# Reliability and Validity of Laboratory and Field Cardiorespiratory Exercise Tests for Wheelchair Users: A Systematic Review

## TL;DR

This study reviews which cardio tests are reliable and valid for wheelchair users, finding some tests work but more research is needed.

## Contribution

The paper systematically evaluates the reliability and validity of cardio tests specifically for wheelchair users.

## Key findings

- Moderate evidence was found for reliability in one field test.
- Moderate evidence was found for validity in two lab and two field tests.
- Sample sizes in studies were small, limiting conclusions.

## Abstract

Background: cardiorespiratory fitness is one of the most important components of physical fitness. In this paper, we set out to identify cardiopulmonary tests evaluated for measurement properties in wheelchair users and determine which are reliable and valid for this population. Methods: Articles were collected from PubMed, Scopus, SPORTDiscus, and Web of Science. The initial search was conducted in October 2022 and updated in July 2023 for recent publications. From 1257 screened studies, 42 met the criteria: (a) participants were wheelchair users, (b) tests measured cardiorespiratory fitness, (c) test reliability or validity was reported, (d) articles were original, and (e) full text was in English. Two independent researchers extracted participant details (number, gender, age, disability) and test information, with a third researcher resolving disagreements. Statistical analyses of test reliability and validity were documented. Results: Methodological quality was assessed using the COSMIN checklist. Evidence levels for reliability and validity were established. Moderate evidence was found for reliability in one field test, and for validity in two lab and two field tests. Conclusions: While most tests show good reliability and validity, sample sizes are small, limiting conclusions. Further research is needed to strengthen the evidence and identify the most suitable tests for wheelchair users. Researchers are encouraged to replicate validation studies to support future testing.