Reliability of the six-minute walk test in individuals with stroke: systematic review and meta-analysis

Macchiavelli, Alice; Giffone, Antonella; Ferrarello, Francesco; Paci, Matteo

doi:10.1007/s10072-020-04829-0

Cited by 26 publications

(24 citation statements)

References 29 publications

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“…As it regards the practising effect, some studies have challenged the reliability of the 6MWT as an assessment test with respect to the possible practice effect. While some studies point out that the practice effect can lead to an increase in the walked distance (for a 2–8% learning effect between repeated 6MWTs) 69 other studies have concluded that the 6MWT has a clear and strong ability to demonstrate change in clinical status, given its high test–retest reliability when used to assess individuals with stroke 70 .…”

Section: Discussionmentioning

confidence: 99%

An impairment-specific hip exoskeleton assistance for gait training in subjects with acquired brain injury: a feasibility study

Livolsi

Conti²,

Guanziroli

et al. 2022

Sci Rep

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This study was designed to investigate the feasibility and the potential effects on walking performance of a short gait training with a novel impairment-specific hip assistance (iHA) through a bilateral active pelvis orthosis (APO) in patients with acquired brain injury (ABI). Fourteen subjects capable of independent gait and exhibiting mild-to-moderate gait deficits, due to an ABI, were enrolled. Subjects presenting deficit in hip flexion and/or extension were included and divided into two groups based on the presence (group A, n = 6) or absence (group B, n = 8) of knee hyperextension during stance phase of walking. Two iHA-based profiles were developed for the groups. The protocol included two overground gait training sessions using APO, and two evaluation sessions, pre and post training. Primary outcomes were pre vs. post-training walking distance and steady-state speed in the 6-min walking test. Secondary outcomes were self-selected speed, joint kinematics and kinetics, gait symmetry and forward propulsion, assessed through 3D gait analysis. Following the training, study participants significantly increased the walked distance and average steady-state speed in the 6-min walking tests, both when walking with and without the APO. The increased walked distance surpassed the minimal clinically important difference for groups A and B, (respectively, 42 and 57 m > 34 m). In group A, five out of six subjects had decreased knee hyperextension at the post-training session (on average the peak of the knee extension angle was reduced by 36%). Knee flexion during swing phase increased, by 16% and 31%, for A and B groups respectively. Two-day gait training with APO providing iHA was effective and safe in improving walking performance and knee kinematics in ABI survivors. These preliminary findings suggest that this strategy may be viable for subject-specific post-ABI gait rehabilitation.

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Section: Discussionmentioning

confidence: 99%

An impairment-specific hip exoskeleton assistance for gait training in subjects with acquired brain injury: a feasibility study

Livolsi

Conti²,

Guanziroli

et al. 2022

Sci Rep

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“…Despite the existence of a learning effect reported in many clinical populations, the 6MWT has shown an excellent test-retest reliability and reproducibility across different populations including chronic cardiovascular and respiratory diseases [15,31,35], neurological conditions [36,37] as well as healthy subjects [31]. However, when comparing studies, we observe that terminology used in these studies (reproducibility, replicability and reliability) is sometimes used interchangeably when they actually refer to different test properties, which hinders the interpretation and comparison of the results across studies.…”

Section: Discussionmentioning

confidence: 99%

Repeatability and learning effect in the 6MWT in preoperative cancer patients undergoing a prehabilitation program

Sebio-García

Dana

Gimeno‐Santos

et al. 2022

Support Care Cancer

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Objective the main objective was to assess repeatability and learning effect of the six-minute walk test (6MWT) in a cohort of preoperative cancer patients referred to a prehabilitation program. As a secondary objective we aimed to identify determinants of improvement in the second test. Materials and Methodssecondary analysis from a large prospective study on the implementation of a multimodal prehabilitation program in a real-life scenario. Eligible patients were assessed at baseline before starting the prehabilitation program. The 6MWT was conducted according to the American Thoracic Society (ATS)/ European Respiratory Society (ERS) guidelines with two tests being performed under identical conditions separated by 30 minutes. The distance covered (in meters) and the physiological responses (heart rate, oxygen saturation, fatigue and dyspnea) to each test were recorded and compared. Results170 patients (60.9%) were analyzed. Repeatability of the distance covered with the 6MWT was excellent (ICC = 0.98; 95% CI: 0.92 -0.99), but a mean increase of +19.5 meters (95% CI: 15.6 -23.5m; p=<.001) in the second test was found, showing a learning effect with limits of agreement between -31.3 and 70.4m.Coe cient of variation was 4%. No clinical factor was found to be associated with an improvement in the second test. Conclusionsthe 6MWT showed excellent repeatability in preoperative cancer patients, but a signi cant learning effect is present. No associated factors with a clinically meaningful improvement in the second test were identi ed. In light of these ndings, two attempts of the 6MWT should be encouraged in this population.

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“…The 6MWT is a reliable and valid tool for measuring distance run, endurance and aerobic capacity. 84 …”

Section: Methodsmentioning

confidence: 99%

Multidimensional analysis of sedentary behaviour and participation in Spanish stroke survivors (Part&Sed-Stroke): a protocol for a longitudinal multicentre study

Diego-Alonso

Alegre-Ayala²,

Buesa-Estéllez³

et al. 2023

BMJ Open

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IntroductionStroke survivors usually experience long-lasting functional, emotional and social consequences that might contribute to sedentary behaviour and participation restrictions, which are important targets to address during rehabilitation. However, the trajectory and inter-relationship between these factors are unknown.Methods and analysisPart&Sed is a research project based on an observational study design with 6 and 12 months of follow-ups in stroke survivors. In addition, a qualitative analysis of the impact of the stroke on the stroke survivor, validation of the Satisfaction with Daily Occupation-Occupational Balance assessment tool and analysis of the reliability of the Fitbit Inspire 2 activity tracker wristband will be carried out. Participants will be chronic stroke survivors with independent walking capacity. Sociodemographic and clinical data, physical activity, ambulation, sleep, quality of life, anxiety and depression, community participation, and occupational satisfaction and balance, as well as data provided by the activity tracker wristband, will be collected. In addition, if the participant has a primary caregiver, the caregiver will also be monitored. A minimum of 130 participants will be recruited to conduct a random-effects multiple regression model. Mixed models for repeated measures will assess the variation over time of the different variables associated with participation and sedentary behaviour. Psychometric properties (eg, internal consistency, construct validity, test–retest reliability) of the Satisfaction with Daily Occupation-Occupational Balance will be determined. Additionally, intraclass correlation coefficients and minimum detectable change will be calculated to assess intrasubject reliability of physical activity and sleep parameters recorded by the Fitbit Inspire 2. The qualitative analysis process will be carried out using the analysis proposed by Giorgi.Ethics and disseminationThe study received ethical approval from the Spanish Regional Ethics Committee ‘Comité de Ética de la Investigación de la Comunidad de Aragón’ (PI21/333). The results will be made available via peer-reviewed publications, international conferences and official channels.

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Reliability of the six-minute walk test in individuals with stroke: systematic review and meta-analysis

Cited by 26 publications

References 29 publications

An impairment-specific hip exoskeleton assistance for gait training in subjects with acquired brain injury: a feasibility study

An impairment-specific hip exoskeleton assistance for gait training in subjects with acquired brain injury: a feasibility study

Repeatability and learning effect in the 6MWT in preoperative cancer patients undergoing a prehabilitation program

Multidimensional analysis of sedentary behaviour and participation in Spanish stroke survivors (Part&Sed-Stroke): a protocol for a longitudinal multicentre study

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