Validity and reliability of the one-minute sit-to-stand test for the measurement of cardio-respiratory responses in children with cystic fibrosis

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Sá Marques, A. Fonseca, R. Lima, I. Ladeira, J. Gomes, M. Guimarães" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M. Sá" "apellidos" => "Marques" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Fonseca" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Lima" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Ladeira" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Gomes" ] 5 => array:2 [ "nombre" => "M." 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Andrade, D.R. Silva, A.P. Santos, F.C.Q. Mello" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L.S." "apellidos" => "Andrade" ] 1 => array:2 [ "nombre" => "D.R." "apellidos" => "Silva" ] 2 => array:2 [ "nombre" => "A.P." "apellidos" => "Santos" ] 3 => array:2 [ "nombre" => "F.C.Q." 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"etiqueta" => "i" "identificador" => "aff0009" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0001" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "Maintaining exercise tolerance in individuals with cystic fibrosis (CF) is essential to limit the impact of the disease and increase survival.<a class="elsevierStyleCrossRef" href="#bib0001">1</a> The cardio-respiratory responses to exercise provide an indication of exercise tolerance, which can be used to prevent unwanted effects during exercise.<a class="elsevierStyleCrossRef" href="#bib0002">2</a> The 6-minute walk test (6MWT) is the gold standard field test for the evaluation of exercise capacity, however this test requires space and cannot always be performed.<a class="elsevierStyleCrossRef" href="#bib0003">3</a> The one-minute sit-to-stand test (STST1’) can be performed in any setting and has recently been proposed as a reliable alternative for the measurement of exercise capacity in patients with CF.<a class="elsevierStyleCrossRef" href="#bib0004">4</a>,<a class="elsevierStyleCrossRef" href="#bib0005">5</a> The measurement of the heart rate (HR) response during the STST1’ is valid and reliable in healthy children, but has not yet been validated in children with CF.<a class="elsevierStyleCrossRef" href="#bib0006">6</a> The aim of this study was to assess the validity and reliability of the measurement of cardiorespiratory responses (HR, respiratory rate (RR) and pulsed oxygen saturation (SpO2)) during the STST1’ in children with CF.This study is a secondary analysis of a previously published multicentre randomised cross-over trial (NCT03069625) and was approved by the Comité de Protection des Personnes Nord-Ouest III.<a class="elsevierStyleCrossRef" href="#bib0004">4</a> Children with CF, aged from 6 to 18 years who had been clinically stable for 4 weeks were recruited from 3 French CF centres.Participants performed two rounds of the STST1’ and 6MWT on the same day, with a 30 min minimum delay between each test, in a randomised order (computerised 1:1 block randomisation).<a class="elsevierStyleCrossRef" href="#bib0004">4</a> The HR response (initial and final HR, and percentage ΔHR: ((HRf-HRi)/HRi) x100), RR response and SpO2 response (using the same indicators) were calculated for both the STST1’ and 6MWT; data from the best performance of each test were used. Concurrent validity of the HR, RR and SpO2 responses was evaluated by correlation analysis with the same responses during the 6MWT: 0–0.19 = very weak, 0.20–0.39 = weak, 0.40–0.59 = moderate, 0.60–0.79 = strong and 0.80–1.0 = very strong. Intra-rater reliability was evaluated using intra-class correlation coefficients (ICC): <0.5 = poor, 0.5–0.75 = moderate, 0.75–0.90 = good, >0.90 = very good. Test-retest reliability was evaluated by calculation of the mean bias using the Bland-Altman method (pre-post comparisons [learning effect verification]). Statistical analyses were performed with Graph Pad Prism 8®, and the significance level was set at p < 0.05.Thirty-six children participated. Mean age was 12.0 ± 3.5 years, and mean FEV1 was 95.8 ± 25.0%. The complete characteristics of the study sample have previously been described.<a class="elsevierStyleCrossRef" href="#bib0004">4</a> Performances during both tests were moderately correlated (r = 0.480; p < 0.01). HR, RR and SpO2 measured before both tests were moderately to strongly correlated (r = 0.566–0.790). Correlations between responses during the STST1’ and 6MWT were moderate to strong and are detailed in the <a class="elsevierStyleCrossRef" href="#tbl0001">Table 1</a>. The 6MWT elicited a higher cardio-respiratory response (HR and RR) than the STST1’ in 26 out of 36 (72%) of the children.<elsevierMultimedia ident="tbl0001"></elsevierMultimedia>The intra-rater reliability of the STST1’ for the measurement of cardio-respiratory responses during exercise was moderate to very good (ICC>0.5). Evaluation of test-retest reliability showed there was no learning effect (<a class="elsevierStyleCrossRef" href="#tbl0002">Table 2</a>). Mean bias was 0.6% and the limits of agreement were -36.6% to 37.8% (lower and upper bound) for the HR response; 3.8% (mean bias) and -70.4% to 78.0% (lower and upper bound) for the RR response; and -0.1% (mean bias) and -2.9% to 2.8 (lower and upper bound) for the SpO2 response.<elsevierMultimedia ident="tbl0002"></elsevierMultimedia>The results of this study demonstrated the concurrent validity and reliability of cardio-respiratory responses measured during the STST1’ in children with CF, despite large variability. Concurrent validity during exercise testing was moderate to strong, and intra-rater reliability was moderate to very good. Evaluation of test-retest reliability showed there was no learning effect. The values of the correlation coefficients suggest that the STST1’ should be used with caution as a surrogate to the 6MWT but could be relevant when the latter cannot be performed. This is supported by the results of Reychler et al. who found a similar level of concurrent validity for the HR response during the STST1’ (r = 0.522) in healthy children.<a class="elsevierStyleCrossRef" href="#bib0006">6</a>However, in contrast with the results of Reychler et al.,<a class="elsevierStyleCrossRef" href="#bib0006">6</a> in the present study peak HR and RR were higher during the 6MWT than the STST1’. However, peak HRs at the end of the tests in that study were much higher than in the present study (∼140 beats min versus 126 and 116 beats min for the 6MWT and STST1’ respectively). A possible explanation for this difference is that healthy children have a different intrinsic motivation or perception of exercise testing procedures than children with CF.To conclude, the measurement of cardio-respiratory responses during the STST1’ is reliable and presents a moderate concurrent validity in children and adolescents with CF. The STST1’ could therefore be relevant when the 6MWT cannot be performed.Funding supportThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0001" "titulo" => "Funding support" ] 1 => array:2 [ "identificador" => "xack589158" "titulo" => "Acknowledgements" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-08-17" "fechaAceptado" => "2021-10-27" "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "Clinical Trial Registration: NCT03069625" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0001" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Data are shown as mean ± SD. Bpm: beats per minute; CI: confidence interval; Cpm: cycles per minute; HRi: initial heart rate; HRf: final heart rate; ΔHRi-f: delta heart rate; RRi: initial respiratory rate; RRf: final respiratory rate; ΔRRi-f: delta respiratory rate; SpO2i: initial pulsed oxygen saturation; SpO2f: final pulsed oxygen saturation; ΔSpO2: delta pulsed oxygen saturation; STST1’: sit-to-stand test; 6MWT: 6-minute walking test" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><a name="en0001"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0002"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Best STST1’ \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0003"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Best 6MWT \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0004"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Mean difference (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0005"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0006"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Correlation coefficient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0007"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><a name="en0008"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">HRi, bpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0009"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95.8 ± 14.4 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0010"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.4 ± 17.8 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0011"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.7 (-4.4 to 3.0) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0012"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.706 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0013"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.790 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0014"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0015"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">HRf, bpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0016"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116.3 ± 19.