Six-minute walk test protocol variations in low-resource settings - A scoping review

Area of Science:

• Pulmonary rehabilitation
• Exercise physiology
• Clinical assessment

Background:

• The 6-minute walk test (6MWT) is a standard tool for measuring functional exercise capacity.
• American Thoracic Society (ATS) guidelines exist for 6MWT standardization.
• Adaptations to the 6MWT are frequently implemented, particularly in low-resource settings (LRS).

Purpose of the Study:

• To identify 6MWT adaptations used in LRS.
• To determine the purpose and rationale behind these adaptations.
• To assess the implications of adapted 6MWT in LRS.

Main Methods:

• Systematic literature search of five databases until February 2021.
• Inclusion of studies that adapted and conducted the 6MWT in LRS.
• Extraction of data on study characteristics, 6MWT purpose, variations, outcomes, and rationale.

Main Results:

• 24 studies were included, mostly from lower-middle income countries.
• The most common adaptation involved modifying the course length.
• Space constraints were the primary reason cited for adapting the 6MWT.

Conclusions:

• Adaptations to 6MWT course length and configuration address space limitations in LRS.
• The utility of the ATS-guided 6MWT in LRS may require re-evaluation.
• Deviations from ATS guidelines risk underestimating patient capacity and impacting care continuity.