Long-term reliability of the incremental shuttle walking test in clinically stable cardiovascular disease patients

Physiotherapy. 2010 Sep;96(3):222-7. doi: 10.1016/j.physio.2009.11.010. Epub 2010 Jan 25.


Objective: The incremental shuttle walking test (ISWT) is a valuable tool for assessing changes in patients' functional capacity during cardiac rehabilitation. However, studies have only assessed its test-retest reliability in the short term. The purpose of this study was to examine long-term test-retest reliability of the ISWT in clinically stable cardiac patients.

Design: Test-retest reliability assessment.

Setting: Continuous, community-based phase IV cardiac rehabilitation centre.

Participants: Thirty patients with cardiovascular disease (15 males, 15 females; age 55 to 80 years) volunteered to participate in the study.

Interventions: Participants undertook two ISWTs, a minimum of 8 weeks apart.

Main outcome measures: ISWT performance in metres.

Results: Overall, the mean distance walked in the pre-test was 502+/-161m and this did not differ from test to retest. The intraclass correlation coefficient was 0.80, indicating good test-retest reliability. Using the Bland and Altman method, there was a small mean test-retest difference (-7m). The 95% limits of agreement were large, ranging from -203m to 189m.

Conclusions: Over long test-retest durations, there appears to be no learning effect in the ISWT, negating the need for a practice walk. The long-term random variation in the ISWT test is larger than in previous studies, probably due to greater physiological and psychological variation in the participants over 8 weeks compared with that seen in day-to-day testing. Factors influencing long-term test-retest reliability of the ISWT require further elucidation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiac Rehabilitation*
  • Exercise Test / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Rehabilitation Centers
  • Walking*