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0017"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">126.4 ± 23.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0018"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-10.1 (-17.0 to -3.2) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0019"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0020"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.585 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0021"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0022"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">ΔHRi – f, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0023"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.8 ± 22.1 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0024"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.6 ± 22.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0025"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-9.8 (-17.2 to -2.5) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0026"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.010 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0027"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.532 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0028"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0029"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">RRi, cpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0030"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.6 ± 4.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0031"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.1 ± 4.5 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0032"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.4 (-1.0 to 1.9) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0033"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.546 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0034"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.566 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0035"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0036"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">RRf, cpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0037"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.6 ± 5.1 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0038"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.3 ± 9.7 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0039"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-3.7 (-6.7 to -0.7) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0040"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.018 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0041"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.410 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0042"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.013 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0043"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">ΔRRi – f, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0044"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.4 ± 37.6 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0045"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.4 ± 45.3 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0046"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-18.1 (-31.8 to -6.4) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0047"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0048"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.603 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0049"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0050"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">SpO2i, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0051"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.8 ± 2.0 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0052"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.1 ± 2.0 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0053"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.2 (-0.6 to 0.1) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0054"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.199 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0055"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.752 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0056"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0057"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">SpO2f, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0058"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.6 ± 1.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0059"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.4 ± 2.8 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0060"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.3 (-0.4 to 0.9) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0061"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.402 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0062"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.681 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0063"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0064"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">ΔSpO2 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0065"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.2 ± 1.4 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0066"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.7 ± 2.4 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0067"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 (-0.2 to 1.2) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0068"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.147 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0069"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.462 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0070"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2845912.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Concurrent validity of cardio-respiratory responses measured during the STST1’ and 6MWT in children with CF." ] ] 1 => array:8 [ "identificador" => "tbl0002" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0002" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Data are shown as mean ± SD. Bpm: beats per minute; CI: confidence interval; Cpm: cycles per minute; HRi: initial heart rate; HRf: final heart rate; ΔHR: delta heart rate; RRi: initial respiratory rate; RRf: final respiratory rate; ΔRR: delta respiratory rate; SpO2i: initial pulsed oxygen saturation; SpO2f: final pulsed oxygen saturation; ΔSpO2: delta pulsed oxygen saturation; STST1’: sit-to-stand test" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><a name="en0071"></a><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="top" scope="col"></th><a name="en0072"></a><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Test-Retest reliability</th><a name="en0073"></a><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intra-Rater Reliability</th></tr><tr title="table-row"><a name="en0074"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0075"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">STST1’1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0076"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">STST1’2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0077"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Mean difference (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0078"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0079"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">ICC \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0080"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">95%CI \t\t\t\t\t\t\n \t\t\t\t\t\t</th><a name="en0081"></a><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><a name="en0082"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">HRi, bpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0083"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.3 ± 18.7 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0084"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.0 ± 17.3 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0085"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.7 (-4.9 to 3.5) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0086"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.740 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0087"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.865 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0088"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.735-0.931 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0089"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0090"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">HRf, bpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0091"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">115.1 ± 20.6 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0092"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">115.4 ± 18.