Heart rate response and clinical determinants of Glittre activities of daily living test performance in pediatrics with cystic fibrosis

Abstract

Abstract The Pediatric Glittre Activities of Daily Living Test (TGlittre-P) is a field test designed to assess the functional performance of activities of daily living (ADL) in pediatric patients with cystic fibrosis (CF). However, the effects of TGlittre-P on heart rate response and the clinical determinants of test performance in this population remain insufficiently understood. To compare the heart rate response elicited by the TGlittre-P and the six-minute walk test (6MWT), and to identify pulmonary and extrapulmonary factors associated with TGlittre-P performance in pediatric patients with CF. Fifty-four pediatric patients with CF (mean age = 14.46 ± 2.16 years, 31 females and 23 males) were included in this cross-sectional study. ADL performance was assessed using the TGlittre-P, and functional capacity was assessed using the 6MWT. Pulmonary function, including forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC), maximal inspiratory and expiratory pressure (MIP and MEP, respectively), handgrip strength (HGS %) and quadriceps muscle strength (QMS %) were measured. A multiple linear regression analysis model was used to determine independent predictors of TGlittre-P performance. The mean TGlittre-P duration was 2.00 ± 0.53 min. There was agreement between recorded peak heart rate (HRpeak) responses during the TGlittre-P and 6MWT (mean difference: -2.33%, with limits of agreement ranging from − 41.19 to 36.52). HRpeak (bpm), HRpeak (% predicted HRmax), and pre-to-post changes in systolic and diastolic blood pressure (mmHg), oxygen saturation (%), and perceived effort were not different between TGlittre-P and 6MWT (p > 0.05). TGlittre-P duration (min) correlated with 6MWT distance (m), FEV1 (%), FEV1z-score, FVC (%), FVC z-score, MIP (cmH2O), MEP (cmH2O), HGS (%) and QMS (%) (p < 0.05). The FEV1 z-score, height z-score and sex were predictors for TGlittre-P duration (min) [Adjusted R2 = 0.402, F(3, 53) = 11.755, p < 0.001, constant = 1.625]. No significant differences were observed in the measured heart rate response between the TGlittre-P and 6MWT. TGlittre-P performance is strongly associated with pulmonary function and respiratory and peripheral muscle strength. Airway obstruction was the strongest predictor of TGlittre-P performance in this population.