Comparison of Hallway and Treadmill Six-minute Walk Tests

Abstract

The 6-min walk test (SMWT) performed in the hallway (HW) is used as a clinical indicator of functional capacity in patients with lung disease. A 6-min walk test utilizing a treadmill (TM) is easier to perform and allows easier patient monitoring. Therefore, we formulated a standardized TM SMWT protocol and compared the results with those of a HW SMWT. All patients were enrolled in a pulmonary rehabilitation program. Patients with current infection, recent change in inhaled medications or oral steroid use, and significant cardiovascular disease were excluded. Each subject performed three HW SMWTs and three TM SMWTs assigned randomly on subsequent days. There was a 30-min rest between each walk and at least a 48-h rest between each test day. All patients completed both HW and TM SMWT within 7 d. Supplemental oxygen was utilized or increased if the saturation fell below 88%. The best of the three tests was used for data analysis. Twenty-one subjects completed the protocol. The mean age was 65 +/- 10.9 yr (range, 35 to 79 yr). Ten subjects were receiving supplemental oxygen. The mean FEV(1) was 1.07 +/- 0.53 L. The mean HW SMWT distance was 1,228 +/- 255 ft (range, 612 to 1,679 ft) and the mean TM SMWT distance was 1,060 +/- 389 ft (range, 475 to 1,819 ft), which were statistically different (p = 0.01). The mean difference was 168 +/- 280 ft (range, -326 to 743 ft). Oxygen saturation and supplemental oxygen requirements did not differ significantly. The intra-test variability of the three HW SMWTs was similar to the three TM SMWTs and no significant difference in the coefficient of variation was found. A standardized TM SMWT is feasible and allows easier patient monitoring, but there is a statistically significant difference between the HW and TM SMWT distance and therefore they are not interchangeable. However, the intratest reproducibility of the TM and HW SMWTs are similar when three walks are performed in a single test session. The role of the TM SMWT in pulmonary rehabilitation requires further exploration.

Reproducibility of Cadence-Free 6-Minute Step Test in Subjects with COPD

“…Standard error of measurement as a percentage of the mean was 5%, which was similar to the same error analysis using the 6-min walk test in other studies that also represented ϳ5% of the mean performance of the test. 21,25 These results show that the performance in this test was not influenced by the learning effect in the COPD population, which leads to the affirmation that this test can be done without a familiarization test, spending only 15 min of assessment time. This characteristic could be an advantage over the 6-min walk test, which requires at least one previous test and a recovery time between them, totaling a time expenditure of at least 50 min.…”

Exercising Your Patient: Which Test(s) and When?

“…In some studies, the achieved distances were comparable, 25 while in other areas the treadmill distance was nearly 15% lower. 26 This may reflect the need for constant pace changing and possibly problems of balance for people not familiar with treadmill walking.…”

Validação de um protocolo para o teste de caminhada de seis minutos em esteira para avaliação de pacientes com hipertensão arterial pulmonar

“…A previous study, also involving COPD patients walking on a treadmill, (6) provided evidence of the need to perform the tread6MWT at least twice in order to obtain a reproducible value. Similar findings have been reported regarding the hallway 6MWT, which is why it is necessary to conduct a first test in patients who have never performed the test before, i.e., to increase the reproducibility of the test.…”

“…The comparison between the original (hallway) 6MWT and the tread6MWT in COPD patients has demonstrated that, although the tread6MWT is not comparable to the 6MWT in terms of the distance covered, it is a satisfactory alternative for the functional evaluation of COPD patients. (6) However, various factors should be considered before conducting the tread6MWT, e.g., whether or not to develop an incremental speed and inclination protocol and whether the speed should be controlled by the patient or the technician responsible for the examination.…”