Short-and long-term reliability of the 6-minute walk test in people with idiopathic pulmonary fibrosis

Anne E. Holland, Catherine J Hill, Leona Dowman, Ian Glaspole, Nicole Goh, Annemarie Louise Lee, Christine F McDonald

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

BACKGROUND: The aim of this work was to investigate the short-and long-term test-retest reliability of the 6-min walk distance (6MWD), peak heart rate, and nadir oxygen desaturation in idiopathic pulmonary fibrosis (IPF). METHODS: A reliability study of 70 adults with IPF was undertaken within out-patient pulmonary rehabilitation programs at 2 tertiary hospitals. Participants completed 2 baseline 6-min walk tests using a standard protocol, with continuous measures of percutaneous SpO2 and heart rate via pulse oximetry. The 6-min walk test was completed immediately following an intervention period and 6 months after. Reproducibility was assessed by intraclass correlation coefficient and Bland-Altman analysis. RESULTS: Participants with a mean = SD diffusing capacity of the lung for carbon monoxide of 48 = 14% were included. The reliability of the 6MWD was high (intraclass correlation coefficient = 0.96) with a mean learning effect of 21 m (95% CI 12–30 m). The learning effect persisted at 8 weeks (mean 14 m, 95% CI 5–23 m) but not 6 months (mean 15 m, 95% CI-1 to 30 m). Using the best (greatest) 6MWD significantly reduced the proportion of participants who were classified as having a clinically important response to rehabilitation compared with using the first 6MWD (40% vs 54%, P = .002). Nadir SpO2 was reproducible, with a mean difference of 0.7 = 2.2%, and limits of agreement of-4 to 5%. Peak heart rate was more variable, with mean difference 5 = 9 beats/min and limits of agreement of-12 to 20 beats/min. CONCLUSIONS: The 6MWD is a reproducible measure of exercise capacity in people with IPF. Whereas the nadir SpO2 may be accurately determined from one test, evaluating change in 6MWD with interventions may require 2 tests on each occasion. (ClinicalTrials.gov registration NCT0016828.) Key words: walk test; pulmonary fibrosis; reliability. [Respir Care 2018;63(8):994 –1001.

Original languageEnglish
Pages (from-to)994-1001
Number of pages8
JournalRespiratory care
Volume63
Issue number8
DOIs
Publication statusPublished - 1 Aug 2018

Cite this

@article{dda2010740b2408fa1e2062dbf810a4b,
title = "Short-and long-term reliability of the 6-minute walk test in people with idiopathic pulmonary fibrosis",
abstract = "BACKGROUND: The aim of this work was to investigate the short-and long-term test-retest reliability of the 6-min walk distance (6MWD), peak heart rate, and nadir oxygen desaturation in idiopathic pulmonary fibrosis (IPF). METHODS: A reliability study of 70 adults with IPF was undertaken within out-patient pulmonary rehabilitation programs at 2 tertiary hospitals. Participants completed 2 baseline 6-min walk tests using a standard protocol, with continuous measures of percutaneous SpO2 and heart rate via pulse oximetry. The 6-min walk test was completed immediately following an intervention period and 6 months after. Reproducibility was assessed by intraclass correlation coefficient and Bland-Altman analysis. RESULTS: Participants with a mean = SD diffusing capacity of the lung for carbon monoxide of 48 = 14{\%} were included. The reliability of the 6MWD was high (intraclass correlation coefficient = 0.96) with a mean learning effect of 21 m (95{\%} CI 12–30 m). The learning effect persisted at 8 weeks (mean 14 m, 95{\%} CI 5–23 m) but not 6 months (mean 15 m, 95{\%} CI-1 to 30 m). Using the best (greatest) 6MWD significantly reduced the proportion of participants who were classified as having a clinically important response to rehabilitation compared with using the first 6MWD (40{\%} vs 54{\%}, P = .002). Nadir SpO2 was reproducible, with a mean difference of 0.7 = 2.2{\%}, and limits of agreement of-4 to 5{\%}. Peak heart rate was more variable, with mean difference 5 = 9 beats/min and limits of agreement of-12 to 20 beats/min. CONCLUSIONS: The 6MWD is a reproducible measure of exercise capacity in people with IPF. Whereas the nadir SpO2 may be accurately determined from one test, evaluating change in 6MWD with interventions may require 2 tests on each occasion. (ClinicalTrials.gov registration NCT0016828.) Key words: walk test; pulmonary fibrosis; reliability. [Respir Care 2018;63(8):994 –1001.",
author = "Holland, {Anne E.} and Hill, {Catherine J} and Leona Dowman and Ian Glaspole and Nicole Goh and Lee, {Annemarie Louise} and McDonald, {Christine F}",
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Short-and long-term reliability of the 6-minute walk test in people with idiopathic pulmonary fibrosis. / Holland, Anne E.; Hill, Catherine J; Dowman, Leona; Glaspole, Ian; Goh, Nicole; Lee, Annemarie Louise; McDonald, Christine F.

