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The 1-minute walk test is as effective as the 6-minute walk test at predicting transplant-free survival in patients with idiopathic pulmonary fibrosis (IPF), based on data from 179 adults. The findings were presented at the CHEST annual meeting.

The 6-minute test is often used to evaluate functional capacity in IPF patients, but is not always practical in a busy clinic setting, according to Flavia S. Nunes, MD, of Inova Fairfax Hospital in Falls Church, VA, and colleagues.

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“The 6-minute walk test (6MWT) is a simple, objective, and reproducible measurement of functional capacity and it is a reliable, valid, and responsive measure of disease status in idiopathic pulmonary fibrosis,” Dr. Nunes said in an interview.

“Among the clinical and physiologic predictors associated with survival in IPF, the 6MWT has been increasingly used over the past 5 years as a secondary endpoint in the efficacy analyses of potential therapies for IPF. Validation of shorter time of walking might make the test more feasible to be applied in routine clinical care,” she said.

To determine the predictive value of the first minute of the 6-minute test, the researchers reviewed data from 142 men and 37 women at a tertiary referral center between May 2010 and February 2017. The average age of the patients was 68 years, the average body mass index was 28.3 kg/m2, and 27% used oxygen supplementation during the walk test.

Overall, the mean distance for the 6-minute test was 372 m, and the average distance for the 1-minute test was 65 m. Study participants who achieved a 6-minute walk distance greater than 372 m were defined as high walkers, and those with a 6-minute walk distance less than 372 m were defined as low walkers. A strong correlation appeared between the 6-minute distance and 1-minute distance in terms of predicting survival, and 1-year transplant-free survival was significantly better in high walkers than in low walkers (27 months vs. 22 months; P = .015).

Dr. Nunes said she was not surprised by the results, in part because previous research has shown a strong correlation among 2-minute, 6-minute, and 12-minute walking tests.

Although more research is needed to validate the findings, the results suggest that the 1-minute test might be a practical substitute for the 6-minute test by providing similar prognostic information more quickly and easily than the 6-minute test, the researchers said.

“It is important for clinicians to know that the time chosen to assess exercise tolerance by walking tests might not be critical,” said Dr. Nunes. “Shorter walks are not only less time consuming, and easier for both patients and clinicians, but are also reproducible and discriminatory of survival.

“We need to validate the test performance characteristics and prognostic value of distance walked in a 1MWT compared to the standard 6MWT in an independent cohort of patients with IPF,” Dr. Nunes noted. “Additionally, the evaluation of alternate instruction, for example changing the wording from ‘walk as far’ to ‘walk as fast’ might facilitate a better effort, and a greater distance with improved reproducibility. Other novel parameters and modifications to the 6MWT or 1MWT might further improve the utility of these tests in the management of IPF and other patients,” she added.

The researchers had no financial conflicts to disclose.

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Dr. Eric J. Gartman,
Dr. Eric J. Gartman
Eric Gartman, MD, FCCP, comments: Functional testing parameters (such as the 6MWT) have been shown to be of great value in prognosticating treatment outcomes and survival in many cardiopulmonary diseases and rehabilitation settings.  Specifically, the 6MWT is a well-defined, structured assessment and is meant to be performed to the standard in each patient, each time - since if we are to apply the results of clinical studies to our patients, we must perform the testing parameter in the same manner as the studies did. As the authors suggest, it is important that any new assessment undergo similar evaluation, especially in this case since one would think that curtailing the 6WMT to 1 minute may decrease its discriminatory ability in a larger population. Finally, I think many would take issue with the assertion that the 6MWT is too burdensome of a test to perform clinically - especially in light of the severity of the conditions for which it typically is being performed.

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Dr. Eric J. Gartman,
Dr. Eric J. Gartman
Eric Gartman, MD, FCCP, comments: Functional testing parameters (such as the 6MWT) have been shown to be of great value in prognosticating treatment outcomes and survival in many cardiopulmonary diseases and rehabilitation settings.  Specifically, the 6MWT is a well-defined, structured assessment and is meant to be performed to the standard in each patient, each time - since if we are to apply the results of clinical studies to our patients, we must perform the testing parameter in the same manner as the studies did. As the authors suggest, it is important that any new assessment undergo similar evaluation, especially in this case since one would think that curtailing the 6WMT to 1 minute may decrease its discriminatory ability in a larger population. Finally, I think many would take issue with the assertion that the 6MWT is too burdensome of a test to perform clinically - especially in light of the severity of the conditions for which it typically is being performed.

Body

Dr. Eric J. Gartman,
Dr. Eric J. Gartman
Eric Gartman, MD, FCCP, comments: Functional testing parameters (such as the 6MWT) have been shown to be of great value in prognosticating treatment outcomes and survival in many cardiopulmonary diseases and rehabilitation settings.  Specifically, the 6MWT is a well-defined, structured assessment and is meant to be performed to the standard in each patient, each time - since if we are to apply the results of clinical studies to our patients, we must perform the testing parameter in the same manner as the studies did. As the authors suggest, it is important that any new assessment undergo similar evaluation, especially in this case since one would think that curtailing the 6WMT to 1 minute may decrease its discriminatory ability in a larger population. Finally, I think many would take issue with the assertion that the 6MWT is too burdensome of a test to perform clinically - especially in light of the severity of the conditions for which it typically is being performed.

 

The 1-minute walk test is as effective as the 6-minute walk test at predicting transplant-free survival in patients with idiopathic pulmonary fibrosis (IPF), based on data from 179 adults. The findings were presented at the CHEST annual meeting.

