The shuttle walking test: a reproducible method

for evaluating the impact of shortness of breath on functional capacity in patients with advanced cancer S Booth*, L Adams Background—Breathlessness leading to exercise limitation is common in patients with advanced cancer and is ineVectively treated. There are few research data to guide clinicians on best practice. The shuttle walking test has been validated for some conditions such as chronic obstruc-tive pulmonary disease but not for advanced cancer. One of the well documented diYculties of doing clinical research in palliative care is the accept-ability of assessment tests. This study examined the reproducibility of the shut-tle walking test in patients with advanced cancer to help facilitate the systematic evaluation of interventions designed to improve breathlessness. Methods—Patients performed three shut-tle walks on separate days with continuous monitoring of arterial oxygen saturation and heart rate; simple pulmonary function (FEV1) was also recorded. Data on quality of life, anxiety, and depression were col-lected throughout the study period using appropriate questionnaires. Breathless-ness was measured before and after exer-cise using a visual analogue scale. Results—Data from 22 patients were com-pared between visits 2 and 3. There were no significant diVerences between the FEV1 (1.89 v 1.90, p=0.73), distance walked on each test (245 m v 256 m, p=0.14), end-exercise levels of heart rate (107/min v 108/min, p=0.11), oxygen saturation (93.4 % v 93.2%, p=0.38), or breathlessness scores (p=0.62) on the two occasions. Indi-ces of quality of life, anxiety, and depres-sion were also not diVerent between the two tests. The investigation was very acceptable to patients, families, and staV. Conclusions—The shuttle walking test is a reproducible test of functional capacity in ambulant patients with advanced cancer, WHO performance status 1 or 2. The data indicate that a practice session is needed. It is easy to carry out and acceptable for patients with advanced cancer