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0093"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.4 (-5.0 to 4.3) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0094"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.875 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0095"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.863 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0096"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.731-0.930 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0097"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0098"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">ΔHR, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0099"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.5 ± 22.1 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0100"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.0 ± 21.7 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0101"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 (-5.9 to 7.0) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0102"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.856 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0103"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.708 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0104"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.426-0.851 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0105"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0106"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">RRi, cpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0107"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.1 ± 3.3 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0108"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.7 ± 4.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0109"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.6 (-2.3 to 1.1) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0110"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.462 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0111"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.448 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0112"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.080-0.719 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0113"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.042 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0114"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">RRf, cpm \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0115"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.6 ± 4.8 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0116"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.5 ± 5.3 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0117"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.9 (-2.7 to 0.8) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0118"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.283 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0119"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.644 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0120"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.301-0.818 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0121"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0122"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">ΔRR, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0123"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.2 ± 31.7 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0124"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.0 ± 38.0 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0125"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-3.8 (-16.6 to 9.0) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0126"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.550 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0127"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.574 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0128"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.164-0.783 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0129"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0130"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">SpO2i, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0131"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.6 ± 2.0 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0132"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.9 ± 2.0 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0133"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.2 (-0.5 to 0.1) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0134"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.160 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0135"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.944 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0136"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.891-0.972 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0137"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0138"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">SpO2f, % \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0139"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.4 ± 1.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0140"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.7 ± 1.9 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0141"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.3 (-0.7 to 0.2) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0142"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.216 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0143"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.865 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0144"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.736-0.931 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0145"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><a name="en0146"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">ΔSpO2 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0147"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.2 ± 1.5 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0148"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.1 ± 1.4 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0149"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">-0.1 (-0.6 to 0.4) \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0150"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.822 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0151"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.649 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0152"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="top">0.311-0.821 \t\t\t\t\t\t\n \t\t\t\t</td><a name="en0153"></a><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2845913.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Test-retest and intra-rater reliability of cardio-respiratory responses measured during the STST1’ in children with CF." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec1" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0001" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiopulmonary exercise testing provides additional prognostic information in cystic fibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H Hebestreit" 1 => "EHJ Hulzebos" 2 => "JE Schneiderman" 3 => "C Karila" 4 => "SR Boas" 5 => "S Kriemler" ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1164/rccm.201806-1110OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2019" "volumen" => "199" "paginaInicial" => "987" "paginaFinal" => "995" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30321487" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1164/rccm.201806-1110OC" "WWW" => array:1 [ "link" => "http://doi.org/10.1164/rccm.201806-1110OC" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0002" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exercise-induced hypoxemia and cardiac arrhythmia in cystic fibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K Ruf" 1 => "H. Hebestreit" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcf.2008.09.008" "Revista" => array:5 [ "tituloSerie" => "J Cyst Fibros" "fecha" => "2009" "volumen" => "8" "paginaInicial" => "83" "paginaFinal" => "90" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0003" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exercise testing and exercise training within cystic fibrosis centres across Australia and New Zealand: what is considered important and what is current practice?" 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Authors would also like to thank Johanna Robertson for language assistance and constructive criticism." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/25310437/0000002800000002/v1_202202260728/S253104372100204X/v1_202202260728/en/main.assets" "Apartado" => array:4 [ "identificador" => "72880" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25310437/0000002800000002/v1_202202260728/S253104372100204X/v1_202202260728/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S253104372100204X?idApp=UINPBA00004E"]

