Journal Information
Vol. 41. Issue 12.
Pages 667-678 (December 2005)
Share
Share
Download PDF
More article options
Vol. 41. Issue 12.
Pages 667-678 (December 2005)
Original Articles
Full text access
Variability in Walk Test Conditions at Pulmonary Rehabilitation Programs in Latin America and on the Iberian Peninsula
Visits
4208
M.R. Tramontinia, A.F. Mayera, F. Cardosoa, J.R. Jardimb,
Corresponding author
joserjardim@yahoo.com.br

Correspondence: Dr. José R. Jardim. Centro de Rehabilitación Pulmonar. Universidade Federal de São Paulo/Lar Escola São Francisco. R. Botucatu, 740, 3.°. 04023-062 São Paulo. Brasil
a Centro de Rehabilitación Pulmonar, Universidade Federal de São Paulo/Lar Escola São Francisco, São Paulo, Brazil
b Departamento de Medicina Respiratoria, Centro de Rehabilitación Pulmonar, Universidade Federal de São Paulo/Lar Escola São Francisco, São Paulo, Brazil
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Objectives

1) To determine the frequency of use of the 6-minute walk test in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula; 2) to identify how the test is performed and possible variations from center to center.

Material and methods

A questionnaire was sent to 55 pulmonary rehabilitation centers in Latin America, Portugal, and Spain.

Results

: Forty-nine (89.1%) centers answered the questionnaire. Forty-seven (95.9%) perform a walk test lasting 6 minutes; 22 (46.8%) take the longest distance of 2 tests as the real one; and 35 (74.5%) carry out the test in a corridor. The course distance ranged from 17 to 90 meters, but in 21 (44.7%) centers, the corridor was between 17 and 30 meters long. In 29 (61.7%) centers, the patients are routinely informed about the time that had elapsed during the test. Verbal encouragement is used in 44 (93.6%) centers. Thirty-eight (80.8%) use supplemental oxygen when a patient needs it. An increase in absolute values in the distance covered is used as a parameter indicating improvement at 21 (46.7%) sites while at 15 (33.3%) other centers the percentage increase is taken as a measure of improvement.

Conclusions

The 6-minute walk test is widely used for the evaluation of the exercise capacity at the pulmonary rehabilitation centers of Latin America and the Iberian Peninsula. However, there is great variability in the way the test is performed.

Key Words:
Walk test
Rehabilitation outcome
Exercise test
Diagnostic techniques
Objetivos

Determinar la frecuencia de utilización de la prueba de la marcha de 6 min en el contexto de los programas de rehabilitación pulmonar que se llevan a cabo en América Latina y en la Península Ibérica. Definir la forma con la que se realiza esta prueba y las posibles variaciones que presenta en los distintos centros.

Material y métodos

Se remitió un cuestionario a 55 centros de rehabilitación pulmonar localizados en América Latina, Portugal y España.

Resultados

Respondieron al cuestionario 49 centros (89,1%); en 47 (95,9%) se realizó la prueba de la marcha con una duración de 6 min; en 22 (46,8%) se aceptó la mayor distancia recorrida por el paciente en 2 pruebas como el valor real de la prueba de la marcha; en 35 (74,5%) se realizó la prueba de la marcha en un pasillo; la distancia recorrida osciló entre 17 y 90 m, pero en 21 centros (44,7%) el pasillo tenía una longitud de 17 a 30 m. En 29 centros (61,7%) se informó sistemáticamente a los pacientes del tiempo transcurrido durante la prueba de la marcha; en 44 (93,6%) se animó verbalmente al paciente mientras realizaba la prueba; en 38 (80,8%) se utilizó oxígeno suplementario cuando el paciente lo necesitó. El incremento de los valores absolutos en la distancia recorrida se utilizó como parámetro para determinar la mejoría en 21 centros (46,7%), mientras que en otros 15 (33,3%) se utilizó como parámetro de mejoría el porcentaje de incremento en la distancia recorrida.

