Activities involving the upper limbs are part of daily life in home, work, or leisure environments. However, children and adolescents with chronic lung disease, in certain situations, may experience limitations in the use of their upper limbs (UL), such as reduced strength and endurance of the UL. UL. Much is known about the Unsupported Upper Limb Exercise Test (UULEX) and Six-Minute Peg Board Ring Test (6MBRT) in adult individuals, but there is no description in the literature regarding the use of UULEX and 6MBRT in the pediatric population.

To evaluate the feasibility and reproducibility of two field clinical tests for upper limbs (Unsupported Upper Limb Exercise Test - UULEX and Six-Minute Pegboard Ring Test - 6PBRT) in children and adolescents.

Feasibility study. Fifteen healthy volunteers aged 6 to 17 years were included. Spirometry was performed, followed by randomization of three tests: Cardiopulmonary Exercise Test (CPET) or UULEX or 6PBRT. The CPET was performed on an upper limb ergometer with a load increment protocol every minute. For UULEX, the volunteer sits in front of a panel and raises their arms while holding bars of different weights (0.25 kg to 2.0 kg) at different heights; outcome: execution time. For 6PBRT, the volunteer sits in front of a panel with four pins (two upper and two lower) and moves rings from the lower pins to the upper ones (and vice versa) for six consecutive minutes; outcome: number of rings moved. For all tests, maximum oxygen consumption (VO2peak) and peak ventilation per minute (VEpeak) were also evaluated as outcomes. The UULEX and 6PBRT were performed twice each (test and retest), with a 30-minute interval between each. For feasibility, less than 15% of volunteers could reach the ceiling effect and/or floor effect.

Volunteers were 11 years (9-15 years), and normal pulmonary function (FVC, FEV1, FEV1/FVC > 80% predicted). The UULEX time in the test and retest was 9.5 min [8.0 - 12.0 min] vs. 9.4 min [8.2 - 12.0 min], respectively; and the number of rings in the 6PBRT was 299 [258 - 373] vs. 340 [244 - 387], respectively, p > 0.05. The CPET showed higher VO2peak 22.8 (19.4 – 26) mL/kg compared to UULEX at 11.8 (10.2 - 13.6) mL/kg and to 6PBRT 11.6 (9 – 12) mL/kg, p = 0.001. The VEpeak was higher at CPET 31.5 (22.9 - 33.9) L/min compared to UULEX 19.7 (15.6 - 23.1) L/min) and to 6PBRT 14.4 (12.2 - 19.3) L/min), p = 0.001 The ICC for the test and retest of UULEX was 0.93 (0.78 - 0.97) p < 0.001, and for 6PBRT was 0.97 (0.91 - 0.99) p < 0.001. Two volunteers (13%) achieving celling effect at UULEX, and no floor effect for any field test.

The UULEX and 6PBRT are feasible and reproducible field tests for upper limbs in children and adolescents, have lower metabolic demand compared to CPET. It provides an alternative to assess upper limbs pediatric population.

New upper limb test for the pediatric population.