In: Respiratory care, Vol. 63, No. 8, 01.08.2018, p. 994-1001.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Short-and long-term reliability of the 6-minute walk test in people with idiopathic pulmonary fibrosis

AU - Holland, Anne E.

AU - Hill, Catherine J

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AU - Glaspole, Ian

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AU - Lee, Annemarie Louise

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N2 - BACKGROUND: The aim of this work was to investigate the short-and long-term test-retest reliability of the 6-min walk distance (6MWD), peak heart rate, and nadir oxygen desaturation in idiopathic pulmonary fibrosis (IPF). METHODS: A reliability study of 70 adults with IPF was undertaken within out-patient pulmonary rehabilitation programs at 2 tertiary hospitals. Participants completed 2 baseline 6-min walk tests using a standard protocol, with continuous measures of percutaneous SpO2 and heart rate via pulse oximetry. The 6-min walk test was completed immediately following an intervention period and 6 months after. Reproducibility was assessed by intraclass correlation coefficient and Bland-Altman analysis. RESULTS: Participants with a mean = SD diffusing capacity of the lung for carbon monoxide of 48 = 14% were included. The reliability of the 6MWD was high (intraclass correlation coefficient = 0.96) with a mean learning effect of 21 m (95% CI 12–30 m). The learning effect persisted at 8 weeks (mean 14 m, 95% CI 5–23 m) but not 6 months (mean 15 m, 95% CI-1 to 30 m). Using the best (greatest) 6MWD significantly reduced the proportion of participants who were classified as having a clinically important response to rehabilitation compared with using the first 6MWD (40% vs 54%, P = .002). Nadir SpO2 was reproducible, with a mean difference of 0.7 = 2.2%, and limits of agreement of-4 to 5%. Peak heart rate was more variable, with mean difference 5 = 9 beats/min and limits of agreement of-12 to 20 beats/min. CONCLUSIONS: The 6MWD is a reproducible measure of exercise capacity in people with IPF. Whereas the nadir SpO2 may be accurately determined from one test, evaluating change in 6MWD with interventions may require 2 tests on each occasion. (ClinicalTrials.gov registration NCT0016828.) Key words: walk test; pulmonary fibrosis; reliability. [Respir Care 2018;63(8):994 –1001.

AB - BACKGROUND: The aim of this work was to investigate the short-and long-term test-retest reliability of the 6-min walk distance (6MWD), peak heart rate, and nadir oxygen desaturation in idiopathic pulmonary fibrosis (IPF). METHODS: A reliability study of 70 adults with IPF was undertaken within out-patient pulmonary rehabilitation programs at 2 tertiary hospitals. Participants completed 2 baseline 6-min walk tests using a standard protocol, with continuous measures of percutaneous SpO2 and heart rate via pulse oximetry. The 6-min walk test was completed immediately following an intervention period and 6 months after. Reproducibility was assessed by intraclass correlation coefficient and Bland-Altman analysis. RESULTS: Participants with a mean = SD diffusing capacity of the lung for carbon monoxide of 48 = 14% were included. The reliability of the 6MWD was high (intraclass correlation coefficient = 0.96) with a mean learning effect of 21 m (95% CI 12–30 m). The learning effect persisted at 8 weeks (mean 14 m, 95% CI 5–23 m) but not 6 months (mean 15 m, 95% CI-1 to 30 m). Using the best (greatest) 6MWD significantly reduced the proportion of participants who were classified as having a clinically important response to rehabilitation compared with using the first 6MWD (40% vs 54%, P = .002). Nadir SpO2 was reproducible, with a mean difference of 0.7 = 2.2%, and limits of agreement of-4 to 5%. Peak heart rate was more variable, with mean difference 5 = 9 beats/min and limits of agreement of-12 to 20 beats/min. CONCLUSIONS: The 6MWD is a reproducible measure of exercise capacity in people with IPF. Whereas the nadir SpO2 may be accurately determined from one test, evaluating change in 6MWD with interventions may require 2 tests on each occasion. (ClinicalTrials.gov registration NCT0016828.) Key words: walk test; pulmonary fibrosis; reliability. [Respir Care 2018;63(8):994 –1001.

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