Purpose: The aim of this study was to evaluate a new field test, the six-minute stepper test (6-MST), by studying its reproducibility, sensitivity and validity. Methods: After a familiarization test, 16 patients with chronic obstructive pulmonary disease (COPD) and 15 healthy subjects performed two six-minute stepper tests per day over three evaluation days. Ten of the 16 patients with COPD also performed a six-minute walking test (6-MWT) with an analysis of gas exchange to compare the metabolic requirements of the two tests. Dyspnoea Borg values were evaluated with Borg’s CR-10 scale. Results: The mean (SD) scores for the COPD group for the first and second six-minute stepper tests were 382.49 (106.01) and 412.45 (118.39) strokes/6 minutes, respectively. Crossed comparison between the first or the second six-minute stepper tests of each evaluation day revealed no significant difference, indicating the reproducibility of the test. The sensitivity was demonstrated by a significantly higher performance in the healthy group (P<0.001), demonstrating the ability of the test to detect two groups with different fitness levels. Finally, mean dyspnoea Borg values (SD) were significantly lower (P<0.05) during the six-minute stepper test than during 6-MWT (2.5 (1.5) versus 3.1 (1.2)). Conclusions: This study demonstrated that the six-minute stepper test is a reproducible, sensitive, secure, well-tolerated and feasible test for patients with COPD. The reproducibility and sensitivity of the six-minute stepper test suggests that this test could be used in the evaluation of exercise tolerance in patients with COPD.

Exercise intolerance is a key element in the pathophysiology and course of Chronic Obstructive Pulmonary Disease (COPD). As such, evaluating exercise tolerance has become an important part of the management of COPD. A wide variety of exercise-testing protocols is currently available, each protocol having its own strengths and weaknesses relative to their discriminative, methodological, and evaluative characteristics. This paper aims to review the responsiveness of several exercise-testing protocols used to evaluate the efficacy of pharmacological and nonpharmacological interventions to improve exercise tolerance in COPD. This will be done taking into account the minimally important difference, an important concept in the interpretation of the findings about responsiveness of exercise testing protocols. Among the currently available exercise-testing protocols (incremental, constant work rate, or self-paced), constant work rate exercise tests (cycle endurance test and endurance shuttle walking test) emerge as the most responsive ones for detecting and quantifying changes in exercise capacity after an intervention in COPD.

Purpose: This study aimed to first investigate synchronous (SYN) versus asynchronous (ASY) mode of propulsion and, second, investigate the wheel camber effects on sprinting performance as well as temporal parameters. Method: Seven wheelchair basketball players performed four maximal eight-second sprints on a wheelchair ergometer. They repeated the test according to two modes of propulsion (SYN and ASY) and two wheel cambers (9° and 15°). Results: The mean maximal velocity and push power output was greater in the synchronous mode compared to the asynchronous mode for both camber angles. However, the fluctuation in the velocity profile is inferior for ASY versus SYN mode for both camber angles. Greater push time/cycle time (Pt/Ct) and arm frequency (AF) for synchronous mode versus asynchronous mode and inversely, lesser Ct and rest time (Rt) values for the synchronous mode, for which greater velocity were observed. Conclusions: SYN mode leads to better performance than ASY mode in terms of maximal propulsion velocity. However, ASY propulsion allows greater continuity of the hand-rim force application, reducing fluctuations in the velocity profile. The camber angle had no effect on ASY and SYN mean maximal velocity and push power output.