Study to Assess if Ability to Ascend and Descend Stairs Within 30 Seconds Will Prove to be a Reliable and Valid Outcome Measure in Individuals With Pulmonary Disease

Protocol Title: The Reliability and Validity of the Timed Stair Climbing Test (TSCT) as an Outcome Measure in Individuals with Pulmonary Disease.

Background An important part of pulmonary rehabilitation is the ability to document progress. Commonly used outcome measures include walking tests like the Six Minute Walk Test (6MWT) and the Shuttle Walk Test, MET levels and questionnaires. A recent study by Annegarn1 et al., analyzed responses from 820 Chronic Obstructive Pulmonary Disease (COPD) patients. While 35% of respondents cited stair climbing as a problematic Activity of Daily Living (ADL), there are very few studies looking at stair climbing ability as an outcome measure.

Step tests using a riser and metronome have long been used as a fitness measure for healthy subjects but can be challenging to administer to a non healthy population and do not mimic the challenge of actually mounting a series of steps. Many of the existing stair climbing studies which use actual stairs for testing are distance based and examine stair climbing as a predictor for outcomes following lung surgery. One study conducted by Randolph2 et al., attempted to compare stair climbing ability and Pulmonary Function Tests (PFTs) as predictors of post-thoracotomy outcomes. Brunelli3 et al., looked at stair climbing as a useful predictor of cardiopulmonary complications following lung resection. Both studies concluded that the stair climbing test was clinically useful.

Bean4 developed a stair climbing test called the Stair Climb Power Test that incorporated an element of time by asking subjects to climb a staircase of ten stairs as quickly and safely as possible and looked at the relationship between muscle strength and functional performance.

The Six Minute Walk Test is well established as a valid and reliable outcome measure for this population5. A study by Dreher6 et al., in 2008 attempted to compare a stair climbing test with the Six Minute Walk Test. Using a randomized cross-over design, they looked at sixteen COPD patients and found that pathophysiological changes during a six minute walk test did not anticipate changes found during stair climbing in patients with severe COPD.