Reliability and minimal detectable change of a new treadmill-based progressive workload incremental test to measure cardiorespiratory fitness in manual wheelchair users

Abstract

Background: Cardiorespiratory fitness training is commonly provided to manual wheelchair users (MWUs) in rehabilitation and physical activity programs, emphasizing the need for a reliable task-specific incremental wheelchair propulsion test.

Objective: Quantifying test-retest reliability and minimal detectable change (MDC) of key cardiorespiratory fitness measures following performance of a newly developed continuous treadmill-based wheelchair propulsion test (WPT_Treadmill).

Methods: Twenty-five MWUs completed the WPT_Treadmill on two separate occasions within one week. During these tests, participants continuously propelled their wheelchair on a motorized treadmill while the exercise intensity was gradually increased every minute until exhaustion by changing the slope and/or speed according to a standardized protocol. Peak oxygen consumption (VO_2peak), carbon dioxide production (VCO_2peak), respiratory exchange ratio (RER_peak), minute ventilation (VE_peak) and heart rate (HR_peak) were computed. Time to exhaustion (TTE) and number of increments completed were also measured. Intra-class correlation coefficients (ICC) were calculated to determine test-retest reliability. Standard error of measurement (SEM) and MDC_90% values were calculated.

Results: Excellent test-retest reliability was reached for almost all outcome measures (ICC=0.91-0.76), except for RER_peak (ICC=0.58), which reached good reliability. TTE (ICC=0.89) and number of increments (ICC=0.91) also reached excellent test-retest reliability. For the main outcome measures (VO_2peak and TTE), absolute SEM was 2.27 mL/kg/min and 0.76 minutes, respectively and absolute MDC_90% was 5.30 mL/kg/min and 1.77 minutes, respectively.

Conclusion: The WPT_Treadmill is a reliable test to assess cardiorespiratory fitness among MWUs. TTE and number of increments could be used as reliable outcome measures when VO₂ measurement is not possible.

Keywords:

• Wheelchairs
• Exercise test
• Rehabilitation
• Cardiorespiratory fitness