Conclusiones

La prueba de la marcha de 6 min se utili-za con mucha frecuencia para la evaluación de la capacidad de ejercicio de los pacientes en los centros de rehabilitación pulmonar de América Latina y de la Península Ibérica. Sin embargo, hay grandes variaciones en la forma con la que se lleva a cabo la prueba.

Palabras clave:
Prueba de la marcha
Resultados de la rehabilitación
Prueba de esfuerzo
Técnicas diagnósticas
Full text is only aviable in PDF
REFERENCES
[1]
JA Barberá, G Peces-Barba, AGN Agustí, JL Izquierdo, E Monsó, T Montemayor, et al.
Guía clínica para el diagnóstico y el tratamiento de la enfermedad pulmonar obstructiva crónica. Normativas SEPAR.
Arch Bronconeumol, 37 (2001), pp. 297-316
[2]
American Thoracic Society ATS Statement: Guidelines for six minute walk test.
Am J Respir Crit Care Med, 166 (2002), pp. 111-117
[3]
T Montemayor, F Ortega.
Estrategias de entrenamiento muscular en la enfermedad pulmonar obstructiva crónica. ¿Entrenamiento de resistencia, de fuerza o combinado?.
Arch de Bronconeumol, 37 (2001), pp. 279-285
[4]
KH Cooper.
A means of assessing maximal oxygen uptake.
JAMA, 203 (1968), pp. 201-204
[5]
L Cahalin, P Pappagianopoulos, S Prevost, J Wain, L Ginns.
The relationship of the 6-minute walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease.
Chest, 108 (1995), pp. 452-459
[6]
LP Cahalin, MA Mathier, MJ Semogran, GW Dec, TG di Salvo.
The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure.
Chest, 110 (1996), pp. 325-332
[7]
ACCP/AACVPR-Pulmonary Rehabilitation Guidelines Panel.
Pulmonary Rehabilitation.
Chest, 112 (1997), pp. 1363-1366
[8]
SJ Singh, MDL Morgan, AE Hardman, C Rowe, PA Bardsley.
Comparison of oxygen uptake during a conventional treadmill test and the shuttle walking test in chronic airflow limitation.
Eur Respir J, 7 (1994), pp. 2016-2020
[9]
DA Gerardi, L Lovett, ML Benoit-Connors, JZ Reardon, RL ZuWallack.
Variables related to increased mortality following outpatient pulmonary rehabilitation.
Eur Respir J, 9 (1996), pp. 431-435
[10]
CR McGavin, SP Gupta, GJ McHardy.
Twelve-minute walking test for assessing disability in chronic bronchitis.
BMJ, 1 (1976), pp. 822-823
[11]
ML Bernstein, JA Despars, NP Singh, K Avalos, DW Stansbury, RW Light.
Reanalysis of the 12-minute walk in patients with chronic obstructive pulmonary disease.
Chest, 105 (1994), pp. 163-167
[12]
Y Lacasse, E Wong, G Guyatt, P King, DJ Cook, RS Goldstein.
Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease.
Lancet, 348 (1996), pp. 1115-1119
[13]
DA Redelmeier, AM Bayoumi, RS Golstein, GH Guyatt.
Interpreting small differences in functional status: The six minute walk test in chronic lung disease patients.
Am J Respir Crit Care Med, 155 (1997), pp. 1278-1282
[14]
RJA Butland, J Pang, ER Gross, AA Woodcock, DM Geddes.
Two, six, and 12-minute walking tests in respiratory disease.
BMJ, 284 (1982), pp. 1607-1608
[15]
CR McGavin, M Artvinli, H Naoe, GJR McHardy.
Dyspnoea, disability and distance walked: comparison of estimates of exercise performance in respiratory disease.
BMJ, 2 (1978), pp. 241-243
[16]
A Ramírez-Venegas, C Sánchez, J Regalado, RH Sansores.
Similitudes y diferencias en el grado de disnea durante el ejercicio en pacientes con EPOC y fibrosis.
