Development of a walking test for the assessment of functional capacity in non-anaemic maintenance dialysis patients

Abstract

Background: Walk tests may be useful adjuncts or even alternatives to the assessment of peak oxygen uptake (VO2 peak) in patients with low functional capacity. Walk tests are easy to administer, appear to be well tolerated by patients and may represent a more meaningful measure for a patient group as they assess capability as well as fitness. However, the use of walk tests for the assessment of functional capacity in maintenance dialysis patients has received scant attention. The aim of this study was to assess the validity of a walking-stair-climbing test to predict VO2 peak in non-anaemic maintenance dialysis patients.

Methods: In the validation phase of the study, 14 subjects completed a cycle ergometer-graded exercise test (GXT) for the determination of VO2 peak and a walking-stair-climbing task (WALK), each separated by a period of 7 days. Three weeks later, 18 subjects completed two WALK tests, each separated by a period of at least 48 h, to facilitate reliability estimation. Estimates of differentiated and undifferentiated ratings of perceived exertion (RPE) were obtained during and immediately consequent to all exercise tests.

Results: VO2 peak (ml kg min) was significantly correlated with total WALK time (s) (r = -0.83; P < 0.001). VO2 peak (ml/kg/min) could be predicted from total WALK time with a standard error of prediction of 11%. Reliability assessment revealed no significant differences for any aspect of the WALK test performance, with intraclass correlation coefficients ranging from r = 0.71 (RPElegs) to 0.96 (total WALK time).

Conclusion: These results indicate that the WALK test is a valid, reliable and potentially useful method by which to assess the functional capacity of non-anaemic maintenance dialysis patients.