Towards a remote deployment of the assessment of physical capacities of patients with COPD: feasibility and validity of the 5STS

With the rise of pulmonary telerehabilitation, having an easy and reliable remote physical capacity assessment test is an important issue. The 5-repetition sit-to-stand test (5STS) is a good candidate, but two aspects must be studied before considering its remote implementation: its feasibility via videoconference (VC) and the existence of a learning effect (LE) which conditions administration and interpretation of the test. 40 stable COPD patients (21♀, 64±9 years) with a median FEV₁ of 44 [28/65] % were included. They carried out home-based 5STS, comprising 2 series (S1 and S2, 24-48h apart) of 5 trials (T1 to T5) each spaced with 5min rest. To evaluate remote feasibility, the number of non-included patients due to inability to use the VC and the number of connection failures were collected. LE was studied by comparing the time across each trial. Of 93 patients approached, 19 refused to participate, 16 had a medical contraindication and 18 had difficulties using VC. 6/40 included patients left the study due to computer failure, exacerbation, or unavailability. 6/67 series were not fully completed due to connection issues. A decrease in the time between the trials (Fr=75, p<0.001) was observed with a median of -1.57[−2.69/-0.81] sec between S1T1 and S1T5 (p<0.001). S1T5 was not significantly different from all times of S2 (all p>0.05), unlike S1T1, S1T2, S1T3, and S1T4. This study demonstrates the existence of a LE for the 5STS carried out remotely via VC and the necessity to perform 5 trials for its stabilization. Remote 5STS is feasible, but its deployment could be eased by material/technical support and must be conditioned by a procedure integrating LE.