Validity and Reliability of the 6-Minute Walk Test in a Cardiac Rehabilitation Population

Background Cardiac rehabilitation is an established performance measure for adults with ischemic heart disease, but patient participation is remarkably low. Home‐based cardiac rehabilitation (HBCR) may be more practical and feasible, but evidence regarding its efficacy is limited. We sought to compare the effects of HBCR versus facility‐based cardiac rehabilitation (FBCR) on functional status in patients with ischemic heart disease. Methods and Results This was a pragmatic trial of 237 selected patients with a recent ischemic heart disease event, who enrolled in HBCR or FBCR between August 2015 and September 2017. The primary outcome was 3‐month change in distance completed on a 6‐minute walk test. Secondary outcomes included rehospitalization as well as patient‐reported physical activity, quality of life, and self‐efficacy. Characteristics of the 116 patients enrolled in FBCR and 121 enrolled in HBCR were similar, except the mean time from index event to enrollment was shorter for HBCR (25 versus 77 days; P <0.001). As compared with patients undergoing FBCR, those in HBCR achieved greater 3‐month gains in 6‐minute walk test distance (+95 versus +41 m; P <0.001). After adjusting for demographics, comorbid conditions, and indication, the mean change in 6‐minute walk test distance remained significantly greater for patients enrolled in HBCR (+101 versus +40 m; P <0.001). HBCR participants reported greater improvements in quality of life and physical activity but less improvement in exercise self‐efficacy. There were no deaths or cardiovascular hospitalizations. Conclusions Patients enrolled in HBCR achieved greater 3‐month functional gains than those enrolled in FBCR. Our data suggest that HBCR may safely derive equivalent benefits in exercise capacity and overall program efficacy in selected patients. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02105246.

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Phase-I cardiac rehabilitation practices among physiotherapists in INDIA - A survey

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v19i2.44998 ◽

2020 ◽

Vol 19 (2) ◽

pp. 214-222

Author(s):

Shruti Chari ◽

Gopala Krishna Alaparthi ◽

Shyam Krishnan K ◽

Ashish Prabhakar ◽

Kalyana Chakravarthy Bairapareddy

Keyword(s):

Cardiac Surgery ◽

Cardiac Rehabilitation ◽

Phase I ◽

Lower Limb ◽

Medical Science ◽

Walk Test ◽

Breathing Exercises ◽

Postural Drainage ◽

6 Minute Walk Test ◽

Minute Walk

Objective: To find out the current practice patterns of Physiotherapists in Phase I Cardiac Rehabilitation of patients following Cardiac Surgery (CABG/Valve Surgery). Materials and Methods: The cross sectional survey included 600 cardio-pulmonary physiotherapists working in Cardiac Care Unit, who filled questionnaires sent to them through e-mail. Results: 252 completed questionnaires were received back, the response rate being of 42 %, with a major portion of responses coming from Maharashtra, Karnataka and Andhra Pradesh. More than 80 % of physiotherapists assess and treat the patient Pre- Operatively. More than 90% of physiotherapists performed Cardiac Rehabilitation Post-Operatively. Cardiac Rehabilitation Treatment Techniques predominantly focused on Breathing Exercises (96.7%), Incentive Spirometry (91.1%), Coughing and Huffing (83.3%), Thoracic Expansion Exercises (82.13%), Positioning (71.16%), Percussion and Vibration (63.6%), Modified Postural Drainage (41.2%), active exercises of the upper limb (89.13%), and lower limb exercises (89.3%). Dangling the lower limb (69%) was started on Post –Operative day 2. Room and corridor mobilisation (73.8%) began on third Post-Operative day. 29.4% Stair case climbing was started on fourth post-operative day. 73.8% of patients practiced 6-minute walk test prior to discharge. Most commonly used sternal precautions were Supported Coughing (96.0%) and Lifting Restrictions (82.5%). Conclusion: Phase I cardiac rehabilitation adopted by physiotherapists for cardiac surgery patients involves treatment which mainly focused on cough and huff techniques, breathing exercises and thoracic expansion exercises. On Post-Operative day 2, dangling the lower limb and room ambulation started on third post-Operative day 3. The training for climbing stairs started on fourthpost-operative day. The most commonly used sternal precautions were supported coughing and lifting restrictions whereas 6-minute walk test was use to assess exercise tolerance,prior to discharge. Bangladesh Journal of Medical Science Vol.19(2) 2020 p.214-222

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Validity and Reliability of Four Clinical Gait Measures in Patients with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2015-006 ◽

2017 ◽

Vol 19 (5) ◽

pp. 247-252 ◽

Cited By ~ 20

Author(s):

Susan E. Bennett ◽

Lacey E. Bromley ◽

Nadine M. Fisher ◽

Machiko R. Tomita ◽

Paulette Niewczyk

Keyword(s):

Multiple Sclerosis ◽

Reliability And Validity ◽

Time Of Day ◽

Self Report ◽

Walk Test ◽

Validity And Reliability ◽

Timed Up And Go ◽

Edss Score ◽

6 Minute Walk Test ◽

Minute Walk

Background: The gold standards for assessing ambulation are the Expanded Disability Status Scale (EDSS) and the Timed 25-Foot Walk (T25FW) test. In relation with these measures, we assessed the reliability and validity of four clinical gait measures: the Timed Up and Go (TUG) test, the Dynamic Gait Index (DGI), the 2-Minute Walk Test (2MWT), and the 6-Minute Walk Test (6MWT). Patient self-report of gait was also assessed using the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Methods: Individuals 20 years or older with a diagnosis of multiple sclerosis (MS) and an EDSS score of 2.0 to 6.5 completed the MSWS-12, T25FW test, TUG test, DGI, 2MWT, and 6MWT. All the tests were repeated 2 weeks later at the same time of day to establish their reliability and concurrent validity. Predictive validity was established using the EDSS. Results: Forty-two patients with MS were included. All measures showed high test-retest reliability. The TUG test, 2MWT, and 6MWT were significantly correlated with the T25FW test (Spearman ρ = −0.902, −0.919, and −0.905, respectively). The EDSS was also significantly correlated with all the walking tests. The MSWS-12 demonstrated the highest correlation to the EDSS (ρ = 0.788). Conclusions: The TUG test, the DGI, the 2MWT, and the 6MWT exhibited strong psychometric properties and were found to be significant predictors of the EDSS score. Use of these tests to prospectively monitor the effects of medical and rehabilitation treatment should be considered in the comprehensive care of patients with MS.

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