The PAY test: a new approach for assessing functional performance in children and adolescents with asthma

ABSTRACT

Abstract Objective: To develop, validate, and test the reproducibility of a new test capable of assessing functional performance in children and adolescents (PAY test Performance Activity in Youth). Methods: participants without and with asthma were included in the development and validation phases, respectively. The PAY test includes five activities transition from sitting to standing, walking 10 m, step climbing, shoulder extension and flexion, and star jumps. Participants underwent the Pediatric Glittre test (TGlittre-P test time), modified shuttle test (MST), and cardiopulmonary exercise test (CPET). Outcomes: PAY test and TGlittre-P test times, oxygen uptake (VO2peak), and distance walked in the MST. Results: 8 healthy volunteers, aged 12 (7 -15) years old were included in the development phase and 34 participants with asthma, aged 11 (7-14) years old, in the validation phase. The PAY test elicited greater physiological responses (VO2peak 33.5 ± 6.9 mL/kg) than the TGlittre-P (VO2peak 27.4 ± 9.0 mL/kg), but lower than the MST (VO2peak 48.9 ± 14.2 mL/kg) and CPET (VO2peak 42.0 ± 8.8 mL/kg), p < .05. Moderate correlation between the PAY test time and the TGlittre-P time (r = 0.70, p < .001) and distance walked in the MST (r = -0.72, p < .001). The PAY test time was longer in participants with asthma than in healthy participants (3.1 [3.0 - 3.3] min vs. 2.3 [2.1 - 2.4 min]), p < .001.; and the test was reproducible (ICC 0.78, CI 95% 0.55-0.90, p < .001). Conclusions: The PAY test is a valid and reproducible tool for assessing functional performance in children and adolescents with asthma.