Correlation of subjective questionnaires with cardiac function as determined by exercise testing in a pediatric population

Rebekah Burns, Inger Olson, Jeffrey Kazmucha, Raymond Balise, Rita Chin, Clifford Chin

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Although exercise testing is an important objective method used to assess cardiopulmonary function, subjective assessment often is used as a proxy in the clinical setting. This study aimed to determine whether responses to a subjective functional capacity questionnaire administered to parents and patients in a pediatric exercise laboratory correlate with objective assessment of functional capacity, measured by peak oxygen consumption during maximal voluntary exercise testing. Methods: Subjective questionnaire responses and exercise test results collected over 10 years were retrospectively analyzed. Symptoms and physical capabilities were assessed using a 6-point Likert scale regarding the ability to attend school/work, walk, climb stairs, and run, as well as the frequency of fatigue, palpitations, and chest pain. Values of 0 to 3 were considered abnormal, whereas values of 4-5 were regarded as normal. Exercise testing was performed on a stationary cycle ergometer with a continuous ramping protocol. Heart rate and oxygen saturation were continuously monitored. Blood pressures and electrocardiograms (ECGs) were obtained at 2-min intervals. Metabolic gas analysis was performed using a breath-by-breath method. The results of the exercise testing were normalized for body size and expressed as a percentage of predicted peak oxygen consumption (%pVO2). Results: Very weak but statistically significant correlations (τ < 0.25; P < 0.05) between the scores of the school/work, walking, stair climbing, running, and fatigue items and %pVO2 were found using Kendall's rank correlations. Conclusions: The subjective Likert scales used to assess basic physical capacity and cardiac-associated symptoms have limited ability to predict actual functional capacity as measured by %pVO2 achieved. The very weak rank-order correlation between %pVO2 achieved and the subjective reporting of the ability to attend school/work, walk, climb stairs, and run has low clinical significance and will not be useful in predicting functional capacity within the clinic setting.

Original languageEnglish (US)
Pages (from-to)1043-1048
Number of pages6
JournalPediatric Cardiology
Volume31
Issue number7
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

Exercise
Pediatrics
Aptitude
Population
Oxygen Consumption
Fatigue
Body Size
Proxy
Chest Pain
Exercise Test
Running
Walking
Electrocardiography
Heart Rate
Gases
Parents
Surveys and Questionnaires
Oxygen
Blood Pressure
Stair Climbing

Keywords

  • Exercise
  • Pediatric
  • Questionnaire

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Correlation of subjective questionnaires with cardiac function as determined by exercise testing in a pediatric population. / Burns, Rebekah; Olson, Inger; Kazmucha, Jeffrey; Balise, Raymond; Chin, Rita; Chin, Clifford.

In: Pediatric Cardiology, Vol. 31, No. 7, 10.2010, p. 1043-1048.

Research output: Contribution to journalArticle

Burns, Rebekah ; Olson, Inger ; Kazmucha, Jeffrey ; Balise, Raymond ; Chin, Rita ; Chin, Clifford. / Correlation of subjective questionnaires with cardiac function as determined by exercise testing in a pediatric population. In: Pediatric Cardiology. 2010 ; Vol. 31, No. 7. pp. 1043-1048.
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AB - Background: Although exercise testing is an important objective method used to assess cardiopulmonary function, subjective assessment often is used as a proxy in the clinical setting. This study aimed to determine whether responses to a subjective functional capacity questionnaire administered to parents and patients in a pediatric exercise laboratory correlate with objective assessment of functional capacity, measured by peak oxygen consumption during maximal voluntary exercise testing. Methods: Subjective questionnaire responses and exercise test results collected over 10 years were retrospectively analyzed. Symptoms and physical capabilities were assessed using a 6-point Likert scale regarding the ability to attend school/work, walk, climb stairs, and run, as well as the frequency of fatigue, palpitations, and chest pain. Values of 0 to 3 were considered abnormal, whereas values of 4-5 were regarded as normal. Exercise testing was performed on a stationary cycle ergometer with a continuous ramping protocol. Heart rate and oxygen saturation were continuously monitored. Blood pressures and electrocardiograms (ECGs) were obtained at 2-min intervals. Metabolic gas analysis was performed using a breath-by-breath method. The results of the exercise testing were normalized for body size and expressed as a percentage of predicted peak oxygen consumption (%pVO2). Results: Very weak but statistically significant correlations (τ < 0.25; P < 0.05) between the scores of the school/work, walking, stair climbing, running, and fatigue items and %pVO2 were found using Kendall's rank correlations. Conclusions: The subjective Likert scales used to assess basic physical capacity and cardiac-associated symptoms have limited ability to predict actual functional capacity as measured by %pVO2 achieved. The very weak rank-order correlation between %pVO2 achieved and the subjective reporting of the ability to attend school/work, walk, climb stairs, and run has low clinical significance and will not be useful in predicting functional capacity within the clinic setting.

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