The Remote Assessment of Physical Capacities of Patients with COPD, Feasibility and Learning Effect of the 5-Repetition Sit-to-Stand Test (5STS)

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Purpose: With the rise of telehealth and telemonitoring respiratory chronic diseases, having a simple and reliable remote physical capacity assessment test is an important issue. The 5-repetition sit-to-stand test (5STS) is a good candidate, but two aspects must be studied before considering its remote implementation, the assessment of a learning effect (LE) which conditions administration and interpretation of the test, and its feasibility via videoconference. Patients and Methods: 40 stable patients with COPD were enrolled. From home, they performed 5STS tests during three visits (V1-V3) of five trials (T1-T5), each with a 5-min rest period. V2 took place 24-48h after V1 and V3 took place one month later. To assess remote feasibility, reasons for non-inclusion related to digital technology use, connection failures, adverse events, and patient satisfaction were recorded. LE was assessed by timing the 5STS tests performed at each visit and corresponds to an improvement in performance over repeated trials. Results: No adverse events were reported. 19% of patients were not enrolled due to a hardware issue or insufficient computer skills. 3% of visits were cancelled due to connection/camera failure. Test acceptability showed an overall satisfaction rate of 96%. Repeatability was excellent with ICC [CI95] of 0.91 [0.85-0.95] at V1; 0.98 [0.96-0.99] at V2; and 0.95 [0.91-0.97] at V3. The smallest detectable change at 95% was 0.99 seconds. Friedman ANOVA of V1 confirmed a LE, with significant differences between the first trial (V1T1) and V1T3, V1T4 and V1T5, and between V1T2 and V1T5 (all p<0.01). The median difference between V1T1 and V1T5 was -1.50 [-2.09/-0.81] seconds. Inter-visit comparison between V1 and V2 showed no difference between V1T5 and any of the trials in V2, confirming a stabilisation of LE after five trials. Conclusion: The remote 5STS is a feasible, safe, and reliable test. Performing five trials is essential to monitor the LE and to avoid underestimating initial physical condition of COPD patients at the start of an exercise training programme. Trial Registration: NCT05852821.

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