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Cited by 127Cardiovascular and exercise physiologyHeart Failure Treatment and ManagementHeart rate and cardiovascular health

The reproducibility and sensitivity of the 6-min walk test in elderly patients with chronic heart failure

Open access
Ingle, Lee, Shelton, Rhidian J., Rigby, Alan S., Nabb, Samantha, Clark, Andrew L., Cleland, John G.F.·2005·European Heart Journal
DOI 10.1093/eurheartj/ehi259
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Abstract

AIMS: The 6-min walk test (6-MWT) is used to estimate functional capacity. However, in elderly patients with chronic heart failure (CHF): (i) 1 year reproducibility of the 6-MWT; (ii) sensitivity of the 6-MWT to self-perceived changes in symptoms of heart failure; and (iii) implications for patient numbers required for studies using the 6-MWT as an endpoint have not been described. METHODS AND RESULTS: One thousand and seventy-seven patients with CHF, aged>60, with NYHA Class > or =II were recruited. Heart failure symptom assessment was determined using a questionnaire related to aspects of physical function, and patients performed a baseline 6-MWT, with follow-up 1 year later. Seventy-four patients with unchanged symptoms had an unchanged 6-MWT distance, with an overall intraclass correlation coefficient of 0.80 (95% CI=0.69-0.87). Four hundred and twenty-three patients reported an improvement in symptoms during follow-up. There was a negative correlation (r=-0.55; P=0.0001) between Delta symptoms and Delta 6-MWT (i.e. a reduced 6-MWT distance is associated with reduced symptom severity at follow-up). Five hundred and sixteen patients reported worsening symptoms of heart failure, a moderate inverse correlation (r=-0.53; P=0.0001) was displayed between Delta symptoms and Delta 6-MWT. For all patients, irrespective of symptom status, a high inverse correlation (r=-0.75; P=0.0001) was evident. On the basis of the data for patients with unchanged symptoms, it is calculated that to detect an increase in 6-MWT of 50 m, with 90% power, a study size of approximately 120 is required. CONCLUSION: In elderly patients with CHF, the 6-MWT shows satisfactory agreement when repeated 1 year later. Change in 6-MWT distance is sensitive to change in self-perceived symptoms of heart failure.

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  • The low sensitivity of NYHA classification and 6 min walk test limits their ability to measure change over time.

    “The low sensitivity of NYHA classification and 6 min walk test limits their ability to measure change over time”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [39]

    The section ‘Sensitivity to changes in the 6-MWT based on changes in symptoms’ (page unavailable) says the opposite for the 6-min walk test: changes in walking distance were sensitive to changes in heart-failure symptoms over time. The cited passages do not establish that NYHA classification has low sensitivity. (LLM, conf=0.88)

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    Experimental — accuracy not yet measured

  • The additional equipment to measure metabolic gas exchange limits the widespread applicability of cardiopulmonary exercise testing.

    “while the additional equipment to measure metabolic gas exchange limits the widespread applicability of cardiopulmonary exercise testing. 38 , 39”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [39]

    The Introduction (page unavailable) describes the six-minute walk test as low-cost and requiring only a measured surface and timing device. Searches for metabolic gas exchange and cardiopulmonary exercise-testing equipment found no passage saying that such equipment limits the test’s widespread applicability. (LLM, conf=0.72)

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Research works printed but not linked: 4

  1. Faggiano P, D'Aloia A, Gualeni A et al. Oxygen uptake during the 6 minute walking test. Preliminary experience using a portable device. Am Heart J 1998;165:225-232.
  2. Donner A. Sample size requirements for the comparison of two or more coefficients of inter-observer agreement. Stat Med 1998;17:1157-1168.
  3. Pinna GD, Opasich C, Mazza A et al. Reproducibility of the six-minute walking test in heart failure patients. Stat Meth 2000;19: 3087-3094.
  4. Fairclough DL, Peterson HF, Chang V. Why are missing quality of life data a problem in clinical trials of cancer therapy? Stat Med 1998;17:667-677.

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Authors
Ingle, L., Shelton, R. J., Rigby, A. S., Nabb, S., Clark, A. L., & Cleland, J. G. F.
Affiliations
Castle Hill Hospital (GB)
Corresponding author
Ingle, Lee
ORCID
Venue
European Heart Journal
Publisher
Oxford University Press (OUP)
Published
2005-04-14
Volume
26
Issue
17
Pages
1742-1751
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
DOI
10.1093/eurheartj/ehi259
OpenAlex
W2110020738
Cited by
126
References
53
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 8 · 2016: 6 · 2015: 10 · 2014: 6 · 2013: 4 · 2012: 4
FWCI
23.49
Type
journal article
Language
en
Open access
Locations
  • European Heart Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
Keywords
6-minute walk test, chronic heart failure, elderly patients, reproducibility, test sensitivity, functional capacity, heart failure symptoms, self-reported symptoms, sample size determination, exercise capacity
MeSH terms
Aged, Exercise Test, Female, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Prognosis, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Walking

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