Pulmonary rehabilitation information for health professionals

The progressive 10 metre shuttle walking test enables the operator to monitor the functional capacity of patients with COPD. 

It is a sensitive test that can be used on a wide range of patients with varying severity of disability. The equipment is very simple, all you need is a CD or MP3 player and two markers placed 9 metres apart. 

This test can be used by all medical personnel and does not require access to laboratory equipment.

References

Sewell L, Singh SJ, Williams JE, Collier R, Morgan MDL (2005). Can Individualised Rehabilitation improve functional independence in elderly patients with COPD. Chest; 128; 1194-1200.

Singh SJ, Morgan MDL, Scott S, et al. Development of a shuttle walking test of disability in patients with chronic airways obstruction.  Thorax 1992;47:1019-24

Singh SJ, Morgan MDL, Hardman AE, et al. Comparison of oxygen uptake during a conventional treadmill test and the shuttle walk test in chronic airflow limitation.  Eur Respir J 1994;7:2016-20

This is a standardised field test for the assessment of endurance capacity in patients with chronic lung disease. The test was developed as an adjunct to the ISWT so that together they form a practical method of assessing both functional and endurance exercise capacity using the same 10 metre shuttle course. 

The ESWT is especially sensitive to interventions of Pulmonary Rehabilitation with exercise training and can be used for the baseline and post training assessments.
There is a conversion chart to help practitioners and researchers establish the corresponding ESWT speed in the related documents below. (NB. These speeds correspond to 85% of predicted maximum).

References
Revill SM, Morgan MDL, Singh SJ et al. The endurance shuttle walk: a new field test for the assessment of endurance capacity in chronic obstructive pulmonary disease. Thorax 1999 Mar; 54(3): 213-22.

(ESWT) Endurance Shuttle Walk Test Conversion table (116kB pdf)

The modified shuttle walk test is an extension of the original 12 level Shuttle Walk Test initially developed to assess patients with COPD. 

The instructions for the MSWT are the same as for the original test, except that there are 3 additional levels, (usually used with younger or fitter patients for example with cystic fibrosis)

References

Bradley J, Howard J, Wallace E, et al.Validity of a modified shuttle walk test in adult cystic fibrosis. Thorax 1999;54;437-439

The shuttle walk test MP3 is available in digital format

Supplied on USB flash drive by the Pulmonary Rehabilitation Department,
University Hospitals of Leicester NHS Trust (copyright owner)

Also available are the Endurance and the Modified Shuttle Walk Test.

Price list

• Endurance Shuttle Walk Test (ESWT): £69.00 excl p+p
• Incremental Shuttle Walk Test (ISWT): £35.00 excl p+p
• Modified Shuttle Walk Test (MSWT): £35.00 excl p+p

This questionnaire has been developed for use as a measure of quality of life for people with chronic lung disease.
The CRQ-SR is designed to be completed by the patient, with assistance given by an administrator only as necessary.

References
Williams JE, Singh SJ, Sewell L, Guyatt GH, Morgan MD. Development of a self-reported Chronic Respiratory Questionnaire (CRQ-SR).Thorax 2001;56:954-9.
Williams JE, Singh SJ, Sewell L, Morgan MD. Health status measurement: sensitivity of the self-reported Chronic Respiratory Questionnaire (CRQ-SR) in pulmonary rehabilitation. Thorax 2003;58:515-8.

The Chronic Respiratory Questionnaire-Self Reported (CRQ-SR) (122kB pdf)

The SPACE for COPD manual is a standardised self management manual for patients with chronic obstructive pulmonary disease (COPD). 

It was developed by healthcare professionals and individuals with COPD and it has been approved by the Plain English Campaign.

The manual is interactive, and is administered by an individual with an in depth knowledge of COPD, exercise and motivational interviewing. We have developed a course to allow other healthcare professionals to deliver the manual (Regional Innovation Fund Award).

The manual is divided into four sections and covers topics such as:

• improving your physical activity,
• managing breathlessness,
• anxiety management,
• managing your medication.

There is also an appendix containing information that may not be relevant to all individuals with COPD but is there for reference, for example oxygen and relationships.

For those patients that are computer literate, there is an online programme for people with a long-term cardiac, respiratory or Covid condition called i-IMPACT (Individualised self-Management Programme for long-term CondiTions).

This programme incorporates previous websites Your Covid Recovery and SPACE for COPD. As the healthcare professional you would register your patients to give them access and they would then be guided through sections to get started and then do a weekly programme that includes exercise, goal setting and education topics.

You would monitor them and their progress ‘remotely’ via the admin part of the site. Patients can only access this programme if their local Pulmonary Rehabilitation team are using the website as part of their clinical service.

SPACE Manual leaflet (682kB pdf)

Web leaflet for i-IMPACT (541kB pdf)

This patient decision aid has been developed to support individuals living with COPD make decisions about Pulmonary Rehabilitation together with their Pulmonary Rehabilitation healthcare professional.

References:

Barradell AC, Houchen-Wolloff L, Robertson N, Bekker HL, Singh SJ. A pulmonary rehabilitation shared decision-making intervention for patients living with COPD: PReSent: protocol for a feasibility study. ERJ Open Res. 2022 Jun 6;8(2):00645-2021. doi: 10.1183/23120541.00645-2021.

Making Decisions about Chronic Obstructive Pulmonary Disease (COPD): A leaflet to help you make decisions about how best to manage your COPD, with or without Pulmonary Rehabilitation. Barradell AC, Singh SJ, Bekker HL, Houchen-Wolloff L, Robertson N, Marshal-Nichols K (2021).

Contact:

If you wish to use this patient decision aid, please contact Amy Barradell.

Amy Barradell ([email protected]) Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, UK.