Cited by 716Cardiovascular and exercise physiologyChronic Obstructive Pulmonary Disease (COPD) ResearchHealth Systems, Economic Evaluations, Quality of Life

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Minimal clinically important difference for change in 6‐minute walk test distance of adults with pathology: a systematic review

Bohannon, Richard W., Crouch, Rebecca·2017·Journal of Evaluation in Clinical Practice

DOI 10.1111/jep.12629

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Abstract

Rationale, aims, and objectives: The 6‐minute walk test (6MWT) is widely used as a test of functional exercise capacity. Several studies have reported the minimal clinically important difference (MCID) for the 6MWT; however, the findings of the studies have not been examined in the context of one another. In this review, we aimed to summarize available information on the MCID for the 6MWT performed by patients with pathology. Methods: Relevant literature was identified by searches of 3 electronic databases (PubMed, Scopus, and Cumulative Index of Nursing and Allied Health), examination of article reference lists, and consultation with an expert. Inclusion necessitated that articles (1) be original, full length, and peer reviewed, (2) report an MCID for the 6MWT, and (3) focus on adults with medical issues. Articles were excluded if the MCID was determined by a procedure other than receiver operating characteristic curve analysis. Articles were abstracted for information on participants, interventions, 6MWT distance, and the determination of MCID. Quality was assessed using a hybrid 9‐item (0‐ to 18‐point) instrument. Results: Six articles were selected based on the inclusion and exclusion criteria. The populations studied included people with chronic obstructive pulmonary disease, lung cancer, coronary artery disease, diffuse parenchymal lung disease, and non–cystic fibrosis bronchiectasis and adults with fear of falling. Mean baseline 6MWT distances ranged from 295 to 551 m. The MCIDs for which the area under the receiver operating characteristic curve was at least 0.70 ranged from 14.0 to 30.5 m. Conclusions: Based on our findings, a change of 14.0 to 30.5 m may be clinically important across multiple patient groups.

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Self-citation
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“The sample calculation was performed accepting the minimum clinically significant difference of 30 m walked in pulmonary disease [28] and an effect size (ES) of 0.85 Cohen’s D value.”
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“It must be noted though that the six minutes’ walk test is an exercise test, used to evaluate aerobic capacity, performance and endurance [47].”
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“60 As such, the 29-m increase in the current, relatively healthy population may not be clinically meaningful.”
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“[23]”
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“In addition, we calculated how many participants (numbers and percentage) did and did not improve on the ASPI [if at least one item improved by ≥ 20%, whereas none of the items worsened by ≥ 20%, it was classified as improved (38)] and how many improved, had no change, and worsened on the 6MWT over at least 30 m, its…”
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Experimental study protocol of the project “MOtor function and VItamin D: Toolkit for motor performance and risk Assessment (MOVIDA)”
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“� The core of the instrumental functional assessment is the performance of an adapted version of the six minutes walking test (6MWT) [55]: the participant will be asked to walk on a passive treadmill, at 0 slope, “as fast as possible without running and trying to maintain the same pace during the test”.”
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“§ For the multilevel analysis of the 6MWT, we used an MCID of ± ⩾ 30 m [33]. ƒ For the multilevel analysis of the CCQ, we used an MCID of ± ⩾ 0.4 points [34].”
Influential
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“However, in total distance walked, the mean difference in 6MWT was 42.9 m, surpassing previously reported minimal clinically important differences (Bohannon & Crouch, 2017; Kwok et al., 2013).”
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“It is worth noting that the baseline 6MWD in previous studies ranged from 295 to 551 m (29), which is nearly two times higher than what we found in the current study (148.0 m in the intervention group and 146.6 m in the control group).”
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Influential
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“While the MCID on the 6MWT for people with MS has not been reported, across multiple ages and different pathologies studied, changes of 15–35 meters are considered minimally clinically important.(21) In our study, 75% of participants exceeded a change of 14 meters and the entire lower functioning group exceeded 32 met…”
Background
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“5 m may be clinically significant across multiple patient groups) [12].”
Background
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“The MCID for 6MWT was an increase of ≥ 30 m from pre- to post-program [6].”
BackgroundMethod
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Self-citation
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“Furthermore, meaningful improvements were observed in the SPPB, BBS, TUG, and 6WMT with an MCID score ≥ 1, an MDC score ≥ 5.9, an MDC ≥ 2.68 s, and an MCID ≥ 30.5 m, respectively [37–40].”
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“An approximately 5% persistent worsening in 6MWD has also been established as a threshold for clinically meaningful progression for a range of similar diseases with compromised neuromuscular and pulmonary function [6 , 16 , 20] .”
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“This exceeds the minimum clinically important difference established for the 6MWT for individuals with pathology, which ranges from 14 to 30.5 m (Bohannon & Crouch, 2017).”
Influential
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“In terms of exercise capacity, although 6MWD increased in message framing groups at T1 compared to NFM (GFM: 11.55 m; LFM: 6.48 m; NFM: 6.38 m), intergroup changes did not exceed the minimal clinically important difference (MCID: 22–42 m) [56–58].”
Influential
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“A minimum clinically important difference (MCID) of 14.0–30.5 m was used based on a previous study [17].”
Influential
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“14”
The six-minute walk test prognostic value in heart failure patients
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“The minimal clinically important difference (MCID) for the 6-min walk test varies from 14 to 54 m across different populations, with chronic respiratory diseases specifically showing MCIDs of 25–33 m 37,38 .”
Can sacubitril/valsartan enhance sleep quality and reduce daytime dysfunction in HFrEF patients?
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“A variation exceeding 50 m in walking distance is deemed to have clini - cal significance, reflecting a meaningful change in patient condition [ 16].”

Authors: Bohannon, R. W., & Crouch, R.
Affiliations: Campbell University (US)
Corresponding author: Crouch, Rebecca
ORCID: Bohannon, Richard W.
Venue: Journal of Evaluation in Clinical Practice
Publisher: Wiley
Published: 2016-09-04
Volume: 23
Issue: 2
Pages: 377-381
ISSN: 1356-1294 (ISSN-L)
1365-2753
DOI: 10.1111/jep.12629
OpenAlex: W2517085950
Cited by: 715
References: 17
Citations by year: 2026: 80 · 2025: 118 · 2024: 88 · 2023: 94 · 2022: 108 · 2021: 75 · 2020: 69 · 2019: 49 · 2018: 22 · 2017: 12
FWCI: 6.13
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Evaluation in Clinical Practice (publishedVersion)
PubMed (publishedVersion)
Funders: Ministerul Cercetării, Inovării şi Digitalizării
Topics: Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords: minimal clinically important difference, 6-minute walk test, exercise capacity, functional capacity, chronic obstructive pulmonary disease, lung cancer, coronary artery disease, interstitial lung disease, non-cystic fibrosis bronchiectasis, fear of falling, ROC curve
MeSH terms: Accidental Falls, Walk Test, Minimal Clinically Important Difference, Bronchiectasis, Coronary Artery Disease, Fear, Humans, Quality of Life, ROC Curve, Lung Diseases, Interstitial, Pulmonary Disease, Chronic Obstructive

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Minimal clinically important difference for change in 6‐minute walk test distance of adults with pathology: a systematic review

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