties documented in centre-based testing. A small number of studies were available for patient groups other than COPD. A rapid review process was selected to ensure we could quickly address the immediate challenge facing the pulmonary rehabilitation community, but inherent limitations to this process must be acknowledged, including searching a single electronic database (Medline), a single author undertaking study selection, and a single author performing data extraction with accuracy checks on a random sample by a second reviewer. As this was a rapid review we did not perform a formal quality assessment, although data extraction included risk of bias related to study design and analysis, which was considered during data synthesis. In conclusion, pulmonary rehabilitation clinicians can confidently perform STS, step and TUG tests at home in people with ch...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
-
-