Figures
- Figure 1
Course layout for the ISWT and ESWT. Cones are inset 0.5 m from either end to avoid abrupt changes in direction. Taken from the ERS/ATS Technical Standard [1].
Tables
- Table 1
Equipment required for conducting field walking tests
At least one chair, positioned at one end of the walking course A validated scale to measure dyspnoea and subjective fatigue Sphygmomanometer for blood pressure measurement Pulse oximeter Stopwatch Pre-measured marks along the track/corridor Access to oxygen and telephone in case of an emergency An emergency plan Portable supplemental oxygen if required to perform exercise test by patient Clipboard with reporting sheet and pen Taken from the ERS/ATS Technical Standard [1].
- Table 2
Absolute and relative contraindications for field walking tests
Absolute Relative Acute myocardial infarction (3–5 days)
Unstable angina
Uncontrolled arrhythmias causing symptoms or hemodynamic compromise
Syncope
Active endocarditis
Acute myocarditis or pericarditis
Symptomatic severe aortic stenosis
Uncontrolled heart failure
Acute pulmonary embolus or pulmonary infarction
Thrombosis of lower extremities
Suspected dissecting aneurysm
Uncontrolled asthma
Pulmonary oedema
Room air SpO2 at rest ≤85%#
Acute respiratory failure
Acute noncardiopulmonary disorder that may affect exercise performance or be aggravated by exercise (i.e. infection, renal failure, thyrotoxicosis)
Mental impairment leading to inability to cooperateLeft main coronary stenosis or its equivalent
Moderate stenotic valvular heart disease
Severe untreated arterial hypertension at rest (200 mmHg systolic, 120 mmHg diastolic)
Tachyarrhythmias or bradyarrhythmias
High-degree atrioventricular block
Hypertrophic cardiomyopathy
Significant pulmonary hypertension
Advanced or complicated pregnancy
Electrolyte abnormalities
Orthopedic impairment that prevents walkingAdapted from the ATS/ACCP Statement on Cardiopulmonary Exercise Testing (2003) and taken from the ERS/ATS Technical Standard [1].#: exercise patient with supplemental oxygen.
- Table 3
Standardised instructions for the 6-min walk test
“The aim of this test is to walk as far as possible for six minutes. You will walk along this hallway between the markers, as many times as you can in six minutes.” “I will let you know as each minute goes past and then at six minutes I will ask you to stop where you are. Six minutes is a long time to walk, so you will be exerting yourself. You are permitted to slow down, to stop, and to rest as necessary, but please resume walking as soon as you are able.” “Remember that the objective is to walk AS FAR AS POSSIBLE for six minutes, but don’t run or jog.” “Do you have any questions?” Taken from the ERS/ATS Technical Standard [1].
- Table 4
Standardised encouragement for the 6-min walk test
1 min: “You are doing well. You have five minutes to go.” 2 min: “Keep up the good work. You have four minutes to go.” 3 min: “You are doing well. You are halfway.” 4 min: “Keep up the good work. You have only two minutes left.” 5 min: “You are doing well. You have only one minute to go.” 6 min: “Please stop where you are.” If the patient stops during the test, provide the following encouragement every 30 s once SpO2 is ≥85%: “Please resume walking whenever you feel able.” Taken from the ERS/ATS Technical Standard [1].
- Table 5
ISWT and ESWT instructions
Incremental shuttle walking test instructions The object of the progressive shuttle walking test is to walk as long as possible there and back along the 10 m course, keeping to the speed indicated by the bleeps on the audio recording. You will hear these bleeps at regular intervals. You should walk at a steady pace aiming to turn around the cone at one end of the course when you hear the first bleep, and at the other end when you hear the next. At first your walking speed will be very slow, but you will need to speed up at the end of each minute. Your aim should be to follow the set rhythm for as long as you can. Each single bleep signals the end of a shuttle and each triple bleep signals an increase in walking speed. You should stop walking only when you become too breathless to maintain the required speed or can no longer keep up with the set pace. The test is maximal and progressive. In other words, it is easier at the start and harder at the end. The walking speed for the first minute is very slow. You have 20 s to complete each 10 m shuttle, so don’t go too fast. The test will start in 15 s, so get ready at the start now. Level one starts with a triple bleep after the 4 s countdown Endurance shuttle walking test instructions Walking test level (1–16) The instructions below are repeated for all 16 levels. The walking speed for the first 2 min is fairly slow, so don’t go too fast. The test will start in 10 s so get ready at the start now. The test starts with a triple bleep after a 4 s countdown. At the next triple bleep increase your walking speed. Taken from the ERS/ATS Technical Standard [1].
Vol 11 Issue 2
Table of Contents
How to carry out a field walking test in chronic respiratory disease