The 6-minute test is often used to evaluate functional capacity in IPF patients, but is not always practical in a busy clinic setting, according to Flavia S. Nunes, MD, of Inova Fairfax Hospital in Falls Church, VA, and colleagues.

czardases/Thinkstock
“The 6-minute walk test (6MWT) is a simple, objective, and reproducible measurement of functional capacity and it is a reliable, valid, and responsive measure of disease status in idiopathic pulmonary fibrosis,” Dr. Nunes said in an interview.

“Among the clinical and physiologic predictors associated with survival in IPF, the 6MWT has been increasingly used over the past 5 years as a secondary endpoint in the efficacy analyses of potential therapies for IPF. Validation of shorter time of walking might make the test more feasible to be applied in routine clinical care,” she said.

To determine the predictive value of the first minute of the 6-minute test, the researchers reviewed data from 142 men and 37 women at a tertiary referral center between May 2010 and February 2017. The average age of the patients was 68 years, the average body mass index was 28.3 kg/m2, and 27% used oxygen supplementation during the walk test.

Overall, the mean distance for the 6-minute test was 372 m, and the average distance for the 1-minute test was 65 m. Study participants who achieved a 6-minute walk distance greater than 372 m were defined as high walkers, and those with a 6-minute walk distance less than 372 m were defined as low walkers. A strong correlation appeared between the 6-minute distance and 1-minute distance in terms of predicting survival, and 1-year transplant-free survival was significantly better in high walkers than in low walkers (27 months vs. 22 months; P = .015).

Dr. Nunes said she was not surprised by the results, in part because previous research has shown a strong correlation among 2-minute, 6-minute, and 12-minute walking tests.

Although more research is needed to validate the findings, the results suggest that the 1-minute test might be a practical substitute for the 6-minute test by providing similar prognostic information more quickly and easily than the 6-minute test, the researchers said.

“It is important for clinicians to know that the time chosen to assess exercise tolerance by walking tests might not be critical,” said Dr. Nunes. “Shorter walks are not only less time consuming, and easier for both patients and clinicians, but are also reproducible and discriminatory of survival.

“We need to validate the test performance characteristics and prognostic value of distance walked in a 1MWT compared to the standard 6MWT in an independent cohort of patients with IPF,” Dr. Nunes noted. “Additionally, the evaluation of alternate instruction, for example changing the wording from ‘walk as far’ to ‘walk as fast’ might facilitate a better effort, and a greater distance with improved reproducibility. Other novel parameters and modifications to the 6MWT or 1MWT might further improve the utility of these tests in the management of IPF and other patients,” she added.

The researchers had no financial conflicts to disclose.

 

The 1-minute walk test is as effective as the 6-minute walk test at predicting transplant-free survival in patients with idiopathic pulmonary fibrosis (IPF), based on data from 179 adults. The findings were presented at the CHEST annual meeting.

The 6-minute test is often used to evaluate functional capacity in IPF patients, but is not always practical in a busy clinic setting, according to Flavia S. Nunes, MD, of Inova Fairfax Hospital in Falls Church, VA, and colleagues.

czardases/Thinkstock
“The 6-minute walk test (6MWT) is a simple, objective, and reproducible measurement of functional capacity and it is a reliable, valid, and responsive measure of disease status in idiopathic pulmonary fibrosis,” Dr. Nunes said in an interview.

“Among the clinical and physiologic predictors associated with survival in IPF, the 6MWT has been increasingly used over the past 5 years as a secondary endpoint in the efficacy analyses of potential therapies for IPF. Validation of shorter time of walking might make the test more feasible to be applied in routine clinical care,” she said.

To determine the predictive value of the first minute of the 6-minute test, the researchers reviewed data from 142 men and 37 women at a tertiary referral center between May 2010 and February 2017. The average age of the patients was 68 years, the average body mass index was 28.3 kg/m2, and 27% used oxygen supplementation during the walk test.

Overall, the mean distance for the 6-minute test was 372 m, and the average distance for the 1-minute test was 65 m. Study participants who achieved a 6-minute walk distance greater than 372 m were defined as high walkers, and those with a 6-minute walk distance less than 372 m were defined as low walkers. A strong correlation appeared between the 6-minute distance and 1-minute distance in terms of predicting survival, and 1-year transplant-free survival was significantly better in high walkers than in low walkers (27 months vs. 22 months; P = .015).

Dr. Nunes said she was not surprised by the results, in part because previous research has shown a strong correlation among 2-minute, 6-minute, and 12-minute walking tests.

Although more research is needed to validate the findings, the results suggest that the 1-minute test might be a practical substitute for the 6-minute test by providing similar prognostic information more quickly and easily than the 6-minute test, the researchers said.

“It is important for clinicians to know that the time chosen to assess exercise tolerance by walking tests might not be critical,” said Dr. Nunes. “Shorter walks are not only less time consuming, and easier for both patients and clinicians, but are also reproducible and discriminatory of survival.

“We need to validate the test performance characteristics and prognostic value of distance walked in a 1MWT compared to the standard 6MWT in an independent cohort of patients with IPF,” Dr. Nunes noted. “Additionally, the evaluation of alternate instruction, for example changing the wording from ‘walk as far’ to ‘walk as fast’ might facilitate a better effort, and a greater distance with improved reproducibility. Other novel parameters and modifications to the 6MWT or 1MWT might further improve the utility of these tests in the management of IPF and other patients,” she added.

The researchers had no financial conflicts to disclose.

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