Elsevier

The Journal of Pediatrics

Volume 167, Issue 5, November 2015, Pages 1057-1061
The Journal of Pediatrics

Original Article
Reference Equation for the Incremental Shuttle Walk Test in Children and Adolescents

https://doi.org/10.1016/j.jpeds.2015.07.068Get rights and content

Objective

To determine a prediction equation for distance walked of incremental shuttle walk test (ISWT) and test its reliability in children and adolescents.

Study design

Cross-sectional study, which included 108 healthy volunteers between 6 and 18 years old. Those who had an abnormal spirometry or had a history of chronic disease were excluded. Two ISWT were performed. Heart rate and peripheral capillary oxygen saturation (SpO2) were continuously measured during the test. Dyspnea and lower limb fatigue were assessed by Borg scale before and after the tests.

Results

Boys walked longer distances compared with girls (1066.4 ± 254.1 m vs 889.7 ± 159.6 m, respectively, P < .0001). Except for dyspnea, there were no significant differences in the other outcomes measured (heart rate, lower limb fatigue, SpO2, and distance walked) at the peak of the two ISWT. The variables included in the predicted equation were age, body mass index, and sex. The predicted equation is: ISWTpred = 845.559 + (sex * 193.265) + (age * 47.850) − (body mass index * 26.179). The distance walked had an excellent reliability between the two ISWT, 0.98 (95% CI 0.97-0.99). The Bland–Altman plot shows agreement between tests (range from −40 to 45 m).

Conclusions

We established a prediction equation for ISWT. It can be used as a reference to evaluate exercise capacity for children and adolescents. ISWT has excellent repeatability and it is a maximal-effort field test for this age group.

Section snippets

Methods

This was a cross-sectional study that included 108 healthy subjects. They were recruited from among students at private and public schools in São Paulo, Brazil. The protocol was approved by the Research Ethics Committee of the University (483692). The protocol began in April 2013 and ended in May 2014. All measurements were obtained in the school or in the physiology laboratory of our university (Nove de Julho University) by trained investigators.

The inclusion criteria were as follows: both

Results

A total of 173 subjects were selected, but 46 of the volunteers had chronic lung disease, 12 had abnormal lung function, and the parents of 7 volunteers did not sign the consent form. The final sample was 108 subjects; 52 (48%) of whom were male. The subjects' characteristics are described in Table I.

As expected, boys walked longer distances during the ISWT compared with girls (1064.4 ± 254.1 vs 889.7 ± 159.6, respectively, P < .0001; Table I). We divided the volunteers into children (≤12 years

Discussion

The present study describes an equation that can be used to predict the distance walked on the ISWT for children and adolescents. Age, sex, and BMI explained 48% of the variance in distance walked. Additionally, boys and the oldest volunteers walked a greater distance than girls and the youngest volunteers, respectively. We also determined that the ISWT is highly reproducible in children and adolescents.

Anthropometric variables have been included in the reference equations for field tests. Age,

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    Supported by São Paulo Research Foundation (2011/23221-7, 2013/11394-0 [to E.d.P.], and 2013/26187-0 [to L.N.]. The authors declare no conflicts of interest.

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