0
Original Research: Pulmonary Physiology |

The Influence of Alternative Instruction on 6-Min Walk Test DistanceFast vs Far Instruction in 6-Min Walk Test

Nargues A. Weir, MD, FCCP; A. Whitney Brown, MD; Oksana A. Shlobin, MD, FCCP; Mary A. Smith; Taylor Reffett; Edwinia Battle, RN; Shahzad Ahmad, MD; Steven D. Nathan, MD, FCCP
Author and Funding Information

From the Advanced Lung Disease and Transplant Program, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA.

Correspondence to: Steven D. Nathan, MD, FCCP, Advanced Lung Disease and Transplant Program, Department of Medicine, Inova Fairfax Hospital, 3300 Gallows Rd, Falls Church, VA 22042; e-mail: steven.nathan@inova.org


Funding/Support: This study was supported by a seed grant of $7,500 from Inova Fairfax Hospital and by the NIH-Inova Advanced Lung Disease Program Fund and the National Heart Lung and Blood Institute Fund.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(6):1900-1905. doi:10.1378/chest.13-0287
Text Size: A A A
Published online

Background:  The goal of the 6-min walk test (6MWT) is to enable patients to walk “as far as possible” as a measure of their functional ability. The impact of the specific walk instructions on patient 6MWT performance is unknown.

Methods:  Patients with pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis (IPF), and other forms of interstitial lung disease (ILD) were recruited to perform four identical 6MWTs with one differing instructional phrase. The standard instruction to walk “as far as possible” was substituted in random order with “as fast as possible,” “at your normal pace,” or “at a leisurely pace.”

Results:  Twenty-four patients (10 with PAH, eight with IPF, six with other ILD) were enrolled and completed all four 6MWTs. Patients attained the greatest distance with the fast instruction, exceeding the standard instruction distance by a mean of 52.7 m (P < .001). The mean difference between the fast and standard walks was 41.5 m in the PAH group, 66.5 m in the IPF group, and 53 m in the other ILD group.

Conclusions:  Patients do not walk as far as they are able with the standard American Thoracic Society instruction for 6MWT. Changing the wording from “far” to “fast” may facilitate a better effort and greater distance during the test. It is possible that this modified 6MWT instruction may result in improved accuracy and reproducibility, thereby enhancing its clinical and research trial usefulness.

Trial registry:  ClinicalTrials.gov; No.: NCT01789996; URL: www.clinicaltrials.gov

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543