• Hayley Lewthwaite, Emily M Koch, Magnus Ekström, Alan Hamilton, Jean Bourbeau, François Maltais, Benoit Borel, and Dennis Jensen.
• Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, Canada.
• J Thorac Dis. 2020 May 1; 12 (5): 2489-2498.

BackgroundThe 3-minute constant-rate stair stepping (3-min CRSST) and constant-speed shuttle tests (3-min CSST) were developed to assess breathlessness in response to a standardized exercise stimulus. Estimating the rate of oxygen consumption (V'O2) during these tests would assist clinicians to relate the stepping/shuttle speeds that elicit breathlessness to daily physical activities with a similar metabolic demand. This study: (I) developed equations to estimate the V'O2 of these tests in people with chronic obstructive pulmonary disease (COPD); and (II) compared the newly developed and American College of Sports Medicine (ACSM) metabolic equations for estimating the V'O2 of these tests.MethodsThis study was a retrospective analysis of people with COPD who completed a 3-min CRSST (n=98) or 3-min CSST (n=69). Multivariate linear regression estimated predictors (alpha <0.05) of V'O2 to construct COPD-specific metabolic equations. The mean squared error (MSE) of the COPD-specific and ACSM equations was calculated and compared. Bland-Altman analyses evaluated level of agreement between measured and predicted V'O2 using each equation; limits of agreement (LoA) and patterns of bias were compared.ResultsStepping rate/shuttle speed and body mass were identified as significant predictors of V'O2. The MSE of the COPD-specific equations was 0.05 L·min-1 for both tests. Mean difference between measured and predicted V'O2 was 0.00 L·min-1 (95% LoA -0.46, 0.46) and 0.00 L·min-1 (95% LoA -0.44, 0.44) for the 3-min CRSST and 3-min CSST, respectively. For the ACSM metabolic equations, the MSE was 0.10 L·min-1 and 0.18 L·min-1 for the 3-min CRSST and 3-min CSST, respectively. The ACSM metabolic equations underestimated V'O2 of the 3-min CRSST by -0.18 L·min-1 (95% LoA -0.68, 0.32), and overestimated V'O2 of the 3-min CSST by 0.35 L·min-1 (95% LoA -0.14, 0.84).ConclusionsThis study presents metabolic equations to predict V'O2 of the 3-min CRSST and 3-min CSST for people with COPD that are more accurate than the ACSM metabolic equations.2020 Journal of Thoracic Disease. All rights reserved.

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