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Ventilatory and Metabolic Response in the Incremental Shuttle and 6-Min Walking Tests Measured by Telemetry in Obese Patients Prior to Bariatric Surgery

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Abstract

Background

Low cardiopulmonary fitness, measured by oxygen uptake peak (VO2pk), is associated with postoperative complications and mortality. Obese people have difficulty in performing the cardiopulmonary exercise test, which requires maximal exertion. The incremental shuttle walking test (ISWT) and 6-min walking test (6MWT) have been used to assess cardiorespiratory capacity, mortality, and complications in the postoperative phase. However, the physiological response elicited by these tests in obese people is unknown. This study analyzed and compared cardiopulmonary fitness (oxygen uptake [VO2] and CO2 output [VCO2]) in the ISWT and 6MWT in obese adults using a telemetry system.

Methods

Fifteen obese patients (10 women; mean age 39.4 ± 10.1 years; mean body mass index 43.5 ± 6.8 kg/m2) with normal forced vital capacity (% FVC 93.7) performed the 6MWT and ISWT in the field in this cross-sectional study. Metabolic (VO2pk, VCO2) and respiratory (minute ventilation; VE) variables were recorded using telemetry.

Results

Obese patients performed the ISWT with an incremental and exponential cardiopulmonary response, with higher VO2pk (15.4 ± 2.9 ml/kg/min), VCO2 (1.7 ± 0.7 l/min), and VE (51.4 ± 21.3 l/min) than the 6MWT (VO2pk = 13.2 ± 2.59 ml/kg/min, VCO2 = 1.4 ± 0.6 l/min; VE = 41.2 ± 16.6 l/min (all p < 0.01). They also demonstrated more effort intensity, assessed by VO2, (p = 0.006) and heart rate (p = 0.04) in the ISWT than the 6MWT. In the 6MWT, patients showed a fast rise in ventilatory and metabolic response, reaching a plateau.

Conclusion

The ISWT test generated superior metabolic and ventilatory stress than the 6MWT and may be more suitable for assessing cardiopulmonary fitness than self-paced tests.

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Acknowledgments

This study was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Counsel of Technological and Scientific Development; Research and Projects Financing-45309/2012) from the Ministry of Science, Technology and Innovation, Brazil.

Conflict of Interest

All the authors declared no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent does not apply.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Postgraduate Program, Federal University Rio Grande Norte, Natal, Brazil

    Nicole Oliver, Tatiana Onofre, Renata Carlos & Juliana Barbosa

  2. Hospital Universitário Onofre Lopes, Federal University Rio Grande Norte, Natal, Brazil

    Eudes Godoy

  3. Integrated Medicine Department, Federal University Rio Grande Norte, Natal, Brazil

    Eliane Pereira

  4. Physical Therapy Department, Federal University Rio Grande Norte, Rua Antônio Lopes Chaves, n° 626, Casa 15, Bairro Nova Parnamirim, Natal, Rio Grande do Norte, Brazil

    Ricardo O. Guerra & Selma Bruno

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  1. Nicole Oliver
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Correspondence to Selma Bruno.

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Oliver, N., Onofre, T., Carlos, R. et al. Ventilatory and Metabolic Response in the Incremental Shuttle and 6-Min Walking Tests Measured by Telemetry in Obese Patients Prior to Bariatric Surgery. OBES SURG 25, 1658–1665 (2015). https://doi.org/10.1007/s11695-014-1548-8

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  • DOI: https://doi.org/10.1007/s11695-014-1548-8

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