PMID- 36470816
OWN - NLM
STAT- MEDLINE
DCOM- 20231106
LR  - 20231106
IS  - 2531-0437 (Electronic)
IS  - 2531-0429 (Linking)
VI  - 29
IP  - 6
DP  - 2023 Nov-Dec
TI  - Test-retest reliability, construct validity and determinants of 6-minute walk 
      test performance in adult patients with asthma.
PG  - 486-494
LID - S2531-0437(22)00257-4 [pii]
LID - 10.1016/j.pulmoe.2022.10.011 [doi]
AB  - INTRODUCTION AND OBJECTIVES: Current knowledge regarding the measurement 
      properties of the 6-minute walk test (6MWT) in patients with asthma is limited. 
      Therefore, the aim of this study was to assess the test-retest reliability, 
      measurement error and construct validity of the 6MWT and identify determinants of 
      6-minute walk distance (6MWD) in patients with asthma. PATIENTS AND METHODS: 201 
      asthma patients referred for pre-pulmonary rehabilitation assessment, were 
      retrospectively analyzed (age 61+/-12 years, 42% male, FEV(1) 78+/-27% predicted). 
      Patients performed two 6MWTs on subsequent days using a 30 m straight walking 
      course. Other measurements included resting dyspnea, maximal exercise capacity, 
      body composition, pulmonary function, pulmonary and quadriceps muscle strength 
      and symptoms of anxiety and depression. Measurement error (absolute reliability) 
      was tested using standard error of measurement (SEM), minimal detectable change 
      at 95% confidence interval (MDC95%) and Bland and Altman 95% limits of agreement, 
      whereas test-retest reliability (relative reliability) and construct validity 
      were assessed using the intra-class correlation coefficient (ICC(2,1)) and 
      correlations, respectively. RESULTS: The 6MWD showed excellent test-retest 
      reliability (ICC(2,1): 0.91). The mean change in 6MWD after the second 6MWT was 
      18m (95%CI 11-24m), with 73% of the patients walking further in the second test. 
      The SEM and MDC95% for the 6MWT were 35 m and 98 m, respectively. The best 6MWD 
      correlated strongly with peak oxygen uptake during CPET and resting dyspnea (r = 
      0.61-0.64) and had no-to-moderate correlations with body composition, pulmonary 
      function, respiratory and quadriceps muscle strength and symptoms of anxiety and 
      depression (r = 0.02-0.45). Multiple linear regression was able to identify 
      maximal workload, BMI, rollator use, maximal expiratory pressure, FEV(1) and 
      DL(CO) as independent determinants of the best 6MWD (R(2) = 0.58). CONCLUSIONS: 
      The 6MWT was considered to be reliable and valid in patients with asthma, which 
      strengthens its clinical utility. However, the majority of patients demonstrated 
      a considerable learning effect in the second 6MWT, providing a strong rationale 
      for performing two 6MWTs.
CI  - Copyright (c) 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier 
      Espana, S.L.U. All rights reserved.
FAU - Meys, R
AU  - Meys R
AD  - Department of Research and Development, Ciro, Horn, the Netherlands; NUTRIM 
      School of Nutrition and Translational Research in Metabolism, Faculty of Health, 
      Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; 
      Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 
      Maastricht, the Netherlands. Electronic address: roymeys@ciro-horn.nl.
FAU - Janssen, S M J
AU  - Janssen SMJ
AD  - Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, Nijmegen, the Netherlands; Basalt Rehabilitation 
      Centre, Leiden, the Netherlands.
FAU - Franssen, F M E
AU  - Franssen FME
AD  - Department of Research and Development, Ciro, Horn, the Netherlands; NUTRIM 
      School of Nutrition and Translational Research in Metabolism, Faculty of Health, 
      Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; 
      Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 
      Maastricht, the Netherlands.
FAU - Vaes, A W
AU  - Vaes AW
AD  - Department of Research and Development, Ciro, Horn, the Netherlands.
FAU - Stoffels, A A F
AU  - Stoffels AAF
AD  - Department of Research and Development, Ciro, Horn, the Netherlands; Department 
      of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University 
      Medical Center, Nijmegen, the Netherlands.
FAU - van Hees, H W H
AU  - van Hees HWH
AD  - Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, Nijmegen, the Netherlands.
FAU - van den Borst, B
AU  - van den Borst B
AD  - Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, Nijmegen, the Netherlands.
FAU - Klijn, P H
AU  - Klijn PH
AD  - Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, the 
      Netherlands; Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the 
      Netherlands.
FAU - Burtin, C
AU  - Burtin C
AD  - REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, 
      Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
FAU - van 't Hul, A J
AU  - van 't Hul AJ
AD  - Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, Nijmegen, the Netherlands.
FAU - Spruit, M A
AU  - Spruit MA
AD  - Department of Research and Development, Ciro, Horn, the Netherlands; NUTRIM 
      School of Nutrition and Translational Research in Metabolism, Faculty of Health, 
      Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; 
      Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 
      Maastricht, the Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20221205
PL  - Spain
TA  - Pulmonology
JT  - Pulmonology
JID - 101723786
SB  - IM
MH  - Humans
MH  - Male
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - Female
MH  - Walk Test
MH  - Retrospective Studies
MH  - Reproducibility of Results
MH  - *Walking/physiology
MH  - *Asthma/diagnosis
MH  - Dyspnea/diagnosis/etiology
OTO - NOTNLM
OT  - Asthma
OT  - Exercise testing
OT  - Field walking tests
OT  - Pulmonary disease
OT  - Pulmonary rehabilitation
OT  - Reliability
COIS- Conflicts of interest FMEF reports grants and personal fees from AstraZeneca, 
      personal fees from Boehringer Ingelheim, personal fees from Chiesi, personal fees 
      from GlaxoSmithKline, grants and personal fees from Novartis, personal fees from 
      TEVA, outside the submitted work. BvdB reports personal fees from AstraZeneca and 
      Boehringer Ingelheim, outside the submitted work. MAS reports grants from 
      Netherlands Lung Foundation, grants from AstraZeneca, grants from Boehringer 
      Ingelheim, and a grant from Stichting Astma Bestrijding, all outside the 
      submitted work. RM, SMJJ, AWV, AAFS, HWHvH, PHK, CB, AJvH have nothing to 
      declare.
EDAT- 2022/12/06 06:00
MHDA- 2023/11/06 06:41
CRDT- 2022/12/05 22:15
PHST- 2022/08/24 00:00 [received]
PHST- 2022/10/13 00:00 [revised]
PHST- 2022/10/16 00:00 [accepted]
PHST- 2023/11/06 06:41 [medline]
PHST- 2022/12/06 06:00 [pubmed]
PHST- 2022/12/05 22:15 [entrez]
AID - S2531-0437(22)00257-4 [pii]
AID - 10.1016/j.pulmoe.2022.10.011 [doi]
PST - ppublish
SO  - Pulmonology. 2023 Nov-Dec;29(6):486-494. doi: 10.1016/j.pulmoe.2022.10.011. Epub 
      2022 Dec 5.