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.
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.
Retrospective chart review.
Inpatient PR program.
Individuals (N=211) who performed the 6MWT at admission and discharge from PR.
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).
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).
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.
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)
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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.
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.