Showing papers by "Gordon H. Guyatt published in 1984"
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TL;DR: The results demonstrate the need for careful standardisation of the performance of walking tests, and suggest caution in interpreting studies in which standardisation is not a major feature of the study design.
Abstract: Walking tests, frequently used to document effects of treatment on exercise capacity, have never been standardised. We studied the effects of encouragement on walking test performance in a randomised study that controlled for the nature of the underlying disease, time of day, and order effects. We randomised 43 patients with chronic airflow limitation or chronic heart failure or both to receive or not receive encouragement as they performed serial two and six minute walks every fortnight for 10 weeks. Simple encouragement improved performance (p less than 0.02 for the six minute walk), and the magnitude of the effect was similar to that reported for patients in studies purporting to show beneficial effects of therapeutic manoeuvres. Age and test repetition also affected performance. These results demonstrate the need for careful standardisation of the performance of walking tests, and suggest caution in interpreting studies in which standardisation is not a major feature of the study design.
804 citations
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TL;DR: The available evidence does not substantiate a causal role of exogenous adrenocorticosteroids in producing clinically important osteoporosis, and does not support withholding steroid therapy on the basis of fears of osteop orosis induced pain and disability.
29 citations
01 Jan 1984
TL;DR: The need for careful standardisation of walking test performance is demonstrated, and caution is suggested ininterpreting studies in which standardisation is not a major feature of the study design.
Abstract: ABSTRACr Walking tests, frequently usedtodocument effects oftreatment on exercise capacity, haveneverbeenstandardised. We studied theeffects ofencouragement on walking testperformance inarandomised study that controlled forthenatureoftheunderlying disease, timeofday, andorder effects. We randomised 43patients withchronic airflow limitation orchronic heart failure or bothtoreceive or notreceive encouragement astheyperformed serial twoandsix minute walks everyfortnight for10weeks. Simple encouragement improved performance (p< 0*02forthesixminute walk), andthemagnitude oftheeffect was similar tothatreported for patients instudies purporting toshowbeneficial effects oftherapeutic manoeuvres.Ageandtest repetition also affected performance. Theseresults demonstrate theneedforcareful standardisationoftheperformance ofwalking tests, andsuggest caution ininterpreting studies inwhich standardisation isnota majorfeature ofthestudy design. In1976McGavinetalintroduced the12minute walking test asameasure ofexercise capacity for patients withchronic lungdisease.' Since thattime walking tests, whicharesimple, easytoadminister, anduseanexercise moderelevant toeveryday activities havebeenwidely usedasmeasures ofoutcomeinclinical trials. Interventions whichhave beeninvestigated withwalking tests inpatients with chronic lungdisease include exercise rehabilitation programmes,2-4 ventilatory muscle training,5-7 and theeffects ofoxygen8 9andofvarious drugs, includingcarbimazole,'0 prednisone," naftidrofuryl,'2 bronchodilators,'3 andsedatives.'4 Although most