Resting Hyperinflation Predicts Incremental Shuttle Walk Distance in Chronic Obstructive Pulmonary Disease.

Srinivasan, M; Touma, D; Blokland, KEC; Tonga, KO; Chapman, DG; King, GG

Resting Hyperinflation Predicts Incremental Shuttle Walk Distance in Chronic Obstructive Pulmonary Disease.

Srinivasan, M Touma, D Blokland, KEC Tonga, KO Chapman, DG King, GG

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Publisher:: Taylor & Francis
Publication Type:: Journal Article
Citation:: COPD, 2025, 22, (1), pp. 2563218
Issue Date:: 2025-12

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Field	Value	Language
dc.contributor.author	Srinivasan, M
dc.contributor.author	Touma, D
dc.contributor.author	Blokland, KEC
dc.contributor.author	Tonga, KO
dc.contributor.author	Chapman, DG
dc.contributor.author	King, GG
dc.date.accessioned	2025-10-15T04:13:51Z
dc.date.available	2025-10-15T04:13:51Z
dc.date.issued	2025-12
dc.identifier.citation	COPD, 2025, 22, (1), pp. 2563218
dc.identifier.issn	1541-2555
dc.identifier.issn	1541-2563
dc.identifier.uri	http://hdl.handle.net/10453/190481
dc.description.abstract	Rationale: The incremental shuttle walk test (ISWT) correlates closely with peak oxygen uptake in COPD and relates to important outcomes such as mortality, response to treatment and hospital readmission. Despite this, there is limited data on the physiological determinants of ISWT distance (ISWD) in COPD. Methods: In this exploratory, prospective observational study, spirometry, lung volumes, diffusion capacity (DLCO) and oscillometry were performed in patients with confirmed COPD. Patients then completed two ISWT with the results of the best test, measured by distanced walked taken. The determinants of ISWD and dyspnoea measured by BORG score were evaluated. Results: 25 COPD patients, mean (SD) age 71 (8.82) years, 48% female with a mean (SD) FEV1 Z-score -2.54 (0.83) were recruited. Median (IQR) ISWD was 350 (210-440) metres (mean (SD) 66.4 (27.9)% predicted distance). Most patients (85%) stopped due to inability to maintain walking speed with submaximal mean heart rate of 77.3 (10.1)% predicted and BORG dyspnoea score of 'severe' (median 5/10 (IQR 4-5.5)). Inspiratory capacity to TLC ratio (IC/TLC) correlated strongly with ISWD, even when corrected for age and height (rs = 0.59 p = 0.02). Oscillatory reactance (Xrs5) and DLCO were also correlated with ISWD. There were no oscillometric or spirometric predictors of dyspnoea. Conclusion: Resting hyperinflation measured by IC/TLC, predicted ISWD despite submaximal dyspnoea, suggesting that hyperinflation may not be the mechanism that limits exercise performance, but rather reflects overall impairment in COPD.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Taylor & Francis
dc.relation.ispartof	COPD
dc.relation.isbasedon	10.1080/15412555.2025.2563218
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1115 Pharmacology and Pharmaceutical Sciences, 1116 Medical Physiology, 1117 Public Health and Health Services
dc.subject.classification	Respiratory System
dc.subject.classification	3201 Cardiovascular medicine and haematology
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Pulmonary Disease, Chronic Obstructive
dc.subject.mesh	Aged
dc.subject.mesh	Walk Test
dc.subject.mesh	Male
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Dyspnea
dc.subject.mesh	Spirometry
dc.subject.mesh	Middle Aged
dc.subject.mesh	Forced Expiratory Volume
dc.subject.mesh	Exercise Tolerance
dc.subject.mesh	Inspiratory Capacity
dc.subject.mesh	Oscillometry
dc.subject.mesh	Lung Volume Measurements
dc.subject.mesh	Pulmonary Diffusing Capacity
dc.subject.mesh	Walking
dc.subject.mesh	Humans
dc.subject.mesh	Pulmonary Disease, Chronic Obstructive
dc.subject.mesh	Dyspnea
dc.subject.mesh	Lung Volume Measurements
dc.subject.mesh	Inspiratory Capacity
dc.subject.mesh	Pulmonary Diffusing Capacity
dc.subject.mesh	Forced Expiratory Volume
dc.subject.mesh	Spirometry
dc.subject.mesh	Walking
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Oscillometry
dc.subject.mesh	Exercise Tolerance
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Walk Test
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Pulmonary Disease, Chronic Obstructive
dc.subject.mesh	Aged
dc.subject.mesh	Walk Test
dc.subject.mesh	Male
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Dyspnea
dc.subject.mesh	Spirometry
dc.subject.mesh	Middle Aged
dc.subject.mesh	Forced Expiratory Volume
dc.subject.mesh	Exercise Tolerance
dc.subject.mesh	Inspiratory Capacity
dc.subject.mesh	Oscillometry
dc.subject.mesh	Lung Volume Measurements
dc.subject.mesh	Pulmonary Diffusing Capacity
dc.subject.mesh	Walking
dc.title	Resting Hyperinflation Predicts Incremental Shuttle Walk Distance in Chronic Obstructive Pulmonary Disease.
dc.type	Journal Article
utslib.citation.volume	22
utslib.location.activity	England
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
utslib.for	1116 Medical Physiology
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Science
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2025-10-15T04:13:49Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	22
utslib.citation.issue	1

Abstract:

Rationale: The incremental shuttle walk test (ISWT) correlates closely with peak oxygen uptake in COPD and relates to important outcomes such as mortality, response to treatment and hospital readmission. Despite this, there is limited data on the physiological determinants of ISWT distance (ISWD) in COPD. Methods: In this exploratory, prospective observational study, spirometry, lung volumes, diffusion capacity (DLCO) and oscillometry were performed in patients with confirmed COPD. Patients then completed two ISWT with the results of the best test, measured by distanced walked taken. The determinants of ISWD and dyspnoea measured by BORG score were evaluated. Results: 25 COPD patients, mean (SD) age 71 (8.82) years, 48% female with a mean (SD) FEV1 Z-score -2.54 (0.83) were recruited. Median (IQR) ISWD was 350 (210-440) metres (mean (SD) 66.4 (27.9)% predicted distance). Most patients (85%) stopped due to inability to maintain walking speed with submaximal mean heart rate of 77.3 (10.1)% predicted and BORG dyspnoea score of 'severe' (median 5/10 (IQR 4-5.5)). Inspiratory capacity to TLC ratio (IC/TLC) correlated strongly with ISWD, even when corrected for age and height (rs = 0.59 p = 0.02). Oscillatory reactance (Xrs5) and DLCO were also correlated with ISWD. There were no oscillometric or spirometric predictors of dyspnoea. Conclusion: Resting hyperinflation measured by IC/TLC, predicted ISWD despite submaximal dyspnoea, suggesting that hyperinflation may not be the mechanism that limits exercise performance, but rather reflects overall impairment in COPD.

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