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Published ahead of print on February 20, 2003, doi:10.1164/rccm.200203-166OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 11, June 2003, 1522-1527

A more recent version of this article appeared on June 1, 2003
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Submitted on March 3, 2002
Accepted on February 18, 2003

Six-Minute Walk Distance in COPD: Reproducibility and Effect of Walking Course Layout and Length

Frank Sciurba1, Gerard J Criner2, Shing M Lee3, Zab Mohsenifar4, David Shade3, William Slivka1, and Robert A Wise3*

1 Pullmonary/Surgery, University of Pittsburgh, Pittsburgh, PA, USA, 2 Pulmonary/Surgery, Temple University School of Medicine, Philadelphia, PA, USA, 3 Pulmonary/Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA, 4 Pulmonary/Surgery, Cedars Sinai - University of California, Los Angeles, CA, USA

* To whom correspondence should be addressed. E-mail: rwise{at}jhmi.edu.

The six-minute walk test is used in clinical practice and clinical trials of lung diseases, however it is not clear whether replicate tests need to be performed to assess performance. Furthermore, little is known about the impact of walking course layout on test performance. We conducted six-minute walks on 761 patients with severe emphysema (Mean ± SD FEV1 % predicted = 26.3 ± 7.2) who were participants in the National Emphysema Treatment Trial (NETT). 470 participants had repeated walks on a separate day. The second test was improved by an average of 7.0 ± 15.2 % (66.1 ± 146 feet (p < 0.0001, by paired t-test) with an intraclass correlation coefficient of 0.88 between days. The course layout had an effect on the distance walked. Participants tested on continuous (circular or oval) courses had a 92.2 ft longer walking distance than those tested on straight (out and back) courses. Course length had no significant effect on walking distance. The training effect found in these patients with severe emphysema is less than in previous reports of patients with COPD. Furthermore, layout of the track may influence six-minute walk performance.
Key words: emphysema, exercise tests, reproducibility of results, diagnostic techniques, clinical trials




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