• Véronique Pepin, Julie Brodeur, Yves Lacasse, Julie Milot, Pierre Leblanc, François Whittom, and François Maltais.
• Centre de Pneumologie, Hôpital Laval, 2725 Chemin Ste-Foy, Ste-Foy, Québec, G1V 4G5, Canada.
• Thorax. 2007 Apr 1; 62 (4): 291-8.

BackgroundThe responsiveness of the endurance shuttle walk to functional changes following bronchodilation has recently been reported. The current literature suggests that the 6 min walking test (6MWT) is less responsive to bronchodilation than the endurance shuttle walk.AimTo compare bronchodilator-induced changes in exercise performance with the 6MWT and the endurance shuttle walk.MethodsIn a randomised, double-blind, placebo-controlled, crossover trial, 14 patients with chronic obstructive pulmonary disease (forced expiratory volume in 1 s (FEV(1)) 50 (8)% predicted) completed two 6MWTs and two endurance shuttle walks, each preceded by nebulised placebo or 500 microg ipratropium bromide. Cardiorespiratory parameters were monitored during each walking test with a portable telemetric gas analyser. Quadriceps twitch force was measured by magnetic stimulation of the femoral nerve before and after each walking test.ResultsThe 6 min walking distance did not change significantly after bronchodilation despite a significant increase in FEV(1) of 0.18 (0.09) litres (p<0.001). A similar change in FEV(1) (0.18 (0.12) litres, p<0.001) was associated with a significant improvement in the distance walked on the endurance shuttle walk (Deltadistance ipratropium bromide--placebo = 144 (219) m, p = 0.03). Quadriceps muscle fatigue was infrequent (<15% of patients) after both walking tests.ConclusionThe endurance shuttle walk is more responsive than the 6MWT for detecting changes in exercise performance following bronchodilation.

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