Abstract
Wong R, Sibley KM, Hudani M, Roeland S, Visconti M, Balsano J, Hill K, Brooks D. Characteristics
of people with chronic lung disease who rest during the six-minute walk test.
Objectives
To examine the incidence of resting during the 6-minute-walk test (6MWT) in patients
with chronic lung disease (CLD) and to explore differences in functional exercise
capacity and response to pulmonary rehabilitation (PR) between resters and nonresters.
Design
Retrospective chart review.
Setting
Inpatient PR program.
Participants
Individuals (N=211) who performed the 6MWT at admission and discharge from PR.
Interventions
Not applicable.
Main Outcome Measures
Primary outcomes were total distance walked (6-minute walk distance [6MWD]) and rest
frequency and duration. Secondary outcomes were walking speed, end-test dyspnea, and
the Chronic Respiratory Questionnaire (CRQ).
Results
At admission, 45 people (21%) rested 1 to 4 times during the 6MWT (total duration,
105±80s) and 166 people walked continuously. At discharge, 9 people continued to rest
(total duration, 28±55s). At admission, nonresters walked 315±93m, whereas resters
walked 197±83m (P<.0001), and 6MWD increased in both groups after PR (P<.0001). Nonresters increased their walking speed at discharge, but resters did not
(interaction P<.001). At admission, the mastery domain of the CRQ was 0.8 point lower in resters
(3.7±1.2) compared with nonresters (4.5±1.7; P=.01). Resters' end-test dyspnea scores decreased from 5.7±0.3 to 4.3±0.2 from admission
to discharge, whereas nonresters' end-test dyspnea scores did not significantly change
from 4.5±0.2 to 4.2±0.2 at discharge (interaction P<.05).
Conclusions
One in 5 individuals with CLD rest during the 6MWT. Decreasing rest duration or increasing
walking speed reflects different strategies used to improve 6MWD after rehabilitation,
both suggesting a positive effect of PR. This may be related to improvements in an
individual's sense of control over dyspnea. Future work should investigate potential
factors related to resting during the 6MWT.
Key Words
List of Abbreviations:
6MWD (six-minute walk distance), 6MWT (six-minute walk test), BMI (body mass index), BODE (Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index), CLD (chronic lung disease), CRQ (Chronic Respiratory Questionnaire), COPD (chronic obstructive pulmonary disease), PR (pulmonary rehabilitation)To read this article in full you will need to make a payment
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References
- Respiratory Diseases in Canada.(Health Canada, Ottawa, Canada)2001
- The COPDX plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease.Med J Aust. 2003; 178: S7-S39
- American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation.Am J Respir Crit Care Med. 2006; 173: 1390-1413
- How should we measure function in patients with chronic heart and lung disease?.J Chronic Dis. 1985; 38: 517-524
- Reanalysis of the 12-min walk in patients with chronic obstructive pulmonary disease.Chest. 1994; 105: 163-167
- The 6-min walk: a new measure of exercise capacity in patients with chronic heart failure.CMAJ. 1985; 132: 919-923
- Relation of lung function, maximal inspiratory pressure, dyspnoea, and quality of life with exercise capacity in patients with chronic obstructive pulmonary disease.Thorax. 1994; 49: 468-472
- ATS statement: guidelines for the six-minute walk test.Am J Respir Crit Care Med. 2002; 166: 111-117
- Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute walk test in chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 2001; 163: 1395-1399
- The relationship of the 6-minute walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease.Chest. 1995; 108: 452-459
- Estimating maximum work rate during incremental cycle ergometry testing from six-minute walk distance in patients with chronic obstructive pulmonary disease.Arch Phys Med Rehabil. 2008; 89: 1782-1787
- Six minute walk test: observed adverse events and oxygen desaturation in a large cohort of patients with chronic lung disease.Intern Med J. 2010 Jan 4; ([Epub ahead of print])
- Physiological responses to incremental and self-paced exercise in COPD: a comparison of three tests.Chest. 2004; 126: 766-773
- The short-term effect of a rollator on functional exercise capacity among individuals with severe COPD.Chest. 2002; 122: 56-65
- Changes in spatiotemporal gait variables over time during a test of functional capacity after stroke.J Neuroeng Rehabil. 2009; 6: 27
- Randomised controlled trial of respiratory rehabilitation.Lancet. 1994; 344: 1394-1397
- Effect of airway clearance techniques in patients experiencing an acute exacerbation of chronic obstructive pulmonary disease: a systematic review.Chron Respir Dis. 2010; 7: 9-17
- Psychophysical bases of perceived exertion.Med Sci Sports Exerc. 1982; 14: 377-381
- Development of a Self-Reported Chronic Respiratory Questionnaire (CRQ-SR).Thorax. 2001; 56: 954-959
- COPD as a systemic disease: impact on physical functional limitations.Am J Med. 2008; 121: 789-796
- The Hospital Anxiety and Depression Scale.Acta Psychiatr Scand. 1983; 67: 361-370
- The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index in chronic obstructive pulmonary disease.N Engl J Med. 2004; 350: 1005-1012
- Measurement of health status.Control Clin Trials. 1989; 10: 407-415
- Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life.J Clin Epidemiol. 1999; 52: 861-873
- The influence of psychological status on respiratory symptom reporting.Am Rev Respir Dis. 1989; 139: 1459-1463
- Ground walk training improves function exercise capacity more than cycle training in people with chronic obstructive pulmonary disease (COPD): a randomized trial.Aust J Physiother. 2010; 56: 105-113
- Patients with coronary artery- or chronic obstructive pulmonary disease walk with mechanical inefficiency.Scand Cardiovasc J. 2007; 41: 405-410
- Randomized controlled trial of an Internet-based versus face-to-face dyspnea self-management program for patients with chronic obstructive pulmonary disease: pilot study.J Med Internet Res. 2008; 10: e9
- COPD patients' ability to follow exercise influences short-term outcomes of rehabilitation.European Respiratory Journal. 2008; 31: 304-310
Article info
Footnotes
Supported by a Canada Research Chair (D. Brooks).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