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Letter to the Editor

Validity and reliability of the one-minute sit-to-stand test for the measurement of cardio-respiratory responses in children with cystic fibrosis

Yann Combreta,b,

Corresponding author

yann.combret@gmail.com

Corresponding author.

, Guillaume Prieura,b,c, Fairuz Boujibard, Francis-Edouard Gravierc,e, Pauline Smondackc,e, Pascal Le Rouxf, Tristan Bonneviec,e, Clément Medrinala,g,h, Grégory Reychlerb,i

a Physiotherapy Department, Le Havre Hospital, F-76600, Le Havre, France

b Research and Clinical Experimentation Institute (IREC), Pulmonology, ORL and Dermatology, Louvain Catholic University, Brussels 1200, Belgium

c Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), F-76000, Rouen, France

d INSERM U1096, UNIROUEN, Normandie Univ, Rouen University Hospital, Rouen, Normandie, France

e ADIR Association, Rouen University Hospital, F-76000, Rouen, France

f Paediatric Department, Le Havre Hospital, F-76600, Le Havre, France

g Paris-Saclay University, UVSQ, Erphan, F-78000, Versailles, France

h Saint Michel School of Physiotherapy, F-75015, Paris, France

i Department of Physical Medicine and Rehabilitation, Saint-Luc University Clinics, Brussels 1200, Belgium.

