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How to carry out a field walking test in chronic respiratory disease.

Holland AE, Spruit MA, Singh SJ - Breathe (Sheff) (2015)

Bottom Line: The 6MWT is also widely used in other chronic respiratory disorders.There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded.The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers.The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT).These factors should be documented and held constant on repeat testing.The lowest S pO2 recorded during a 6MWT is an important marker of disease severity and prognosis.

View Article: PubMed Central - PubMed

Affiliation: Dept of Physiotherapy, La Trobe University, Melbourne, Australia ; Dept of Physiotherapy, Alfred Health, Melbourne, Australia ; Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.

ABSTRACT

Educational aims: To provide recommendations for conducting field walking tests in people with chronic respiratory disease, from the new European Respiratory Society/American Thoracic Society Technical StandardTo provide information to assist in selecting a field walking test in people with chronic respiratory disease.

Key points: The 6MWT, ISWT and ESWT are valid and reliable tests of functional exercise capacity in people with COPD. The 6MWT is also widely used in other chronic respiratory disorders.There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded.The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be held constant when the test is repeated.The 6MWT, ISWT and ESWT are strenuous tests, with cardiorespiratory responses that are similar to those during a maximal incremental exercise test. As a result, the contraindications and precautions for these field walking tests should be the same as for a laboratory-based incremental exercise test.

Summary: The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT). The Technical Standard shows that all three tests are valid and reliable measures of functional exercise capacity in people with chronic respiratory disease and makes recommendations for standardising their performance. Key findings and recommendations of the Technical Standard include: The 6MWT, ISWT and ESWT are strenuous tests which elicit cardiorespiratory responses that are similar to those observed during a maximal incremental exercise test. As a result, the contraindications and precautions for field walking tests should be consistent with those used for a laboratory-based incremental exercise test.There is strong evidence of a learning effect for the 6MWT and ISWT. Two tests should be performed when the 6MWT or ISWT are used to measure change over time.The 6MWT, ISWT and ESWT are responsive to treatment effects in people with chronic respiratory disease, particularly for rehabilitation.The 6MWT is very sensitive to variations in methodology, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be documented and held constant on repeat testing.The lowest S pO2 recorded during a 6MWT is an important marker of disease severity and prognosis. Continuous pulse oximetry is recommended during the 6MWT, to ensure that the lowest S pO2 is recorded.In adults with chronic respiratory disease, a change in 6-min walk distance of 30 m or more indicates a clinically significant change has occurred.

No MeSH data available.


Related in: MedlinePlus

Course layout for the ISWT and ESWT. Cones are inset 0.5 m from either end to avoid abrupt changes in direction. Taken from the ERS/ATS Technical Standard [1].
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Figure 1: Course layout for the ISWT and ESWT. Cones are inset 0.5 m from either end to avoid abrupt changes in direction. Taken from the ERS/ATS Technical Standard [1].

Mentions: Unlike the 6MWT, the track for the ISWT and the ESWT is fixed (fig. 1) and the instructions are given on the audio recording, which assists with standardisation. Use of supplemental oxygen and the way in which it is delivered will affect the measured distance. If patients are required to transport their own oxygen cylinder, oxygen supplementation many not improve the recorded distance [29]; but if it is transported by a clinician, the distance walked will increase [30]. As a result, if supplemental oxygen is to be used during testing, exactly the same mode of delivery should be used for repeat testing.Figure 1


How to carry out a field walking test in chronic respiratory disease.

Holland AE, Spruit MA, Singh SJ - Breathe (Sheff) (2015)

Course layout for the ISWT and ESWT. Cones are inset 0.5 m from either end to avoid abrupt changes in direction. Taken from the ERS/ATS Technical Standard [1].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4487379&req=5

Figure 1: Course layout for the ISWT and ESWT. Cones are inset 0.5 m from either end to avoid abrupt changes in direction. Taken from the ERS/ATS Technical Standard [1].
Mentions: Unlike the 6MWT, the track for the ISWT and the ESWT is fixed (fig. 1) and the instructions are given on the audio recording, which assists with standardisation. Use of supplemental oxygen and the way in which it is delivered will affect the measured distance. If patients are required to transport their own oxygen cylinder, oxygen supplementation many not improve the recorded distance [29]; but if it is transported by a clinician, the distance walked will increase [30]. As a result, if supplemental oxygen is to be used during testing, exactly the same mode of delivery should be used for repeat testing.Figure 1

Bottom Line: The 6MWT is also widely used in other chronic respiratory disorders.There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded.The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers.The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT).These factors should be documented and held constant on repeat testing.The lowest S pO2 recorded during a 6MWT is an important marker of disease severity and prognosis.

View Article: PubMed Central - PubMed

Affiliation: Dept of Physiotherapy, La Trobe University, Melbourne, Australia ; Dept of Physiotherapy, Alfred Health, Melbourne, Australia ; Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.

ABSTRACT

Educational aims: To provide recommendations for conducting field walking tests in people with chronic respiratory disease, from the new European Respiratory Society/American Thoracic Society Technical StandardTo provide information to assist in selecting a field walking test in people with chronic respiratory disease.

Key points: The 6MWT, ISWT and ESWT are valid and reliable tests of functional exercise capacity in people with COPD. The 6MWT is also widely used in other chronic respiratory disorders.There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded.The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be held constant when the test is repeated.The 6MWT, ISWT and ESWT are strenuous tests, with cardiorespiratory responses that are similar to those during a maximal incremental exercise test. As a result, the contraindications and precautions for these field walking tests should be the same as for a laboratory-based incremental exercise test.

Summary: The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT). The Technical Standard shows that all three tests are valid and reliable measures of functional exercise capacity in people with chronic respiratory disease and makes recommendations for standardising their performance. Key findings and recommendations of the Technical Standard include: The 6MWT, ISWT and ESWT are strenuous tests which elicit cardiorespiratory responses that are similar to those observed during a maximal incremental exercise test. As a result, the contraindications and precautions for field walking tests should be consistent with those used for a laboratory-based incremental exercise test.There is strong evidence of a learning effect for the 6MWT and ISWT. Two tests should be performed when the 6MWT or ISWT are used to measure change over time.The 6MWT, ISWT and ESWT are responsive to treatment effects in people with chronic respiratory disease, particularly for rehabilitation.The 6MWT is very sensitive to variations in methodology, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be documented and held constant on repeat testing.The lowest S pO2 recorded during a 6MWT is an important marker of disease severity and prognosis. Continuous pulse oximetry is recommended during the 6MWT, to ensure that the lowest S pO2 is recorded.In adults with chronic respiratory disease, a change in 6-min walk distance of 30 m or more indicates a clinically significant change has occurred.

No MeSH data available.


Related in: MedlinePlus