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Published online before print October 18, 2006
Eur Respir J 2006, doi:10.1183/09031936.00094006
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ORIGINAL ARTICLE

A step test to assess exercise-related oxygen desaturation in interstitial lung disease

S.D. Corso 1, S.R. Duarte 1, J.A. Neder 1*, C. Malaguti 1, M.B. de Fuccio 1, C.A. de Castro Pereira 1, L.E. Nery 1

1 Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respiratory Diseases, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil

* To whom correspondence should be addressed. E-mail: albneder{at}pneumo.epm.br.


  Abstract

A 6-min step test (6MST) may constitute a practical alternative for routinely assessing effort tolerance and exercise-related desaturation (ERD) in the primary care of patients with interstitial lung disease (ILD).

Thirty-one patients (19 men) with idiopathic pulmonary fibrosis (N=25) and chronic hypersensitivity pneumonia were submitted, on different days, to two 6MSTs. Physiological responses were compared with those found on maximal and submaximal (at same V'O2) cycle ergometer tests. Chronic breathlessness was also determined (Baseline dyspnoea Index, BDI).

Responses to 6MST showed to be highly reproducible: 1.3±2.0 steps·min-1, ±5 bpm (HR), ±50 mL·min-1 (V'O2), ±7 L·min-1 (V'E), and±2 % (SpO2). The number of steps climbed in 6 min was correlated to peak V'O2 and the BDI (R=0.52 and 0.55, p<0.01). There were significant associations among the tests in relation to presence ({Delta} rest-exercise SpO2 ≥4%) and severity (SpO2 <88%) of ERD (p<0.05); 4 patients, however, presented ERD only in response to 6MST. Resting DLCO and {Delta}P(A-a)O2 were the independent predictors of the number of steps climbed (R2=0.40, p<0.01).

A single-stage, self-paced 6-min step test provided reliable and reproducible estimates of exercise capacity and ERD in ILD patients.

Keywords:  Exercise-induced, exercise tests, interstitial lung diseases, oxygen saturation, oxygen uptake, pulmonary dysfunction




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