Test‐Retest Reliability, Learning Effect and Measurement Error of the Modified Shuttle Test (MST) in Children With Asthma: A Multicenter Study
Lara Bezerra Radis, Vitória Cavalheiro Puzzi, Thaila Corsi Dias, Natielly Soares Correia, Jéssica Lane Felippe Montes, Mariana Mazzuca Reimberg, Fernanda Cordoba Lanza, Evelim Leal de Freitas Dantas Gomes, Cláudio Luiz Castro Gomes de Amorim, Karina Couto FurlanettoABSTRACT
Objective
To investigate test‐retest reliability, measurement error (standard error of measurement [SEM] and minimum detectable difference [MDD]), and the learning effect of the Modified Shuttle Test (MST) in children with asthma.
Methods
Multicenter cross‐sectional study including clinically stable children aged 6–12 years with asthma. Lung function and exercise capacity were assessed using MST. Intraclass Correlation Coefficient (ICC) was calculated to assess test‐retest reliability. The first and second tests were compared using the paired Student's t‐ test to assess differences between tests. SEM and MDD were calculated to quantify measurement error.
Results
One hundred and twenty three children were included (71 boys [57%]; median age 9 [7–10] years). The mean distance covered in the best MST was 611 ± 214 meters (confidence interval [95% CI] = 573–649meters). The MST showed an excellent test‐retest reliability (ICC = 0.96; 95% CI: 0.95–0.97). Distance was significantly lower in the second test than in the first (574 ± 218 vs. 601 ± 216 m; p = 0.0001). Learning effect was −27 ± 79 (4% ± 14%), the SEM was 56 meters (9.5%), and the MDD was 156 m (26.6%).
Conclusion
The MST demonstrated excellent test–retest reliability and acceptable measurement error for assessing exercise capacity in children with asthma. Although a systematic difference was observed between tests, there was no evidence of a consistent learning effect, with individual variability in repeated performance.