Abstract
PURPOSE: The aim of this study was to explore the potential and safety of a stair-climbing test as a tool to monitor improvement following pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD).
METHODS: Stair-climbing capacity was assessed in 139 patients with COPD before and after a comprehensive 8-week PR program, which included stair-climbing training. Stair-climbing capacity was assessed as the total number of flights of stairs climbed without stopping. A constant work rate endurance test (CET) was also performed before and after PR. Change in stair-climbing after PR ([DELTA]stairs) was compared and correlated to the change in endurance time ([DELTA]CET) and, for 40 patients, to the change in COPD assessment test ([DELTA]CAT) score.
RESULTS: Most patients had moderate to severe COPD (mean forced expiratory volume in 1 second = 54% +/- 20% predicted). Stair-climbing capacity, endurance time, and CAT score improved after PR (2.8 +/- 1.4 vs 8.3 +/- 3.3 flights, 408 +/- 272 vs 717 +/- 415 seconds, and 20.0 +/- 6.4 vs 17.6 +/- 6.6 units, respectively; P value for all < .001). [DELTA]stairs was moderately correlated to [DELTA]CET (r = 0.49; P < .001) and well correlated to [DELTA]CAT (r = -0.71; P < .001). Patients with greater change in [DELTA]stairs had better baseline resting lung function and aerobic capacity. No adverse events were reported during stair-climbing.
CONCLUSION: Stair-climbing is responsive to training in patients with COPD and is correlated to the change in CAT score following PR. Although the test requires further standardization, it could eventually be used as a simple and safe way to assess improvement following interventions in COPD.