Walking Test Can be a Measure of Lung Disease in Lupus

Mar 21, 2016

Researchers reporting in the journal Lupus find that a simple walking test can help assess the status of pulmonary disease in patients with systemic lupus erythematosus.

Researchers reporting in the journal Lupus find that a simple walking test can help assess the status of pulmonary disease in patients with systemic lupus erythematosus.

More than half of patients with lupus experience pulmonary involvement, commonly including pleural disease (thickening, fibrosis or effusions on CT imaging), interstitial lung disease (ILD), pulmonary manifestations (pulmonary infarction, pulmonary hypertension and pleural fibrosis), abnormal pulmonary function tests (PFTs), or the presence of shrinking lung syndrome (SLS).

For patients with lupus, pulmonary disease can impact their ability to walk longer distances without necessarily affecting other patient reported outcomes, such as dyspnea, cough, shortness of breath, sleep or fatigue. So, the researchers, led by Shikha Mittoo, M.D., of Mount Sinai Hospital in Toronto, decided to assess the use of the six-minute walk test in evaluating pulmonary disease.

The cross-sectional study included 110 patients with lupus of which 62 (56 percent) had pulmonary disease:  54 (49%) abnormal pulmonary function test; 13 (12%) pleural disease; 12 (11%) interstitial lung disease; 11 (10%) shrinking lung syndrome and five (5%) pulmonary hypertension. Dyspnea was the only PRO found to be significantly associated with pulmonary disease (P = 0.0004).  [[{"type":"media","view_mode":"media_crop","fid":"46987","attributes":{"alt":"©arka38/Shutterstock.com","class":"media-image media-image-right","id":"media_crop_411549834527","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5496","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"©arka38/Shutterstock.com","typeof":"foaf:Image"}}]]

Researchers found that patients with pulmonary disease were able to walk significantly shorter distances (P = 0.00015, 95% CI for mean 39–125 m) and a predicted distance (P = 0.00001, 10%–26%) based on the six-minute walk test as compared to participants without pulmonary disease. Patients with pulmonary disease had a significant reduction in six-minute walk test six-minute walking distance compared to those without:  486 (17) m vs 569 (14) m (P = 0.0002) and 85.0 (3.0)% vs 103.1 (2.7) % (P = 0.000010), respectively.

The “six-minute walk test holds promise as an inexpensive, reproducible and feasible Patient Performed Outcomes test to detect or assess pulmonary disease in SLE patients while patients are in the que for PFTs (Plumonary Function Tests) and imaging,” the researchers wrote in the Feb. 3 issue of Lupus.

The authors suggest a need to explore testing strategies for pulmonary disease that include expanding patient performed outcomes.

The study’s limitations included its cross-sectional design and the small sample of patients.

 

References:

Fidler L, Keen KJ, Touma Z, Mittoo S.

Impact of pulmonary disease on patient-reported outcomes and patient-performed functional testing in systematic lupus erythematosus.

 

Lupus. 

2016. (In press.) DOI: 10.1177/0961203316630818.

 

 

 

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