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Published ahead of print on January 7, 2005, doi:10.1164/rccm.200405-578OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 10, May 2005, 1150-1157

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Submitted on May 5, 2004
Accepted on December 29, 2004

Six-minute Walk, Maximal Exercise Tests: Reproducibility in Fibrotic Interstitial Pneumonia

Tam Eaton1, Pam Young1, David Milne1, and Athol U Wells2*

1 Department of Respiratory Services, Green Lane Hospital, Auckland, New Zealand, 2 Interstitial Lung Disease Unit, Royal Brompton Hospital, London, United Kingdom

* To whom correspondence should be addressed. E-mail: A.Wells{at}rbh.nthames.nhs.uk.

Resting pulmonary function and exercise variables are widely used to stage and monitor idiopathic interstitial pneumonia. However, the variability of exercise data (maximal exercise and the six-minute walk testing) has not been evaluated definitively. We have prospectively quantified the reproducibility of resting and exercise functional data in fibrotic idiopathic interstitial pneumonia (idiopathic pulmonary fibrosis, fibrotic non-specific interstitial pneumonia) and have evaluated inter-relationships between variables. Thirty consecutive patients with fibrotic idiopathic interstitial pneumonia underwent serial resting pulmonary function tests, six-minute walk (n=29) and maximal exercise (n=24) at an interval of one week, with all testing performed in accordance with ATS standards. Within-subject reproducibility was excellent for six-minute walk distance (SD/mean = 4.2%) and clinically acceptable for resting pulmonary function indices and VO2max on maximal exercise testing. However, the amplitude of oxygen desaturation at the end of exercise was poorly reproducible in both six-minute walk and maximal exercise testing (SD/mean>25%). There was a highly significant relationship between VO2max on maximal exercise testing and six-minute walk distance (rs = 0.78, p<0.0001). In fibrotic idiopathic interstitial pneumonia , the excellent reproducibility of the six-minute walk distance is a major advantage in routine staging and monitoring, whereas maximal exercise variables are poorly reproducible.
Key words: interstitial lung disease, variability, exercise tests




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