Glittre-ADL test to assess functional capacity in patients with heart failure and reduced ejection fraction: Reproducibility, minimal detectable change, and cutoff point

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Brazil)), 2024-11, Vol.28 (6), p.101144, Article 101144
• Main Authors: Leite, Jéssica Costa, Dornelas de Andrade, Armele, Araújo, Bruna T.S., Nunes da Hora, Endy Bianca, Figueiredo, Thainá de Gomes, da Silva, Josicléia Leôncio, Remígio de Aguiar, Maria Inês, Martins, Sílvia Marinho, Campos, Shirley Lima, Brandão, Daniella Cunha
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Cardiac insufficiency; Cross-Sectional Studies; Exercise Test - methods; Exercise tolerance; Heart Failure - physiopathology; Heart function tests; Humans; Middle Aged; Original Research; Oxygen Consumption - physiology; Reproducibility of Results; ROC Curve; Sensitivity and specificity; Stroke Volume - physiology; Submaximal exercise
• ISSN: 1413-3555; 1809-9246; 1809-9246
• DOI: 10.1016/j.bjpt.2024.101144

•Heart failure (HF) that causes fatigue and dyspnea at rest and during exercise.•Maximum tests do not reflect limitations in activities of daily living.•Activities of daily living performance is better predicted using functional tests.•The cutoff point of the Glittre-ADL test can identify patients with severe HF.•Glittre-ADL test is capable of predicting the prognosis of patients with HF. Cardiopulmonary exercise testing (CPET) is the gold standard for functional capacity assessment, although it is costly and not easily accessible. The Glittre-ADL test may be a low-cost alternative for patients with heart failure. To establish a cutoff point for functional capacity of patients with heart failure using the Glittre-ADL test. We also assessed agreement, reliability, and minimal detectable change. This cross-sectional study was conducted with 78 patients (aged 21 to 65 years) with heart failure and reduced ejection fraction (functional classes II and III of the New York Heart Association). Test-retest reliability was measured using the intraclass correlation coefficient (ICC), while receiver operating characteristic (ROC) curves were used to determine whether ADL-time, could distinguish between patients with peak oxygen consumption (VO2peak) < 16 versus those ≥ 16 ml/kg/min. A cutoff point of 255 s (76 % sensitivity [95 % CI 58, 89] and 72 % specificity [95 % CI 56, 85]) was established based on the total time spent on Glittre-ADL test; the area under the curve was 0.773 (95 % CI 0.663, 0.861; p < 0.0001). Regarding agreement, a significant correlation was found between test and retest (r = 0.83, r2 = 0.69, p < 0.001). Intraclass correlation coefficient, absolute reliability, and minimal detectable change were 0.84 (95 % CI 0.45, 0.94; p < 0.001), 3.2 %, and 8.8 % (23.1 s), respectively. Glittre-ADL test showed good reproducibility in repeated tests. Thus, the cutoff point established by our study can be used in clinical practice instead of CPET to identify patients with severe heart failure.