Obstructive Airways DiseaseField Tests of Exercise Capacity in Chronic Obstructive Pulmonary DiseaseCanavan, Jane L. PhD*,†; Jones, Sarah E. MSc*,†; Kon, Samantha S.C. MD*,†; Nolan, Claire M. BSc*,†; Man, William D.-C. PhD*,†; Maddocks, Matthew PhD†,‡ Author Information *NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS, Foundation Trust and Imperial College †Harefield Pulmonary Rehabilitation Unit, Royal Brompton & Harefield NHS, Foundation Trust ‡King’s College London, Cicely Saunders Institute, London, UK J.L.C., S.E.J., S.S.C.K., and C.M.N. contributed equally. J.L.C. and S.E.J. are supported by the NIHR Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London. S.S.C.K. is supported by the Medical Research Council (MRC). W.D.-C.M. is supported by a National Institute for Health Research Clinician Scientist Award, a Medical Research Council (UK) New Investigator Research Grant, and a National Institute for Health Research Clinical Trials Fellowship. M.M. is supported by a National Institute for Health Research Post-Doctoral Fellowship. This project was undertaken at the NIHR Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London. The views expressed in this publication are those of the authors and not necessarily those of the NHS, The National Institute for Health Research, nor the Department of Health. Disclosure: The authors declare no conflicts of interest. Address correspondence to: Matthew Maddocks, PhD, King’s College London, Cicely Saunders Institute, London SE5 9PJ, UK. E-mail: [email protected]. Clinical Pulmonary Medicine: January 2015 - Volume 22 - Issue 1 - p 1-7 doi: 10.1097/CPM.0000000000000074 Buy Metrics Abstract Exercise intolerance is a common symptom in chronic obstructive pulmonary disease (COPD), and reflects not only cardiorespiratory status, but global disease severity and prognosis. Evaluating exercise capacity allows the monitoring of disease trajectory and response to intervention. Although formal cardiopulmonary metabolic exercise testing provides a wealth of physiological information, this is impractical in some settings. Field tests, which do not require specialist equipment and expertise, are widely used as surrogates. This review examines established and emerging field tests of exercise capacity, and examines the evidence supporting the validity, reliability, and interpretation of these tests in the assessment of individuals with COPD. The 6-minute walk, incremental shuttle walk, and endurance shuttle walk tests have well-established psychometric properties in COPD. Nonetheless, issues with the time and space required to perform these tests prevent widespread implementation across all health care settings. A range of simpler and shorter functional tests are emerging in COPD, which are suited to most clinical settings including the bedside. These include the 4-meter gait speed, sit-to-stand tests, the Short Physical Performance Battery, and the Stair Climb Power Test. Data on the psychometric properties of these emerging tests are variable in COPD populations and are currently strongest for the 4-meter gait speed and 5-sit-to-stand test. In summary, exercise capacity is an important outcome measure in COPD. There are several well-established and validated field walking tests that reflect exercise capacity. Simpler tests are emerging, which will allow the routine measurement of exercise capacity at the bedside or in home settings. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.