Measurement Properties of Aerobic Capacity Measures in Neuromuscular Diseases: A Systematic Review.
Tim Veneman, Fieke Sophia Koopman, Joost Daams and 2 others
PMID 35307744WHAT IT FOUND
Evidence for aerobic capacity tests in neuromuscular diseases is very low.
Maximal oxygen uptake testing is often incomplete, and the six-minute walk test predicts it poorly in spinal muscular atrophy. Do not rely on these scores to track patient progress or prescribe exercise intensity without caution.
Key findings
01Low-quality evidence supports the content validity of VO2peak measured through maximal exercise testing, but 113 of 136 participants met criteria across studies.
02Criterion validity of the six-minute walk test distance was rated sufficient in Pompe disease but insufficient in spinal muscular atrophy.
03No studies in this review investigated the reliability or responsiveness of aerobic capacity measures in neuromuscular diseases.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included only nine studies with small sample sizes (4 to 44 participants), which severely limits the precision of the findings. No studies reported on the reliability or responsiveness of aerobic capacity measures, so clinicians cannot know if these tests are stable over time or sensitive to change. The criteria used to define maximal exercise varied between studies, and in many cases, participants did not meet standard physiological thresholds for maximal effort, casting doubt on the validity of the VO2peak values reported. The search was limited to English, German, and Dutch publications, potentially missing relevant studies. The COSMIN risk of bias checklist had to be adjusted for aerobic capacity measures, which may affect the validity of the bias assessment.
Declared interests
The study was funded by the Post-polio Health International (PHI) research grant. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that the six-minute walk test accurately measures aerobic capacity in all neuromuscular diseases. It was rated insufficient for spinal muscular atrophy but sufficient for Pompe disease. Furthermore, because no studies assessed reliability or responsiveness, you cannot assume that a change in test score reflects a real change in the patient's aerobic capacity.