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Treadmill versus Shuttle Walk Tests of Walking Ability in Intermittent Claudication

ZWIERSKA, IRENA1; NAWAZ, SHAH2; WALKER, RICHARD D.2; WOOD, RICHARD F. M.2; POCKLEY, A GRAHAM2; SAXTON, JOHN M.1

Medicine & Science in Sports & Exercise: November 2004 - Volume 36 - Issue 11 - p 1835-1840
doi: 10.1249/01.MSS.0000145471.73711.66
Clinical Sciences: Clinical Investigations

Purpose: To compare treadmill and shuttle walk tests for assessing functional capacity in patients with intermittent claudication, with respect to test-retest reliability, cardiovascular responses, and patient preferences.

Methods: Patients with stable intermittent claudication (N = 55, ages 52–85 yr, median age 68 yr) were recruited from the Sheffield Vascular Institute at the Northern General Hospital, Sheffield, UK. Each patient performed an incremental shuttle walk test, a constant-pace shuttle walk test, and a standardized treadmill test (3.2 km·h−1, 12% gradient), each on three occasions. The incremental shuttle walk began at 3 km·h−1 and increased by 0.5 km·h−1 every minute, whereas the constant-pace shuttle walk was performed at the fixed pace of 4 km·h−1. Claudication distance (CD), maximum walking distance (MWD), heart rate (HR), and blood pressure were assessed in each testing session. The patients also completed a test preference questionnaire.

Results: CD and MWD for both shuttle walks were greater than the corresponding walking distances achieved in the treadmill test (P < 0.001). Average coefficients of variation for repeated incremental shuttle walk, constant-pace shuttle walk, and treadmill tests were 15.9%, 21.1%, and 18.7%, respectively, for MWD, corresponding to average intraclass correlation coefficients of 0.87, 0.82, and 0.87. Treadmill walking evoked greater increases in HR and blood pressure (P < 0.001), and fewer patients expressed a preference for it (24 vs 43% for shuttle walking).

Conclusion: These findings indicated that shuttle walk testing exhibits similar test-retest reliability as treadmill testing, but that it evoked a lower level of cardiovascular stress and is preferred to treadmill testing by a large proportion of patients.

1The Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UNITED KINGDOM; and 2Division of Clinical Sciences (North), University of Sheffield, Sheffield, UNITED KINGDOM

Address for correspondence: Dr. John M. Saxton, The Centre for Sport and Exercise Science, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP, United Kingdom; E-mail: j.m.saxton@shu.ac.uk.

Submitted for publication March 2004.

Accepted for publication July 2004.

This study was supported by the British Heart Foundation (Project Grant PG-99130).

©2004The American College of Sports Medicine