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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0003" class="elsevierStylePara elsevierViewall">Maintaining exercise tolerance in individuals with cystic fibrosis &#40;CF&#41; is essential to limit the impact of the disease and increase survival&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> The cardio-respiratory responses to exercise provide an indication of exercise tolerance&#44; which can be used to prevent unwanted effects during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a> The 6-minute walk test &#40;6MWT&#41; is the gold standard field test for the evaluation of exercise capacity&#44; however this test requires space and cannot always be performed&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> The one-minute sit-to-stand test &#40;STST1&#8217;&#41; can be performed in any setting and has recently been proposed as a reliable alternative for the measurement of exercise capacity in patients with CF&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> The measurement of the heart rate &#40;HR&#41; response during the STST1&#8217; is valid and reliable in healthy children&#44; but has not yet been validated in children with CF&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a> The aim of this study was to assess the validity and reliability of the measurement of cardiorespiratory responses &#40;HR&#44; respiratory rate &#40;RR&#41; and pulsed oxygen saturation &#40;SpO2&#41;&#41; during the STST1&#8217; in children with CF&#46;</p><p id="para0004" class="elsevierStylePara elsevierViewall">This study is a secondary analysis of a previously published multicentre randomised cross-over trial &#40;NCT03069625&#41; and was approved by the Comit&#233; de Protection des Personnes Nord-Ouest III&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> Children with CF&#44; aged from 6 to 18 years who had been clinically stable for 4 weeks were recruited from 3 French CF centres&#46;</p><p id="para0005" class="elsevierStylePara elsevierViewall">Participants performed two rounds of the STST1&#8217; and 6MWT on the same day&#44; with a 30&#160;min minimum delay between each test&#44; in a randomised order &#40;computerised 1&#58;1 block randomisation&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> The HR response &#40;initial and final HR&#44; and percentage &#916;HR&#58; &#40;&#40;HR<span class="elsevierStyleInf">f</span>-HR<span class="elsevierStyleInf">i</span>&#41;&#47;HR<span class="elsevierStyleInf">i</span>&#41; x100&#41;&#44; RR response and SpO2 response &#40;using the same indicators&#41; were calculated for both the STST1&#8217; and 6MWT&#59; data from the best performance of each test were used&#46; Concurrent validity of the HR&#44; RR and SpO2 responses was evaluated by correlation analysis with the same responses during the 6MWT&#58; 0&#8211;0&#46;19&#8239;&#61;&#8239;very weak&#44; 0&#46;20&#8211;0&#46;39&#8239;&#61;&#8239;weak&#44; 0&#46;40&#8211;0&#46;59&#8239;&#61;&#8239;moderate&#44; 0&#46;60&#8211;0&#46;79&#8239;&#61;&#8239;strong and 0&#46;80&#8211;1&#46;0&#8239;&#61;&#8239;very strong&#46; Intra-rater reliability was evaluated using intra-class correlation coefficients &#40;ICC&#41;&#58; &#60;0&#46;5&#8239;&#61;&#8239;poor&#44; 0&#46;5&#8211;0&#46;75&#8239;&#61;&#8239;moderate&#44; 0&#46;75&#8211;0&#46;90&#8239;&#61;&#8239;good&#44; &#62;0&#46;90&#8239;&#61;&#8239;very good&#46; Test-retest reliability was evaluated by calculation of the mean bias using the Bland-Altman method &#40;pre-post comparisons &#91;learning effect verification&#93;&#41;&#46; Statistical analyses were performed with Graph Pad Prism 8&#174;&#44; and the significance level was set at <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#46;05&#46;</p><p id="para0006" class="elsevierStylePara elsevierViewall">Thirty-six children participated&#46; Mean age was 12&#46;0 &#177; 3&#46;5 years&#44; and mean FEV1 was 95&#46;8 &#177; 25&#46;0&#37;&#46; The complete characteristics of the study sample have previously been described&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> Performances during both tests were moderately correlated &#40;<span class="elsevierStyleItalic">r</span>&#8239;&#61;&#8239;0&#46;480&#59; <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#46;01&#41;&#46; HR&#44; RR and SpO2 measured before both tests were moderately to strongly correlated &#40;<span