The safety, physiological response and repeatability of the incremental shuttle walk test in survivors of COVID-19

TY - JOUR

T1 - The safety, physiological response and repeatability of the incremental shuttle walk test in survivors of COVID-19

AU - Baldwin, Molly M.

AU - Daynes, Enya

AU - Karsanji, Urvee

AU - McAuley, Hamish J.C.

AU - Bishop, Nicolette C.

AU - Bolton, Charlotte E.

AU - Man, William D.C.

AU - Vogiatzis, Ioannis

AU - Chalmers, James D.

AU - Ho, Ling Pei

AU - Horsley, Alex

AU - Marks, Michael

AU - Poinasamy, Krisnah

AU - Raman, Betty

AU - Leavy, Olivia C.

AU - Richardson, Matthew

AU - Elneima, Omer

AU - Shikotra, Aarti

AU - Singapuri, Amisha

AU - Sereno, Marco

AU - Saunders, Ruth M.

AU - Harris, Victoria C.

AU - Houchen-Wolloff, Linzy

AU - Greening, Neil J.

AU - Harrison, Ewen M.

AU - Docherty, Annemarie B.

AU - Lone, Nazir I.

AU - Quint, Jennifer K.

AU - Wain, Louise V.

AU - Brightling, Christopher E.

AU - Evans, Rachael A.

AU - Singh, Sally J.

N1 - Publisher Copyright: © The authors 2025.

PY - 2025/11

Y1 - 2025/11

N2 - Background The incremental shuttle walk test (ISWT) may be a valuable tool for measuring exercise tolerance in patients after a hospital admission with COVID-19. However, the safety, physiological response and repeatability of the ISWT are unknown in this cohort. The present study aimed to explore the properties of this test using the Post-Hospital COVID-19 (PHOSP-COVID) study. Methods Participants performed two ISWTs, with a 30-min rest between tests, at 5 and 12 months post-hospital discharge for COVID-19. Heart rate and fingertip peripheral oxygen saturation were recorded pre-and post-test. Reasons for test termination were noted. Results 1593 individuals (median (interquartile range) age 58 (50–66) years and body mass index 31.2 (27.6–35.8) kg·m−2; 967 (60.7%) males) performed an ISWT; two tests were performed by 1034 and 390 participants at the 5-and 12-month visit, respectively. At 5 months post-discharge, six patients (0.4%) had an adverse event and the most common reason contributing to test termination was breathlessness (826 (54.2%) participants). 336/1470 (22.9%) participants experienced exertional desaturation. Distance walked was greater in the second ISWT compared to the first ISWT at 5 and 12 months post-discharge (mean±SD difference: 5 months: 19±94 m; 12 months: 11±80 m; p<0.05), with an intraclass correlation coefficient estimate of 0.96 (95% CI 0.95–0.97) at 5 months and 0.97 (95% CI 0.96–0.97) at 12 months. Conclusions The ISWT appeared to be safe in this large cohort, supporting use of this field walking test for this population in clinical and research settings. A familiarisation test is recommended, with further study needed to determine the number of familiarisation tests required to achieve acceptable within-day repeatability.

AB - Background The incremental shuttle walk test (ISWT) may be a valuable tool for measuring exercise tolerance in patients after a hospital admission with COVID-19. However, the safety, physiological response and repeatability of the ISWT are unknown in this cohort. The present study aimed to explore the properties of this test using the Post-Hospital COVID-19 (PHOSP-COVID) study. Methods Participants performed two ISWTs, with a 30-min rest between tests, at 5 and 12 months post-hospital discharge for COVID-19. Heart rate and fingertip peripheral oxygen saturation were recorded pre-and post-test. Reasons for test termination were noted. Results 1593 individuals (median (interquartile range) age 58 (50–66) years and body mass index 31.2 (27.6–35.8) kg·m−2; 967 (60.7%) males) performed an ISWT; two tests were performed by 1034 and 390 participants at the 5-and 12-month visit, respectively. At 5 months post-discharge, six patients (0.4%) had an adverse event and the most common reason contributing to test termination was breathlessness (826 (54.2%) participants). 336/1470 (22.9%) participants experienced exertional desaturation. Distance walked was greater in the second ISWT compared to the first ISWT at 5 and 12 months post-discharge (mean±SD difference: 5 months: 19±94 m; 12 months: 11±80 m; p<0.05), with an intraclass correlation coefficient estimate of 0.96 (95% CI 0.95–0.97) at 5 months and 0.97 (95% CI 0.96–0.97) at 12 months. Conclusions The ISWT appeared to be safe in this large cohort, supporting use of this field walking test for this population in clinical and research settings. A familiarisation test is recommended, with further study needed to determine the number of familiarisation tests required to achieve acceptable within-day repeatability.

UR - https://www.scopus.com/pages/publications/105026386971

U2 - 10.1183/23120541.00089-2025

DO - 10.1183/23120541.00089-2025

M3 - Article

C2 - 41403426

AN - SCOPUS:105026386971

SN - 2312-0541

VL - 11

JO - ERJ Open Research

JF - ERJ Open Research

IS - 6

M1 - 00089-2025

ER -