Short- and Long-Term Reliability of the 6-Minute Walk Test in People With Idiopathic Pulmonary Fibrosis

AuthorsHolland, A.E.
Hill, C.J.
Dowman, L.
Glaspole, I.
Goh, N.
Lee, A.L.
McDonald, C.F.
TypeJournal Article (Original Research)
JournalRespiratory Care
PubMed ID29945909
Year of Publication2018
AbstractBACKGROUND: 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.

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