A modified six-minute walk test (6MWT) for low-resource settings-a cross-sectional study

Area of Science:

• Pulmonary Medicine
• Cardiology
• Rehabilitation Science

Background:

• The 6-minute walk test (6MWT) is a standard for assessing functional capacity.
• Space limitations often necessitate adaptations to the standard 6MWT protocol.
• These adaptations may impact clinical practice and research, especially in low-resource settings.

Purpose of the Study:

• To evaluate the agreement between the standard 30m 6-minute walk distance (6MWD) and shorter 10m straight or figure-of-eight configurations.
• To assess the feasibility of modified 6MWT protocols in resource-constrained environments.

Main Methods:

• A cross-sectional study involving 27 adults with non-communicable diseases.
• Participants were randomized to perform the 6MWT on a 10m straight (6MWT10) or 10m figure-of-eight (6MWTF8) course, in addition to the standard 30m course (6MWT30).
• Agreement was analyzed using pairwise comparisons and concordance correlation coefficients.

Main Results:

• The mean 6MWD was significantly lower on the 10m straight course (371m) and the 10m figure-of-eight course (347m) compared to the standard 30m course (437m and 424m, respectively).
• Mean differences were 67m (p<0.01) for 6MWT30 vs 6MWT10 and 77m (p<0.01) for 6MWT30 vs 6MWTF8.
• Moderate concordance was observed between the standard and adapted test configurations.

Conclusions:

• Shorter 6MWT pathways result in significantly reduced walking distances, irrespective of configuration.
• Adapted 6MWT protocols may offer a practical alternative in low-resource settings.
• Standardization of adapted 6MWT protocols is crucial for reliable functional capacity assessment in diverse clinical and research contexts.