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8-Foot-Up-and-Go Test is Associated with Hospitalizations and Mortality in Idiopathic Pulmonary Fibrosis: A Prospective Pilot Study

  • Baruch Vainshelboim
  • Mordechai Reuven Kramer
  • Jonathan Myers
  • Avraham Unterman
  • Shimon Izhakian
  • Jose Oliveira
INTERSTITIAL LUNG DISEASE
  • 17 Downloads

Abstract

Purpose

To assess the prognostic value of the 8-foot-up-and-go test (8-FUGT) in pilot cohort of patients with idiopathic pulmonary fibrosis (IPF).

Methods

Thirty-four patients with IPF (68 ± 8 years) underwent 8-FUGT at baseline and were followed for up to 40 months. Receiver operating characteristics and age-adjusted Cox hazard ratios (HR) were analyzed for 8-FUGT, hospitalizations, and mortality. Correlation coefficients were determined between 8-FUGT and other exercise tests.

Results

8-FUGT ≥ 6.9 s was found to be associated with hospitalization (sensitivity = 77%, specificity = 76%, p = 0.03) and mortality (sensitivity = 91%, specificity = 70% p = 0.008) in patients with IPF. Categorical models demonstrated that 8-FUGT ≥ 6.9 s was associated with 14.1- (p < 0.001) and 55.4-fold (p = 0.001) increased risks for hospitalization and mortality, respectively. In continuous models, for every 1-s slower performance in the 8-FUGT there were 54% [HR = 1.54, 95% CI (1.11–2.15) p = 0.01] increased risk for hospitalization and 94% [HR = 1.94, 95% CI (1.26–2.99) p = 0.003] increased risk for mortality. 8-FUGT was inversely related to 6-min walk distance (r = − 0.61), peak oxygen consumption (r = − 0.58), and peak work rate (r = − 0.72), all p < 0.001.

Conclusions

The 8-FUGT was strongly associated with hospitalizations and mortality in patients with IPF, as well as correlated with established prognostic markers. These novel findings suggest a prognostic value of the 8-FUGT for risk stratification, referral to pulmonary rehabilitation, and considering listing for lung transplantation. 8-FUGT is an inexpensive and practical tool that has prospective for implementation in clinical and research settings in IPF. Future prospective studies should evaluate the effect of changes in 8-FUGT on clinical outcomes.

Trial registration

NCT01499745, Clinicaltrials.gov.

Keywords

Functional capacity Survival Prognostic predictors Risk stratification Clinical outcomes 

Notes

Author Contributions

BV was responsible for study design and conception, data collection, results interpretation, statistical analysis, drafting, writing, and submitting the manuscript. MRK supervising physician of the study was responsible for study design and conception, results interpretation, drafting the article, and revising it critically for important intellectual content. JM was involved in results interpretation, statistical analysis, drafting the article, and revising it critically for important intellectual content. AU and SI participated in results interpretation, statistical analysis, drafting the article, and revising it critically for important intellectual content. JO was involved in study design and conception, results interpretation, statistical analysis, drafting the article, and revising it critically for important intellectual content. All authors have read and approved the manuscript.

Funding

No funding was received for this study.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Master of Cancer Care Program, School of Health SciencesSaint Francis UniversityLorettoUSA
  2. 2.Pulmonary InstituteRabin Medical Center, Beilinson HospitalPetach TikvaIsrael
  3. 3.Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of SportUniversity of PortoPortoPortugal
  4. 4.Cardiology DivisionVeterans Affairs Palo Alto Health Care System/Stanford UniversityPalo AltoUSA
  5. 5.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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