Treadmill versus Shuttle Walk Tests of Walking Ability in Intermittent Claudication

Abstract

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. 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 x h(-1), 12% gradient), each on three occasions. The incremental shuttle walk began at 3 km x h(-1) and increased by 0.5 km x h(-1) every minute, whereas the constant-pace shuttle walk was performed at the fixed pace of 4 km x 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. 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). 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.