Key result
The Siconolfi step test provided a valid prediction of cardiopulmonary fitness in men over 60 years old with prostate cancer, with a non-significant mean difference of 0.64 ml/kg/min compared to the gold standard cardiopulmonary exercise test.
Why the study?
CPET is the gold standard for cardiopulmonary fitness assessment but requires expensive equipment and may not always be appropriate, whereas the simpler and cheaper Siconolfi step test could provide an alternative.
Does the Siconolfi step test provide a valid and reliable alternative to the cardiopulmonary exercise test for assessing cardiopulmonary fitness in older men with prostate cancer?
Observational (n=83)
Yes
Does the Siconolfi step test provide a valid and reliable alternative to the cardiopulmonary exercise test for assessing cardiopulmonary fitness in older men with prostate cancer?
Mean Difference: 0.64 (95% CI -0.38–1.66)
Absolute Event Rate: 19.2% vs 19.8%
p-value: p=0.217
The Siconolfi step test is a valid, reliable, and low-cost alternative to CPET for assessing cardiopulmonary fitness in men over 60 with prostate cancer, though it underestimates fitness in younger men.
May support Siconolfi step test for fitness assessment in older prostate cancer patients; leaves open prospective validation.
Assessing fitness and promoting regular physical activity can improve health outcomes and early recovery in prostate cancer. This is however, underutilised in clinical practice. The cardiopulmonary exercise test (CPET) is increasingly being used pre-treatment to measure aerobic capacity and peak oxygen consumption (VO 2 peak - a gold standard in cardiopulmonary fitness assessment). However, CPET requires expensive equipment and may not always be appropriate. The Siconolfi step test (SST) is simpler and cheaper, and could provide an alternative. The aim of this study was to evaluate the validity and reliability of SST for predicting cardiopulmonary fitness in men with prostate cancer. Men were recruited to this two-centre study (Surrey and Newcastle, United Kingdom) after treatment for locally advanced prostate cancer. They had one or more of three risk factors: elevated blood pressure, overweight (BMI > 25), or androgen deprivation therapy (ADT). Cardiopulmonary fitness was measured using SST and cycle ergometry CPET, at two visits three months apart. The validity of SST was assessed by comparing it to CPET. The VO 2 peak predicted from SST was compared to the VO 2 peak directly measured with CPET. The reliability of SST was assessed by comparing repeated measures. Bland-Altman analysis was used to derive limits of agreement in validity and reliability analysis. Sixty-six men provided data for both SST and CPET. These data were used for validity analysis. 56 men provided SST data on both visits. These data were used for reliability analysis. SST provided valid prediction of the cardiopulmonary fitness in men > 60 years old. The average difference between CPET and SST was 0.64 ml/kg/min with non-significant positive bias towards CPET ( P = 0.217). Bland-Altman 95% limits of agreement of SST with CPET were ± 7.62 ml/kg/min. SST was reliable across the whole age range. Predicted VO 2 peak was on average 0.53 ml/kg/min higher at Visit 2 than at Visit 1 ( P = 0.181). Bland-Altman 95% limits of agreement between repeated SST measures were ± 5.84 ml/kg/min. SST provides a valid and reliable alternative to CPET for the assessment of cardiopulmonary fitness in older men with prostate cancer. Caution is advised when assessing men 60 years old or younger because the VO 2 peak predicted with SST was significantly lower than that measured with CPET.
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Lemańska et al. (2019) conducted an observational in Prostate cancer (n=83). Siconolfi step test vs. Cardiopulmonary exercise test was evaluated on Difference in predicted vs measured VO2peak in men > 60 years old (MD 0.64 ml/kg/min, 95% CI -0.38-1.66, p=0.217). The Siconolfi step test provided a valid prediction of cardiopulmonary fitness in men over 60 years old with prostate cancer, with a non-significant mean difference of 0.64 ml/kg/min compared to the gold standard cardiopulmonary exercise test.
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