Changes Observed in the 6-minute Walk Test in Response to Exercise-based Cardiac Rehabilitation

Abstract

Objectives: The six-minute walk test (6MWT) is widely used in exercise based cardiac rehabilitation (EBCR) for assessment of functional capacity. The purpose of this study was to assess the effect of structured exercise in an EBCR program on 6MWT change and to determine the significance of age, gender, body mass index (BMI), pathology and exercise attendance on influencing this outcome.Methods: Data from a single centre 6-week (twice weekly exercise and education of one-hour duration) exercise-based cardiac rehabilitation program were analysed. Between 2006 and 2019, 2524 patients (males 1923, females 601, mean age 63.5 ± 11.2 years) with cardiovascular disease completed a pre and post 6MWT. Analysis included the effect of age, gender, pathology, BMI and exercise attendance on 6MWT outcome.Results: The group mean improvement in the 6MWT was 21.8% (pre 6MWT 432 ± 83, post 6MWT 527 ± 102 metres). The age-related improvement showed that both males and females achieved a post 6MWT results equivalent to the pre 6MWT result of patients two decades younger with improvement in the 6MWT unrelated to exercise attendance.Conclusions: The 6MWT provides simple safe method for assessment of functional capacity in an out-of-hospital environment being suitable for all ages. The post EBCR 6MWT results showed a group mean improvement in excess of 20% for both sexes. The decline per decade in 6MWT distance is less than 20 metres up to the sixth decade with a more marked decline from the sixth to the eighth decade, the decline being approximately 40-metres for both sexes in the eighth decade.

Nurse-Led Cardiac Rehabilitation Care Coordination Program

“…Increases in the 6MWT from baseline to CR Phase 2 completion were 28% and 26% higher for the pre- and post-intervention groups, respectively. The functional gains for the post-intervention group are consistent with those from a study of 2524 patients who completed CR 20. For the 6MWT, the patients in the study (age 63.5 ± 11.2 yr) walked 1382.9 ± 267.4 ft at enrollment and 1679.8 ± 313.3 ft at program completion, which typically occurred after 12 sessions.…”

“…The functional gains for the post-intervention group are consistent with those from a study of 2524 patients who completed CR. 20 For the 6MWT, the patients in the study (age 63.5 ± 11.2 yr) walked 1382.9 ± 267.4 ft at enrollment and 1679.8 ± 313.3 ft at program completion, which typically occurred after 12 sessions. Their 6MWT enrollment and completion scores representing a 20.8% improvement compare similarly to this study's post-intervention group.…”

National survey of Australian cardiac rehabilitation programmes: does current exercise programming adhere to evidence-based guidelines and best practice?

“…Consequently, the 6MWT is recommended in European guidelines as an accepted assessment of exercise tolerance in CR, where access to an exercise stress test is not possible 23. In the Australian context, where our study found a low uptake of exercise capacity assessments, 6MWT may be a useful alternate method of assessing the functional response to CR, where mean pre–post improvement has been reported to exceed 20% in a single-centre study of 2524 CR participants 24. However, observational data from Australia suggest that exercise capacity assessments are needed in practice to accurately classify initial exercise capacity and subsequently tailor exercise prescription in CR 25…”

“…23 In the Australian context, where our study found a low uptake of exercise capacity assessments, 6MWT may be a useful alternate method of assessing the functional response to CR, where mean pre-post improvement has been reported to exceed 20% in a single-centre study of 2524 CR participants. 24 However, observational data from Australia suggest that exercise capacity assessments are needed in practice to accurately classify initial exercise capacity and subsequently tailor exercise prescription in CR. 25 The specific assessment of resting ECG is recommended in major North American and European guidelines, 23 26 despite the inconclusive prognostic benefit in high-risk cohorts.…”

The Relationship Between Self-Efficacy and Functional Capacity Among Discharged Heart Failure Patients in Jordan

“…It is a widely used and easy-to-use applicable tool for measuring the functional capacity of HFPs. 14 The 6-MWT is a reliable test and has been previously used in many populations, including healthy adults, 15 people with osteoarthritis, 16 cardiac patients, 17 patients with respiratory diseases, 18 and HFPs. 19 The 6-MWT is a simple test that requires no expensive equipment or substantial technician training.…”