class="elsevierStyleItalic">r</span>&#8239;&#61;&#8239;0&#46;566&#8211;0&#46;790&#41;&#46; Correlations between responses during the STST1&#8217; and 6MWT were moderate to strong and are detailed in the <a class="elsevierStyleCrossRef" href="#tbl0001">Table 1</a>&#46; The 6MWT elicited a higher cardio-respiratory response &#40;HR and RR&#41; than the STST1&#8217; in 26 out of 36 &#40;72&#37;&#41; of the children&#46;</p><elsevierMultimedia ident="tbl0001"></elsevierMultimedia><p id="para0007" class="elsevierStylePara elsevierViewall">The intra-rater reliability of the STST1&#8217; for the measurement of cardio-respiratory responses during exercise was moderate to very good &#40;ICC&#62;0&#46;5&#41;&#46; Evaluation of test-retest reliability showed there was no learning effect &#40;<a class="elsevierStyleCrossRef" href="#tbl0002">Table 2</a>&#41;&#46; Mean bias was 0&#46;6&#37; and the limits of agreement were -36&#46;6&#37; to 37&#46;8&#37; &#40;lower and upper bound&#41; for the HR response&#59; 3&#46;8&#37; &#40;mean bias&#41; and -70&#46;4&#37; to 78&#46;0&#37; &#40;lower and upper bound&#41; for the RR response&#59; and -0&#46;1&#37; &#40;mean bias&#41; and -2&#46;9&#37; to 2&#46;8 &#40;lower and upper bound&#41; for the SpO2 response&#46;</p><elsevierMultimedia ident="tbl0002"></elsevierMultimedia><p id="para0008" class="elsevierStylePara elsevierViewall">The results of this study demonstrated the concurrent validity and reliability of cardio-respiratory responses measured during the STST1&#8217; in children with CF&#44; despite large variability&#46; Concurrent validity during exercise testing was moderate to strong&#44; and intra-rater reliability was moderate to very good&#46; Evaluation of test-retest reliability showed there was no learning effect&#46; The values of the correlation coefficients suggest that the STST1&#8217; should be used with caution as a surrogate to the 6MWT but could be relevant when the latter cannot be performed&#46; This is supported by the results of Reychler et al&#46; who found a similar level of concurrent validity for the HR response during the STST1&#8217; &#40;<span class="elsevierStyleItalic">r</span>&#8239;&#61;&#8239;0&#46;522&#41; in healthy children&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a></p><p id="para0009" class="elsevierStylePara elsevierViewall">However&#44; in contrast with the results of Reychler et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a> in the present study peak HR and RR were higher during the 6MWT than the STST1&#8217;&#46; However&#44; peak HRs at the end of the tests in that study were much higher than in the present study &#40;&#8764;140&#160;beats&#160;min versus 126 and 116&#160;beats&#160;min for the 6MWT and STST1&#8217; respectively&#41;&#46; A possible explanation for this difference is that healthy children have a different intrinsic motivation or perception of exercise testing procedures than children with CF&#46;</p><p id="para0010" class="elsevierStylePara elsevierViewall">To conclude&#44; the measurement of cardio-respiratory responses during the STST1&#8217; is reliable and presents a moderate concurrent validity in children and adolescents with CF&#46; The STST1&#8217; could therefore be relevant when the 6MWT cannot be performed&#46;</p><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Funding support</span><p id="para0011" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "sec0001"
          "titulo" => "Funding support"
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        1 => array:2 [
          "identificador" => "xack589158"
          "titulo" => "Acknowledgements"
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        2 => array:1 [
          "titulo" => "References"
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    "tienePdf" => true
    "fechaRecibido" => "2021-08-17"
    "fechaAceptado" => "2021-10-27"
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        "nota" => "<p class="elsevierStyleNotepara" id="notep0001"><span class="elsevierStyleUnderline">Clinical Trial Registration&#58;</span> NCT03069625</p>"
