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European Journal of Physical and Rehabilitation Medicine 2021 Feb 23

DOI: 10.23736/S1973-9087.21.06713-7


language: English

Is the Short and Fast Step Test a safe and feasible tool for exploring anaerobic capacities of individuals with coronary heart disease in clinical practice?

Delphine BESSON 1, 2, Anais GOUTERON 1, 2, 3, Armelle HANNEQUIN 2, Jean-Marie CASILLAS 1, 2, 3, Lucie RIGAUD 2, Paul ORNETTI 1, 3, 4, Isabelle FOURNEL 5, Elea KSIAZEK 5, Davy LAROCHE 1, 3, Mathieu GUEUGNON 1

1 INSERM, CIC 1432, Centre d’Investigation Clinique, Module Plurithématique, Plateforme d’Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France; 2 Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France; 3 INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France; 4 Department of Rheumatology, CHU Dijon-Bourgogne, Dijon, France; 5 INSERM, CIC1432, Clinical Epidemiology Unit, Dijon, France Dijon-Bourgogne University Hospital, Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials Unit, Dijon, France


BACKGROUND: While its importance in daily living, the anaerobic metabolism is not taken into account in clinical practice. The lack of validated functional performance tests for patients with chronic disabilities may explain this defect. In this context, the Short and Fast Step Test (SFST) was recently developed and validated in healthy volunteers.
AIM: The purpose of this study was to investigate the safety, feasibility and reliability of the SFST, a functional test exploring anaerobic metabolism in coronary patients during cardiac rehabilitation. DESIGN: This study was a monocentric prospective study.
SETTINGS: This study took place in the rehabilitation center of the University Hospital Center of Dijon, France.
POPULATION: 44 coronary patients, addressed for a first cardiac rehabilitation, were included in this protocol.
METHODS: All participants performed three SFST: T1 and T2 (including respiratory gas exchange) the first day of the program and T3 after 3 to 7 days. SFST consists of walking up and down a 17.5cm-high step as many times as possible in 1 minute. Safety was assessed by the percentage of patients who performed the SFST without reporting a fall, or muscular or cardiovascular events. Feasibility was evaluated by the percentage of patients who succeeded in doing the SFST. Reliability was assessed with the number of raised steps in same condition (T1-T3) and different conditions (T1-T2) using a 2-way intraclass correlation coefficient (ICC). Values were given with their 90% confidence interval [90%CI].
RESULTS: The safety was 95.2% [85.8;99.2] for T1, 88.1% [76.6;95.2] for T2 and 90.4% [79.5;96.7] for T3. 100% [93,1;100] of participants completed T1 and T2, 92.9% [82.6;98] T3. An ICC of 0.74 [0.60;0.84] was observed between T1 and T3 and of 0.87 [0.79;0.92] between T1 and T2.
CONCLUSIONS: This study demonstrates the good safety, feasibility and reliability of the SFST to assess anaerobic metabolism in coronary patients in a rehabilitation program.
CLINICAL REHABILITATION IMPACT: These results show that the SFST seems suitable for the evaluation of brief submaximal functional capacity in daily activities. It offers a real possibility to assess such capacity during the cardiac rehabilitation routine.

KEY WORDS: Functional test; Coronary patients; Anaerobic metabolism; Safety; Feasibility; Reliability

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