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The Siconolfi step test: a valid and reliable assessment of cardiopulmonary fitness in older men with prostate cancer

Lemanska, Agnieszka, Poole, Karen, Aning, Jonathan J., Griffin, Bruce A., Manders, Ralph, Saxton, John M., Wainwright, Joe and Faithfull, Sara (2019) The Siconolfi step test: a valid and reliable assessment of cardiopulmonary fitness in older men with prostate cancer European Review of Aging and Physical Activity, 16 (1). pp. 1-10.

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Abstract

Background

Assessing fitness and promoting regular physical activity can improve health outcomes and early recovery in prostate cancer. This is however, underutilised in clinical practice. The cardiopulmonary exercise test (CPET) is increasingly being used pre-treatment to measure aerobic capacity and peak oxygen consumption (VO2peak - a gold standard in cardiopulmonary fitness assessment). However, CPET requires expensive equipment and may not always be appropriate. The Siconolfi step test (SST) is simpler and cheaper, and could provide an alternative.

The aim of this study was to evaluate the validity and reliability of SST for predicting cardiopulmonary fitness in men with prostate cancer. Men were recruited to this two-centre study (Surrey and Newcastle, United Kingdom) after treatment for locally advanced prostate cancer. They had one or more of three risk factors: elevated blood pressure, overweight (BMI ˃ 25), or androgen deprivation therapy (ADT). Cardiopulmonary fitness was measured using SST and cycle ergometry CPET, at two visits three months apart. The validity of SST was assessed by comparing it to CPET. The VO2peak predicted from SST was compared to the VO2peak directly measured with CPET. The reliability of SST was assessed by comparing repeated measures. Bland-Altman analysis was used to derive limits of agreement in validity and reliability analysis.

Results

Sixty-six men provided data for both SST and CPET. These data were used for validity analysis. 56 men provided SST data on both visits. These data were used for reliability analysis. SST provided valid prediction of the cardiopulmonary fitness in men ˃ 60 years old. The average difference between CPET and SST was 0.64 ml/kg/min with non-significant positive bias towards CPET (P = 0.217). Bland-Altman 95% limits of agreement of SST with CPET were ± 7.62 ml/kg/min. SST was reliable across the whole age range. Predicted VO2peak was on average 0.53 ml/kg/min higher at Visit 2 than at Visit 1 (P = 0.181). Bland-Altman 95% limits of agreement between repeated SST measures were ± 5.84 ml/kg/min.

Conclusions

SST provides a valid and reliable alternative to CPET for the assessment of cardiopulmonary fitness in older men with prostate cancer. Caution is advised when assessing men 60 years old or younger because the VO2peak predicted with SST was significantly lower than that measured with CPET.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Lemanska, Agnieszkaa.lemanska@surrey.ac.uk
Poole, Karenk.poole@surrey.ac.uk
Aning, Jonathan J.
Griffin, Bruce A.B.Griffin@surrey.ac.uk
Manders, Ralphr.manders@surrey.ac.uk
Saxton, John M.
Wainwright, JoeJ.Wainwright@surrey.ac.uk
Faithfull, SaraS.Faithfull@surrey.ac.uk
Date : 10 January 2019
DOI : 10.1186/s11556-018-0207-9
Copyright Disclaimer : © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Depositing User : Clive Harris
Date Deposited : 21 Mar 2019 11:17
Last Modified : 21 Mar 2019 11:17
URI: http://epubs.surrey.ac.uk/id/eprint/850829

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