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          "leyenda" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Data are shown as mean &#177; SD&#46; Bpm&#58; beats per minute&#59; CI&#58; confidence interval&#59; Cpm&#58; cycles per minute&#59; HR<span class="elsevierStyleInf">i</span>&#58; initial heart rate&#59; HR<span class="elsevierStyleInf">f&#58;</span> final heart rate&#59; &#916;HR<span class="elsevierStyleInf">i-f</span>&#58; delta heart rate&#59; RR<span class="elsevierStyleInf">i</span>&#58; initial respiratory rate&#59; RR<span class="elsevierStyleInf">f</span>&#58; final respiratory rate&#59; &#916;RR<span class="elsevierStyleInf">i-f</span>&#58; delta respiratory rate&#59; SpO2<span class="elsevierStyleInf">i</span>&#58; initial pulsed oxygen saturation&#59; SpO2<span class="elsevierStyleInf">f</span>&#58; final pulsed oxygen saturation&#59; &#916;SpO2&#58; delta pulsed oxygen saturation&#59; STST1&#8217;&#58; sit-to-stand test&#59; 6MWT&#58; 6-minute walking test</p>"
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                  \t\t\t\t</td><a name="en0012"></a><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="top">0&#46;706&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="top">HR<span class="elsevierStyleInf">f</span>&#44; bpm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="top">RR<span class="elsevierStyleInf">f</span>&#44; cpm&nbsp;\t\t\t\t\t\t\n
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                  """
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          "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Concurrent validity of cardio-respiratory responses measured during the STST1&#8217; and 6MWT in children with CF&#46;</p>"
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        "identificador" => "tbl0002"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Data are shown as mean &#177; SD&#46; Bpm&#58; beats per minute&#59; CI&#58; confidence interval&#59; Cpm&#58; cycles per minute&#59; HR<span class="elsevierStyleInf">i</span>&#58; initial heart rate&#59; HR<span class="elsevierStyleInf">f&#58;</span> final heart rate&#59; &#916;HR&#58; delta heart rate&#59; RR<span class="elsevierStyleInf">i</span>&#58; initial respiratory rate&#59; RR<span class="elsevierStyleInf">f</span>&#58; final respiratory rate&#59; &#916;RR&#58; delta respiratory rate&#59; SpO2<span class="elsevierStyleInf">i</span>&#58; initial pulsed oxygen saturation&#59; SpO2<span class="elsevierStyleInf">f</span>&#58; final pulsed oxygen saturation&#59; &#916;SpO2&#58; delta pulsed oxygen saturation&#59; STST1&#8217;&#58; sit-to-stand test</p>"
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                  \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Test-Retest reliability</th><a name="en0073"></a><th class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intra-Rater Reliability</th></tr><tr title="table-row"><a name="en0074"></a><th class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-0&#46;7 &#40;-4&#46;9 to 3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0086"></a><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;0 &#177; 21&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;6 &#40;-5&#46;9 to 7&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="top">0&#46;708&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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        "titulo" => "Acknowledgements"
        "texto" => "<p id="para0013" class="elsevierStylePara elsevierViewall">The authors would like to thank the teams of Le Havre&#44; Caen and Rouen Cystic Fibrosis Centres and the GHAHR Association &#40;Le Havre&#44; France&#41; for their support&#46; Authors would also like to thank Johanna Robertson for language assistance and constructive criticism&#46;</p>"
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Article information

ISSN: 25310437
Original language: English

DOI:10.1016/j.pulmoe.2021.10.005

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2024 November	11	6	17
2024 October	56	54	110
2024 September	94	18	112
2024 August	100	38	138
2024 July	109	28	137
2024 June	92	38	130
2024 May	91	42	133
2024 April	93	33	126
2024 March	79	26	105
2024 February	78	26	104
2024 January	78	32	110
2023 December	57	19	76
2023 November	66	47	113
2023 October	78	34	112
2023 September	52	33	85
2023 August	60	18	78
2023 July	53	34	87
2023 June	72	21	93
2023 May	92	36	128
2023 April	84	26	110
2023 March	131	38	169
2023 February	51	26	77
2023 January	48	27	75
2022 December	81	32	113
2022 November	87	28	115
2022 October	118	55	173
2022 September	84	51	135
2022 August	81	45	126
2022 July	91	38	129
2022 June	87	38	125
2022 May	103	58	161
2022 April	154	49	203
2022 March	119	124	243
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