RELIABILITY OF INCREMENTAL SHUTTLE WALKING TEST IN RESTRICTIVE LUNG DISEASE: A SYSTEMATIC REVIEW.

Background: The incremental shuttle walk test is an externally paced field walking test that measures maximal exercise capacity and widely used in patients undergoing pulmonary rehabilitation. Objective: To evaluate the reliability of the Incremental Shuttle Walk Test (ISWT) in patients with restrictive lung diseases. Methods: Following PRISMA guidelines, a comprehensive search was conducted across databases such as PubMed, Web of Science, and Scopus up to July 2024. The results were organized in EndNote online. The reliability of the ISWT was assessed primarily through test- retest reliability in studies with participants suffering from restrictive lung diseases. Intraclass correlation coefficients (ICCs) served as the main measure for consistency. The studies included both cross-sectional and longitudinal designs, with repeated ISWT trials. An ICC greater than 0.80 confirmed excellent reliability, emphasizing the ISWT's effectiveness in measuring functional capacity. COSMIN guidelines were applied to evaluate the risk of bias (RoB) in the reliability studies. Results: The review identified seven studies assessing the test-retest reliability of the ISWT. The ICCs ranged from 0.88 to 0.97, indicating excellent reliability. Singh et al. (2018) reported an ICC of 0.91 (95% CI: 0.810.95), demonstrating consistent results between test sessions in patients with restrictive lung disease. These findings validate the ISWT as a reliable measure of exercise capacity in clinical settings. Conclusion: The ISWT shows excellent reliability in assessing functional exercise capacity in individuals with restrictive lung disease, supporting its clinical use for monitoring disease progression and treatment efficacy. Implications: The high test-retest reliability of the ISWT underscores its utility as a reliable assessment tool for exercise capacity in clinical settings.