Validity and reliability of cardiopulmonary tests for people with disabilities: a sistematic review

Abstract

Background Physical fitness, and especially cardiorespiratory fitness, are very important indicators of health in the general population, and even more so in people with disabilities. In order to measure cardiorespiratory fitness correctly, it is necessary to use valid and reliable tests, and to do so, these psychometric properties must be measured beforehand. Objective The aim of this systematic review is to know which cardiopulmonary tests have been evaluated for psychometric properties in people with disabilities and which of these tests are reliable and valid for this population. Methods PubMed, Scopus, SPORTDiscus and Web of Science databases were searched on 30 November 2020. After screening 563 studies, 35 articles met the inclusion criteria: a) participants had any physical, intellectual or sensory disability; b) the test under study measured cardiorespiratory fitness; c) the article provided information on reliability or validity of the test; and d) studies must be original articles. The quality of the studies was assessed according to the COSMIN checklist and this was taken into account when establishing the evidence for each test. Results Data from a total of 1126 people (370 females and 756 males) have been included in this review, analysing 29 different tests. 23 studies had people with intellectual disabilities as a population, 10 had people with physical disabilities and there were only 2 articles with people with visual disabilities. Conclusion In people with intellectual disabilities (including those with Down's Syndrome) the six-minute walking test and the shuttle run tests (16 and 20 metre versions) appear to be the tests with the best reliability and validity and the Gold Standard is considered to be an incremental treadmill test. In people with physical disabilities no clear conclusions could be drawn, as the literature seems to be scattered. The incremental wheelchair test has been proposed as a possible Gold Standard versus the arm crank ergometer test for wheelchair-dependent people or wheelchair sports players. In visually impaired people there are very few studies and more research is needed.