Document Detail


Optimizing the 6-min walk test as a measure of exercise capacity in COPD.
MedLine Citation:
PMID:  23364913     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is uncertain whether the effort and expense of performing a second walk for the 6-min walk test improves test performance. Hence, we attempted to quantify the improvement in 6-min walk distance if an additional walk were to be performed.
METHODS: We studied patients consecutively enrolled into the National Emphysema Treatment Trial who prior to randomization and after 6 to 10 weeks of pulmonary rehabilitation performed two 6-min walks on consecutive days (N = 396). Patients also performed two 6-min walks at 6-month follow-up after randomization to lung volume reduction surgery (n = 74) or optimal medical therapy (n = 64). We compared change in the first walk distance to change in the second, average-of-two, and best-of-two walk distances.
RESULTS: Compared with the change in the first walk distance, change in the average-of-two and best-of-two walk distances had better validity and precision. Specifically, 6 months after randomization to lung volume reduction surgery, changes in the average-of-two (r = 0.66 vs r = 0.58, P = .01) and best-of-two walk distances (r = 0.67 vs r = 0.58, P = .04) better correlated with the change in maximal exercise capacity (ie, better validity). Additionally, the variance of change was 14% to 25% less for the average-of-two walk distances and 14% to 33% less for the best-of-two walk distances than the variance of change in the single walk distance, indicating better precision.
CONCLUSIONS: Adding a second walk to the 6-min walk test significantly improves its performance in measuring response to a therapeutic intervention, improves the validity of COPD clinical trials, and would result in a 14% to 33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in patients with COPD.
Authors:
Divay Chandra; Robert A Wise; Hrishikesh S Kulkarni; Roberto P Benzo; Gerard Criner; Barry Make; William A Slivka; Andrew L Ries; John J Reilly; Fernando J Martinez; Frank C Sciurba;
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  142     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-01-31     Completed Date:  2013-04-03     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1545-52     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Bronchodilator Agents / therapeutic use
Exercise Test / methods*
Exercise Tolerance / physiology*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Outcome Assessment (Health Care)*
Pneumonectomy
Pulmonary Disease, Chronic Obstructive / physiopathology*,  rehabilitation,  therapy
Reproducibility of Results
Respiratory Function Tests
Walking / physiology*
Grant Support
ID/Acronym/Agency:
N01HR76101/HR/NHLBI NIH HHS; N01HR76102/HR/NHLBI NIH HHS; N01HR76103/HR/NHLBI NIH HHS; N01HR76104/HR/NHLBI NIH HHS; N01HR76105/HR/NHLBI NIH HHS; N01HR76106/HR/NHLBI NIH HHS; N01HR76107/HR/NHLBI NIH HHS; N01HR76108/HR/NHLBI NIH HHS; N01HR76109/HR/NHLBI NIH HHS; N01HR76110/HR/NHLBI NIH HHS; N01HR76111/HR/NHLBI NIH HHS; N01HR76112/HR/NHLBI NIH HHS; N01HR76113/HR/NHLBI NIH HHS; N01HR76114/HR/NHLBI NIH HHS; N01HR76115/HR/NHLBI NIH HHS; N01HR76116/HR/NHLBI NIH HHS; N01HR76117/HR/NHLBI NIH HHS; N01HR76118/HR/NHLBI NIH HHS; N01HR76119/HR/NHLBI NIH HHS; P50HL084948/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Bronchodilator Agents
Investigator
Investigator/Affiliation:
Alfred P Fishman / ; Betsy Ann Bozzarello / ; Ameena Al-Amin / ; Marcia Katz / ; Carolyn Wheeler / ; Elaine Baker / ; Peter Barnard / ; Phil Cagle / ; James Carter / ; Sophia Chatziioannou / ; Karla Conejo-Gonzales / ; Kimberly Dubose / ; John Haddad / ; David Hicks / ; Neal Kleiman / ; Mary Milburn-Barnes / ; Chinh Nguyen / ; Michael Reardon / ; Joseph Reeves-Viets / ; Steven Sax / ; Amir Sharafkhaneh / ; Owen Wilson / ; Christine Young / ; Rafael Espada / ; Rose Butanda / ; Minnie Ellisor / ; Pamela Fox / ; Katherine Hale / ; Everett Hood / ; Amy Jahn / ; Satish Jhingran / ; Karen King / ; Charles Miller / ; Imran Nizami / ; Jeannie Ricketts / ; Joe Rodarte / ; Robert Teague / ; Kedren Williams / ; John Reilly / ; David Sugarbaker / ; Carol Fanning / ; Simon Body / ; Sabine Duffy / ; Vladmir Formanek / ; Anne Fuhlbrigge / ; Philip Hartigan / ; Sarah Hooper / ; Andetta Hunsaker / ; Francine Jacobson / ; Marilyn Moy / ; Susan Peterson / ; Roger Russell / ; Diane Saunders / ; Scott Swanson / ; Rob McKenna / ; Zab Mohsenifar / ; Carol Geaga / ; Manmohan Biring / ; Susan Clark / ; Jennifer Cutler / ; Robert Frantz / ; Peter Julien / ; Michael Lewis / ; Jennifer Minkoff-Rau / ; Valentina Yegyan / ; Milton Joyner / ; Malcolm DeCamp / ; James Stoller / ; Yvonne Meli / ; John Apostolakis / ; Darryl Atwell / ; Jeffrey Chapman / ; Pierre DeVilliers / ; Raed Dweik / ; Erik Kraenzler / ; Rosemary Lann / ; Nancy Kurokawa / ; Scott Marlow / ; Kevin McCarthy / ; Priscilla McCreight / ; Atul Mehta / ; Moulay Meziane / ; Omar Minai / ; Mindi Steiger / ; Kenneth White / ; Janet Maurer / ; Terri Durr / ; Charles Hearn / ; Susan Lubell / ; Peter O'Donovan / ; Robert Schilz / ; Mark Ginsburg / ; Byron Thomashow / ; Patricia Jellen / ; John Austin / ; Matthew Bartels / ; Yahya Berkmen / ; Patricia Berkoski / ; Frances Brogan / ; Amy Chong / ; Glenda DeMercado / ; Angela DiMango / ; Sandy Do / ; Bessie Kachulis / ; Arfa Khan / ; Berend Mets / ; Mitchell O'Shea / ; Gregory Pearson / ; Leonard Rossoff / ; Steven Scharf / ; Maria Shiau / ; Paul Simonelli / ; Kim Stavrolakes / ; Donna Tsang / ; Denise Vilotijevic / ; Chun Yip / ; Mike Mantinaos / ; Kerri McKeon / ; Jacqueline Pfeffer / ; Neil MacIntyre / ; R Duane Davis / ; John Howe / ; R Edward Coleman / ; Rebecca Crouch / ; Dora Greene / ; Katherine Grichnik / ; David Harpole / ; Abby Krichman / ; Brian Lawlor / ; Holman McAdams / ; John Plankeel / ; Susan