Should the 6-Minute Walk Test Be Compared When Conducted by 2 Different Assessors in Subjects With COPD?

Respir Care. 2016 Oct;61(10):1323-30. doi: 10.4187/respcare.04500.

Abstract

Background: The 6-min walk test (6MWT) is an important tool in the assessment of functional capacity and prognosis in patients with COPD. However, especially in long-term follow-up in clinical settings, this test may be executed by a different assessor, and it is not well known whether 6MWT has an acceptable inter-rater reliability. The aim of this study is to analyze the intra- and inter-rater reliability of the performance in 6MWT, its cardiorespiratory changes, and effort perception in subjects with COPD.

Methods: Thirty-two subjects with a diagnosis of COPD participated in the study, but 3 subjects did not appear on the second day of evaluation and therefore were included only in the intra-rater analysis; the first and second tests were executed by the same assessor with a 30-min interval between them, and the last was executed by a different assessor a week later. The intra-rater reliability was verified comparing the first and second 6MWT performance, and the inter-rater reliability was verified comparing the third test with the best performance of the first and second tests.

Results: The intraclass correlation coefficient values were >0.75 (P < .001) for the walked distance on the 6MWT; however, the limits of agreement, SE of measurement, and minimal detectable difference were higher than the minimum clinically important differences already mentioned in the literature (∼25, 26, and 54 m), and the coefficient of variation was small in both intra- and inter-rater comparisons.

Conclusions: The 6MWT showed excellent reliability for distance and perceived exertion and moderate to excellent for HR and SD as assessed by intra- and inter-rater analysis. Thus, based on the main study outcomes, we concluded that the 6MWT can be compared when conducted by 2 different evaluators.

Keywords: COPD; exercise test; reliability; walking.

MeSH terms

  • Aged
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Reproducibility of Results
  • Time Factors
  • Walk Test / methods
  • Walk Test / statistics & numerical data*