ORCID Profile
0000-0003-2663-1049
Current Organisation
Alfred Health
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Publisher: Wiley
Date: 17-09-2021
DOI: 10.1002/PPUL.25667
Abstract: Exercise testing is important in people with cystic fibrosis (pwCF). The aim was to develop an incremental maximal step test to assess exercise capacity across the range of pwCF, without floor or ceiling effects, within restrictions of space, and infection prevention. The step test was developed in adults with stable CF. Subjects assisted in selecting: step height, start rate, increments, stage and test duration parameters. Equipment to externally pace and time the test and measure exercise parameters were selected. Reasons for stopping, criteria for achieving a maximal test, and key outcome measures were determined. Documentation to record and standardize the test and instructions to set up the metronome and timer App were developed. Infection control practices were considered. Eight subjects were recruited to develop the Alfred Step Test Exercise Protocol (A‐STEP) on a 20 cm portable step. The A‐STEP package included a pretest information sheet, clinical assessment and instructions, recording worksheet, and the metronome/timer instructions. The test started at 18 steps/min. Each level increased by two steps/min to a maximum of 48 steps (Level 16). Results were presented as mean ( SD ) [range] for: age 30.63 (5.89) [21–39] years FEV 1 58.13 (18.33) [32–89]% levels: 10.31 (3.29) [6–15.5]. The A‐STEP required space of 2 m 2 and complied with current infection control guidelines. The A‐STEP is a new incremental maximal step test to assess exercise capacity in pwCF, without floor or ceiling effects. It addresses the issues of space restrictions and the need for strict infection prevention in the clinical setting.
Publisher: Wiley
Date: 18-04-2016
DOI: 10.1111/RESP.12764
Publisher: Wiley
Date: 18-07-2022
DOI: 10.1002/PPUL.26069
Abstract: To evaluate feasibility of the Alfred Step Test Exercise Protocol (A‐STEP) for the assessment of exercise capacity in adults and children with cystic fibrosis (CF) in adults to test whether demographics and/or lung function correlated with exercise capacity. Adults and children with stable CF from two centres completed the A‐STEP (a recently developed incremental maximal‐effort step test). Feasibility was evaluated by: usefulness for exercise capacity assessment (measures of exercise capacity were: level reached, exercise‐induced desaturation, and achievement of at least one maximal effort criteria) safety operational factors time to complete floor and/or ceiling effects. We used multiple linear regression to test whether demographics and/or lung function correlated with exercise capacity. A total of 49 participants: 38 adults (18 male), percent predicted (pp) forced expiration in one second (FEV 1 ) 29–109, aged 22–48 years and 11 children (6 male), ppFEV 1 68–107, aged 10–15 years were included. Levels reached (mean ( SD ) [range]) were 10.2 (2.4) [6–15] (adults), 10.1 (2.5) [7–14] (children) desaturation (change between baseline and peak‐exercise SpO 2 ): was 8.4 (3.8 [0–15]% (adults), 2.0 (2.0) [0–7]% (children). A total of 8 (21%) adults and no children desaturated % SpO 2 . At least one criterion for maximal effort was reached by 33 (84%) adults and 10 (91%) children. There were no adverse events. The A‐STEP was straightforward to use and carried out by one operator. A total of 26 (68.4%) adults and 7 (63.6%) children completed the test within the recommended 8–12 min. All participants completed a minimum of 6 levels, and completed the test before the final 16th level. In adults, ppFEV 1 and ppFVC correlated with the level reached ( r = 0.55 p = .001 and r = 0.66, p = .0001) and desaturation ( r = 0.55, p = .001 and r = 0.45, p = .005). In adults and children with stable CF, the A‐STEP was feasible, safe, and operationally easy to use for the assessment of exercise capacity, without floor or ceiling effects. In adults, lung function correlated with exercise capacity.
Publisher: European Respiratory Society (ERS)
Date: 07-2021
DOI: 10.1183/23120541.00120-2021
Abstract: Quality of life has improved dramatically over the past two decades in people with cystic fibrosis (CF). Quantification has been enabled by patient-reported outcome measures (PROMs) however, many are lengthy and can be challenging to use in routine clinical practice. We propose a short-form PROM that correlates well with established quality-of-life measures. We evaluated the utility of a 10-item score (AWESCORE) by measuring reliability, validity and responsiveness in adults with CF. The questions were developed by thematic analysis of survey questions to patients in a single adult CF centre. Each question was scored using a numerical rating scale 0 to 10. Total scores ranged from 0 to 100. Test–retest reliability was assessed over 24 h. To determine validity, comparisons were sought between stable subjects and those in pulmonary exacerbation, and between AWESCORE and Cystic Fibrosis Questionnaire – Revised (CFQ-R). Responsiveness to pulmonary exacerbation in in idual subjects was evaluated. Five domains, each with two questions, were identified for respiratory, physical, nutritional, psychological and general health. A total of 246 consecutive adults attending the outpatient clinic completed the AWESCORE. Scores were higher during clinical stability compared to pulmonary exacerbation (mean± sd): 73±11 versus 48±11 (p .001). Each domain scored worse during an acute exacerbation (p .001). No differences in reliability were observed in scores on retesting using Bland–Altman comparison. The CFQ-R scores (mean± sd : 813±125) and AWESCORE (81±13) were moderately correlated (Pearson's r=0.649 p=0.002). The AWESCORE is valid, reliable and responsive to altered health status in CF.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Lisa Wilson.