Arch Bronconeumol, 37 (2001), pp. 221-226
[17]
AL Knox, JFJ Morrison, MF Muers.
Reproducibility of walking test results in chronic obstructive airways disease.
Thorax, 43 (1988), pp. 388-392
[18]
GH Guyatt, SO Pugsley, MJ Sullivan, PJ Thompson, LB Berman, NL Jones, et al.
Effect of encouragement on walking test performance.
Thorax, 39 (1984), pp. 818-822
[19]
LV Cavalheiro, SP Cendon, IM Ferreira, AS Ribeiro, A Gastaldi, JR Jardim.
Six minute walking test accompanied by a physiotherapist assess better the physical capacity of patients with COPD.
Am J Respir Crit Care Med, 155 (1997), pp. A167
[20]
D Stevens, E Elpern, K Sharma, P Szidon, M Ankin, S Kesten.
Comparison of hallway and treadmill six-minute walk tests.
Am J Respir Crit Care Med, 160 (1999), pp. 1540-1543
[21]
A Beaumont, A Cockcroft, A Guz.
A self paced treadmill walking test for breathless patients.
Thorax, 40 (1985), pp. 459-464
[22]
P Swerts, R Mostert, E Wouters.
Comparison of corridor and treadmill walking in patients with severe chronic obstructive pulmonary disease.
Phys Ther, 70 (1990), pp. 439-442
[23]
RA Wise, GJ Criner, SM Lee, Z Mohsenifar, D Shade, W Slivka.
Six-minute walk distance in chronic obstructive pulmonary disease: reproducibility and effect of walking course layout and length.
Am J Respir Crit Care Med, 167 (2003), pp. 1522-1527
[24]
EH Elpern, D Stevens, S Kesten.
Variability in performance of timed walk tests in pulmonary rehabilitation programs.
Chest, 118 (2000), pp. 98-105
[25]
JR Jardim, A Camelier, D Miki.
Pulmonary rehabilitation. Guidelines to success.
The Latin American perspective, 3rd ed., pp. 661-668
[26]
Grupo de trabajo de la SEPAR.
Pruebas de ejercicio cardiopulmonar.
Arch Bronconeumol, 37 (2001), pp. 247-268
[27]
S Solway, D Brooks, Y Lacasse, S Thomas.
A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain.
Chest, 119 (2001), pp. 256-270
[28]
P Enright, D Sherrill.
Reference equations for the six-minute walk in healthy adults.
Am J Respir Crit Care Med, 158 (1998), pp. 1384-1387
[29]
American Thoracic Society/American College of Chest Physicians.
ATS/ACCP. Statement on cardiopulmonary exercise testing.
Am J Respir Crit Care Med, 167 (2003), pp. 211-277
[30]
AO Harris-Eze, G Sredhar, RE Clemens, CG Gallangher, DD Marciniuk.
Oxygen improves maximal exercise performance in interstitial lung disease.
Am J Respir Crit Care Med, 150 (1994), pp. 1616-1622
[31]
VHF Mak, JR Bugler, CM Roberts, SG Spiro.
Effect of arterial oxygen desaturation on six minute walk distance, perceived effort, and perceived breathlessness in patients with airflow limitation.
Thorax, 48 (1993), pp. 33-38
[32]
RM Leach, AC Davidson, S Chinn, CHC Twort, IR Cameron, NT Batemen.
Portable liquid oxygen and exercise ability in severe respiratory disability.
Thorax, 47 (1992), pp. 781-789
[33]
T Troosters, R Gosselink, M Decramer.
Six minute walking distance in healthy elderly subjects.
Eur Respir J, 14 (1999), pp. 270-274
[34]
MAC Moreira, MR Moraes, R Tannus.
Teste da caminhada de seis minutos em pacientes com DPOC durante programa de reabilitação.
J Pneumol, 27 (2002), pp. 295-300

This study was partially funded by CAPES and CNPq, Brazil.

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?