Reliability and Responsiveness of Cardiopulmonary Exercise Testing in Fatigued Persons with Multiple Sclerosis and Low to Mild Disability

Background

Peak oxygen uptake (VO₂peak) via cardiopulmonary exercise testing is considered the gold standard for testing aerobic capacity in healthy participants and people with various medical conditions. The reliability and responsiveness of cardiopulmonary exercise testing outcomes in persons with MS (PwMS) have not been extensively studied.

Objective

(1) to investigate the reliability of cardiopulmonary exercise parameters in PwMS; (2) to determine the responsiveness, in terms of the smallest detectable change (SDC), for each parameter.

Design

Two repeated measurements of cardiopulmonary exercise outcomes were obtained, with a median time interval of 16 days.

Methods

Thirty-two PwMS suffering from subjective fatigue performed cardiopulmonary exercise tests on a cycle ergometer, to voluntary exhaustion. We calculated the reliability, in terms of the intra-class correlation coefficient (ICC [2,k]; absolute agreement), and the measurement error, in terms of standard error of measurement (SEM) and SDC at individual (SDC_individual) and group level (SDC_group).

Results

The ICC for VO₂peak was 0.951, with an SEM of 0.131 L∙min⁻¹ and an SDC_individual of 0.364 L∙min⁻¹. When corrected for bodyweight, the ICC of VO₂peak was 0.933, with an SEM of 1.7 mL∙kg⁻¹∙min⁻¹ and in an SDC_individual of 4.6 mL∙kg⁻¹∙min⁻¹.

Limitations

Generalization of our study results is restricted to fatigued PwMS with a low to mild level of disability.

Conclusions

At individual level, cardiopulmonary exercise testing can be used reliably to assess physical fitness in terms of VO₂peak, but less so to determine significant changes. At group level, VO₂peak can be reliably used to determine physical fitness status and establish change over time.