The 6-minute walk test in outpatient cardiac rehabilitation: validity, reliability and responsiveness—a systematic review
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Background: The six-minute-walk-test (6MWT) is a common outcome measurement in cardiac rehabilitation (CR); however, a search of the literature found no guidelines established for the use of the 6MWT in CR. Objectives: Systematically review the validity, reliability, and responsiveness of the 6MWT in CR. Data Sources: OvidMEDLINE, SPORTdiscus, EMBASE, CINAHL, Cochrane Reviews, Cochrane Clinical Trials between January 1948 and April 2011. Eligibility Criteria: Studies using 6MWTs in subjects with coronary artery disease undergoing outpatient-CR were included. Non-English-language articles were excluded. Study appraisal and methods: Quantitative and qualitative analyses were conducted including, methodology quality assessment, meta-analysis and assessment against level of evidence criteria. Results: Fifteen articles met inclusion criteria. One high quality study was identified for reliability, six for validity and eleven for responsiveness. Meta-analysis indicated strong evidence that the 6MWT was responsive to change in clinical status following CR with an estimated mean difference (95% CI, p-value) in 6MWD of 60.43m (54.57, 66.30, <0.00001). Qualitative analysis indicated moderate evidence for the repeatability of the 6MWT in the CR population, for a 2-8% learning effect between repeated-6MWTs, for a relationship between peak heart rate during 6MWT and during cycle-exercise at ventilatory threshold and for a moderate to high correlation between the 6MWD and maximum-metabolic-equivalents achieved on symptom-limited-exercise-test. Limitations: Few studies assessed similar aspects of validity for the 6MWT
Copyright 2012 Chartered Society of Physiotherapy, published by Elsevier. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
Cardiology (incl. Cardiovascular Diseases)