We read with interest the study by Little et al1 comparing three approaches to increase physical activity in at-risk patients. We agree that further research is needed to clarify the role of fitness assessment in exercise promotion in general practice. It was noted that the 6-minute walk test2 was the more reliable measure used, but there were some practical difficulties with its use in general practice.
We would like to propose the shuttle walking test (SWT) as an alternative form of fitness testing. The SWT was developed to measure fitness in patients with respiratory disease.3 More recently it has been used in patients before and after cardiac rehabilitation, either following cardiac surgery4 or pacemaker insertion.5 It has also been used to monitor functional capacity in patients with chronic heart failure,6 cancer7 and chronic low-back pain.8
A significant correlation in the prediction of maximal oxygen uptake has been shown between the SWT and conventional treadmill testing.9 In patients with chronic heart failure,10 the SWT has been shown to predict event-free survival at 1 year better than the 6-minute walk test.
The SWT consists of a series of signals played on a cassette tape. The patient walks at a steady pace along a 10-metre course, aiming to turn around a cone at each end when the signal is heard. At the end of each minute the speed of walking increases. The test is terminated when an individual is too breathless to maintain the required speed. Fitness is recorded as the total distance walked during the test.
The test is easy to administer, requires little equipment and only one member of staff to run. We believe that this makes the SWT an attractive option when considering possible fitness tests for use in general practice.
- © British Journal of General Practice, 2004.
