- •There are no data to support recommendation for 6-minute walk test (6MWT) termination if oxyhemoglobin saturation <80%.
- •Retrospective audit of tests was conducted in stable patients by experienced clinicians.
- •A total of 672 tests were reviewed; 2 adverse events were recorded during tests without desaturation.
- •Findings do not support 6MWT termination due to desaturation.
To examine the occurrence of adverse events in patients undergoing assessment for pulmonary rehabilitation when a 6-minute walk test (6MWT) continues despite desaturation below 80%.
Retrospective audit following REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement.
Large teaching hospital.
All patients (N=549) (55% men, mean age 69±11y) assessed for pulmonary rehabilitation (September 2005 to January 2016).
The standardized tests were conducted by experienced cardiorespiratory physiotherapists. Oxyhemoglobin saturation was monitored continuously using a pulse oximeter (lowest value used for analysis). Medical records were reviewed, and adverse events defined as tachycardia, bradycardia, chest pain, or other sign/symptom necessitating cessation.
Main Outcome Measure
Data from 672 walk tests were included with mean distance 369 (124) meters. The main diagnoses were chronic obstructive pulmonary disease (70%), interstitial lung disease (14%), and bronchiectasis (8%). Sixty individuals (11%) recorded desaturation below 80% without adverse events. Two adverse events were recorded during tests without desaturation; in 1 instance, chest pain with no evidence of cardiorespiratory compromise and in another, the patient stopped due to concern regarding blood sugar levels (11.5 mmol/L when tested). Independent predictors of desaturation to less than 80% were resting oxyhemoglobin saturation <95% (odds ratio [OR] 3.82, 95% confidence interval [CI] 2.06-7.08) and a diagnosis of interstitial lung disease or pulmonary arterial hypertension (OR 5.24, 95% CI 2.59-10.58).
This study found that desaturation to less than 80% during a 6MWT was not associated with adverse events in a large cohort of patients referred to pulmonary rehabilitation and assessed by experienced physiotherapists, suggesting that test cessation due to desaturation in stable patients may be unwarranted.
List of abbreviations:6MWT (6-minute walk test), 6MWD (6-minute walk distance), CI (confidence interval), OR (odds ratio), RECORD (REporting of studies Conducted using Observational Routinely-collected health Data), SpO2 (oxyhemoglobin saturation)
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- An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease.Eur Respir J. 2014; 44: 1428-1446
- Pulse oximetry oxygen sauration during the 6-min walk test: a limit for stopping the test without resuming it.Eur Respir J. 2015; 46: 1222-1223
- ATS statement: guidelines for the six-minute walk test.Am J Respir Crit Care Med. 2002; 166: 111-117
- Should oxyhaemoglobin saturation be monitored continuously during the 6-minute walk test?.Chron Respir Dis. 2011; 8: 181-184
- The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement.PLoS Med. 2015; 12: e1001885
- Hypoxemia and arrhythmia during daily activities and six-minute walk test in fibrotic interstitial lung diseases.J Korean Med Sci. 2011; 26: 372-378
- Six-minute walk test: observed adverse events and oxygen desaturation in a large cohort of patients with chronic lung disease.Intern Med J. 2011; 41: 416-422
- Serious adverse events during a 6-min walk test in patients with pulmonary hypertension.Eur Respir J. 2015; 45: 1179-1182
- 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).Eur Respir J. 2015; 46: 903-975
- Development of the new lung allocation system in the United States.Am J Transplant. 2006; 6: 1212-1227
Published online: August 18, 2018
© 2018 by the American Congress of Rehabilitation Medicine