Rinaldo-Gallo / ; Sheila Shearer / ; Jeanne Smith / ; Mark Stafford-Smith / ; Victor Tapson / ; Mark Steele / ; Jennifer Norten / ; James Utz / ; Claude Deschamps / ; Kathy Mieras / ; Martin Abel / ; Mark Allen / ; Deb Andrist / ; Gregory Aughenbaugh / ; Sharon Bendel / ; Eric Edell / ; Marlene Edgar / ; Bonnie Edwards / ; Beth Elliot / ; James Garrett / ; Delmar Gillespie / ; Judd Gurney / ; Boleyn Hammel / ; Karen Hanson / ; Lori Hanson / ; Gordon Harms / ; June Hart / ; Thomas Hartman / ; Robert Hyatt / ; Eric Jensen / ; Nicole Jenson / ; Sanjay Kalra / ; Philip Karsell / ; Jennifer Lamb / ; David Midthun / ; Carl Mottram / ; Stephen Swensen / ; Anne-Marie Sykes / ; Karen Taylor / ; Norman Torres / ; Rolf Hubmayr / ; Daniel Miller / ; Sara Bartling / ; Kris Bradt / ; Barry Make / ; Marvin Pomerantz / ; Mary Gilmartin / ; Joyce Canterbury / ; Martin Carlos / ; Phyllis Dibbern / ; Enrique Fernandez / ; Lisa Geyman / ; Connie Hudson / ; David Lynch / ; John Newell / ; Robert Quaife / ; Jennifer Propst / ; Cynthia Raymond / ; Jane Whalen-Price / ; Kathy Winner / ; Martin Zamora / ; Reuben Cherniack / ; Philip Diaz / ; Patrick Ross / ; Tina Bees / ; Jan Drake / ; Charles Emery / ; Mark Gerhardt / ; Mark King / ; David Rittinger / ; Mahasti Rittinger / ; Keith Naunheim / ; Robert Gerber / ; Joan Osterloh / ; Susan Borosh / ; Willard Chamberlain / ; Sally Frese / ; Alan Hibbit / ; Mary Ellen Kleinhenz / ; Gregg Ruppel / ; Cary Stolar / ; Francisco Alvarez / ; Cesar Keller / ; Gerard Criner / ; Satoshi Furukawa / ; Anne Marie Kuzma / ; Roger Barnette / ; Kevin Carney / ; Wissam Chatila / ; Francis Cordova / ; Gilbert D'Alonzo / ; Michael Keresztury / ; Karen Kirsch / ; Chul Kwak / ; Kathy Lautensack / ; Madelina Lorenzon / ; Ubaldo Martin / ; Peter Rising / ; Scott Schartel / ; John Travaline / ; Gwendolyn Vance / ; Phillip Boiselle / ; Gerald O'Brien / ; Andrew Ries / ; Robert Kaplan / ; Catherine Ramirez / ; David Frankville / ; Paul Friedman / ; James Harrell / ; Jeffery Johnson / ; David Kapelanski / ; David Kupferberg / ; Catherine Larsen / ; Trina Limberg / ; Michael Magliocca / ; Frank J Papatheofanis / ; Dawn Sassi-Dambron / ; Melissa Weeks / ; Mark Krasna / ; Henry Fessler / ; Iris Moskowitz / ; Timothy Gilbert / ; Jonathan Orens / ; Steven Scharf / ; David Shade / ; Stanley Siegelman / ; Kenneth Silver / ; Clarence Weir / ; Charles White / ; Fernando Martinez / ; Mark Iannettoni / ; Catherine Meldrum / ; William Bria / ; Kelly Campbell / ; Paul Christensen / ; Kevin Flaherty / ; Steven Gay / ; Paramjit Gill / ; Ella Kazerooni / ; Vivian Knieper / ; Tammy Ojo / ; Lewis Poole / ; Leslie Quint / ; Paul Rysso / ; Thomas Sisson / ; Mercedes True / ; Brian Woodcock / ; Lori Zaremba / ; Larry Kaiser / ; John Hansen-Flaschen / ; Mary Louise Dempsey / ; Abass Alavi / ; Theresa Alcorn / ; Selim Arcasoy / ; Judith Aronchick / ; Stanley Aukberg / ; Bryan Benedict / ; Susan Craemer / ; Ron Daniele / ; Jeffrey Edelman / ; Warren Gefter / ; Laura Kotler-Klein / ; Robert Kotloff / ; David Lipson / ; Wallace Miller / ; Richard O'Connell / ; Staci Opelman / ; Harold Palevsky / ; William Russell / ; Heather Sheaffer / ; Rodney Simcox / ; Susanne Snedeker / ; Jennifer Stone-Wynne / ; Gregory Tino / ; Peter Wahl / ; James Walter / ; Patricia Ward / ; David Zisman / ; James Mendez / ; Angela Wurster / ; Frank Sciurba / ; James Luketich / ; Colleen Witt / ; Gerald Ayres / ; Michael Donahoe / ; Carl Fuhrman / ; Robert Hoffman / ; Joan Lacomis / ; Joan Sexton / ; William Slivka / ; Diane Strollo / ; Erin Sullivan / ; Tomeka Simon / ; Catherine Wrona / ; Gerene Bauldoff / ; Manuel Brown / ; Elisabeth George / ; Robert Keenan / ; Theodore Kopp / ; Laurie Silfies / ; Joshua Benditt / ; Douglas Wood / ; Margaret Snyder / ; Kymberley Anable / ; Nancy Battaglia / ; Louie Boitano / ; Andrew Bowdle / ; Leighton Chan / ; Cindy Chwalik / ; Bruce Culver / ; Thurman Gillespy / ; David Godwin / ; Jeanne Hoffman / ; Andra Ibrahim / ; Diane Lockhart / ; Stephen Marglin / ; Kenneth Martay / ; Patricia McDowell / ; Donald Oxorn / ; Liz Roessler / ; Michelle Toshima / ; Susan Golden / ; Lynn Bosco / ; Yen-Pin Chiang / ; Carolyn Clancy / ; Harry Handelsman / ; Steven M Berkowitz / ; Tanisha Carino / ; Joe Chin / ; JoAnna Baldwin / ; Karen McVearry / ; Anthony Norris / ; Sarah Shirey / ; Claudette Sikora Steven Sheingold / ; Steven Piantadosi / ; James Tonascia / ; Patricia Belt / ; Amanda Blackford / ; Karen Collins / ; Betty Collison / ; Ryan Colvin / ; John Dodge / ; Michele Donithan / ; Vera Edmonds / ; Gregory L Foster / ; Julie Fuller / ; Judith Harle / ; Rosetta Jackson / ; Shing Lee / ; Charlene Levine / ; Hope Livingston / ; Jill Meinert / ; Jennifer Meyers / ; Deborah Nowakowski / ; Kapreena Owens / ; Shangqian Qi / ; Michael Smith / ; Brett Simon / ; Paul Smith / ; Alice Sternberg / ; Mark Van Natta / ; Laura Wilson / ; Robert Wise / ; Robert M Kaplan / ; J Sanford Schwartz / ; Yen-Pin Chiang / ; Marianne C Fahs / ; A Mark Fendrick / ; Alan J Moskowitz / ; Dev Pathak / ; Scott Ramsey / ; Steven Sheingold / ; A Laurie Shroyer / ; Judith Wagner / ; Roger Yusen / ; Scott Ramsey / ; Ruth Etzioni / ; Sean Sullivan / ; Douglas Wood / ; Thomas Schroeder / ; Karma Kreizenbeck / ; Kristin Berry / ; Nadia Howlader / ; Eric Hoffman / ; Janice Cook-Granroth / ; Angela Delsing / ; Junfeng Guo / ; Geoffrey McLennan / ; Brian Mullan / ; Chris Piker / ; Joseph Reinhardt / ; Blake Wood / ; Jered Sieren / ; William Stanford / ; John A Waldhausen / ; Gordon Bernard / ; David DeMets / ; Mark Ferguson / ; Eddie Hoover / ; Robert Levine / ; Donald Mahler / ; A John McSweeny / ; Jeanine Wiener-Kronish / ; O Dale Williams / ; Magdy Younes / ; Gerard Criner / ; Charles Soltoff / ; Gail Weinmann / ; Joanne Deshler / ; Dean Follmann / ; James Kiley / ; Margaret Wu / ; Arthur Gelb /
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