Comparison between 20 and 30 meters in walkway length affecting the 6-minute walk test in patients with chronic obstructive pulmonary disease: A randomized crossover study

Abstract

Background A 30-m walkway length for the 6-minute walk test (6MWT) is the standard recommendation established by the American Thoracic Society to assess patients with chronic obstructive pulmonary disease (COPD). This study aimed to compare between the distances of 20 and 30 m long corridor affecting 6MWT in COPD patients. Methods A randomized crossover study was conducted with patients. COPD patients were randomized 1:1 to either a 20-m or a 30-m walkway in the first test, then switched to the other in the second test. Physiologic parameters and 6-minute walking distance (6MWD) were recorded. Results Fifty subjects (92% men) were included: age 69.1±7.4 years, body mass index 22.9±5.5 kg/m2, FEV1 63.0±21.3%, and 50% having cardiovascular disease. The 6MWD in a 20-m and a 30-m walkway were 337.82±71.80 m and 359.85±77.25 m, respectively (P<0.001). Mean distance difference was 22.03 m (95% CI -28.29 to -15.76, P<0.001). Patients with a 20-m walkway had more turns than those with a 30-m walkway (mean difference of 4.88 turns, 95% CI 4.48 to 5.28, P<0.001). Also, higher systolic blood pressure was found in patients with a 20-m walkway after 6MWT (4.62 mmHg, P = 0.019). Other parameters and Borg dyspnea scale did not differ. Conclusions The walkway length had significant effect on walking distance in COPD patients. A 30-m walkway length should still be recommended in 6MWT for COPD assessment. Clinical trial registration Clinicaltrials.in.th number: TCTR20200206003.

Ergospirometric testing: a modern approach to the diagnosis of physical health

“…This shows that the treadmill test may underestimate the functional capacity of individuals with COPD. These findings may be due to particular group or due to more stress associated with ergospirometric testing like treadmill [40]. In addition, another study conducted to evaluate the accuracy of the six-minute walk test in children with congenital heart disease determined specific values that can be used to categorize physical fitness and found connections with variables from the cardiopulmonary exercise test stressing on the use of the traditional testing like 6-minute walk testing as compared to treadmill Ergospirometric testing [41].…”

The modified Borg/6-min walk distance ratio: a method to assess exertional breathlessness and leg discomfort using the 6-min walk test

“…A 20-m course was used in CanCOLD study for feasibility across all nine participating sites [18]. Data on differences when using a 20-m compared with a 30-m course are conflicting, with some studies reporting a lower 6WMD (possibly due to more frequent turns) [15,[34][35][36], whereas other studies report no difference in 6MWD between the different course lengths [14,37,38]. Symptom intensity ratings at the end of the 6MWT were reported to be similar between using a 20-m and 30-m walking course [15,[34][35][36][37][38].…”

“…Data on differences when using a 20-m compared with a 30-m course are conflicting, with some studies reporting a lower 6WMD (possibly due to more frequent turns) [15,[34][35][36], whereas other studies report no difference in 6MWD between the different course lengths [14,37,38]. Symptom intensity ratings at the end of the 6MWT were reported to be similar between using a 20-m and 30-m walking course [15,[34][35][36][37][38]. The current methodology should be extended to validate normative references for 6MWT using a 30-m walk course.…”

“…The 6MWT is a standardised [ 12 ] and reproducible [ 13 ] self-paced exercise test where the participant is instructed to walk as far as possible during 6 min between two cones on a flat course [ 10 ]. The course length is most often 30 m, but a 20-m course is sometimes used due to space limitations [ 14 , 15 ]. The 6MWT is recommended as an integral part of management across cardiorespiratory conditions such as COPD [ 8 , 9 , 16 ].…”

Tele-Assessment of Functional Capacity through the Six-Minute Walk Test in Patients with Diabetes Mellitus Type 2: Validity and Reliability of Repeated Measurements

“…While the current guidelines for the 6MWT recommend using a standardized 30m straight track with strict environmental control [ 14 ], it is therefore unknown whether this can be achieved in the home setting through tele-assessment. One negative effect of using track corridors shorter than 30 m is the fewer meters being covered due to time wasted while patients are turning [ 15 , 16 , 17 ]. In patients with low-performance levels, the length of the indoor track does not affect the outcome of the 6MWT [ 13 ].…”