Original articleDetermining the Minimal Clinically Important Difference for the Six-Minute Walk Test and the 200-Meter Fast-Walk Test During Cardiac Rehabilitation Program in Coronary Artery Disease Patients After Acute Coronary Syndrome
Section snippets
Participants
Patients referred to the cardiac rehabilitation department of Dijon University Hospital after an ACS were invited to participate. Patients were eligible if they had been admitted to an ambulatory cardiac rehabilitation program after percutaneous transluminal coronary angioplasty or coronary stent placement after an ACS. Only patients admitted within 2 months after the ACS under optimal medical treatment according to the latest recommendations32 (ie, β-blockers, angiotensin-converting enzyme
Participants
Eighty-one patients were recruited, and all completed the rehabilitation program. Two patients did not complete the third evaluation (both had to stop training for 2 weeks for personal or family reasons). Demographic and anthropometric characteristics of the 81 included patients are listed in table 1.
Walk Test and Maximal Exercise Test Results
Overall, there were mean improvements of 73.2±56.5m in 6MWD (15.7%±12.2%) and 5±17.7 seconds in 200-m FWT time (−5.3%±10.8%) (fig 1). All walk tests were well tolerated both before and after
Discussion
We estimated MCID for the 6MWD at approximately 25m in patients with CAD who recently experienced an ACS and who had benefited from cardiac rehabilitation. This estimate was consistent regardless of the estimation method used (anchor or distribution based). Using the same method, we could not determine an MCID with satisfactory metrologic qualities for 200-m FWT time.
To our knowledge, this is the first study to evaluate the MCID for walk tests in patients with CAD. A previous study determined
Conclusions
Our study provides the first estimates of an MCID, approximately 25m, in performance at the 6MWT in a CAD population. This result supports the use of the 6MWT during cardiac rehabilitation programs in patients with CAD after ACS and will help practitioners and researchers interpret changes in 6MWD in this population.
Acknowledgments
We thank the rehabilitation team for participation in this study and Arnaud Dupeyron, MD, PhD, and Anthony Gelis, MD, MsC, for their unconditional 10-year support. The English was revised by Philip Bastable.
References (55)
- et al.
How should we measure function in patients with chronic heart and lung disease?
J Chronic Dis
(1985) The use of field walking tests for assessment of functionnal capacity in patients with chronic airways obstruction
Physiotherapy
(1992)- et al.
A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain
Chest
(2001) - et al.
Cardiorespiratory requirements and reproducibility of the six-minute walk test in elderly patients with coronary artery disease
Arch Phys Med Rehabil
(2004) - et al.
Six-minute walk performance and quality of life comparisons in North Carolina cardiac rehabilitation programs
Heart Lung
(2003) - et al.
Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise
Am J Cardiol
(2006) - et al.
Measurement of health statusAscertaining the minimal clinically important difference
Control Clin Trials
(1989) - et al.
Toward a standard definition of clinically significant change
Behav Ther
(1986) - et al.
Defining clinically meaningful change in health-related quality of life
J Clin Epidemiol
(2003) - et al.
An integrated method to determine meaningful changes in health-related quality of life
J Clin Epidemiol
(2004)
Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance
J Chronic Dis
The Dijon Physical Activity Score: reproducibility and correlations with physical fitness in patients with coronary artery disease
Ann Readapt Med Phys
Determination of the minimal clinically important difference in the FIM instrument in patients with stroke
Arch Phys Med Rehabil
Estimating minimal clinically important differences of upper-extremity measures early after stroke
Arch Phys Med Rehabil
Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease
Arch Phys Med Rehabil
Clinically important differences in health status for patients with heart disease: an expert consensus panel report
Am Heart J
Small changes in six-minute walk distance are important in diffuse parenchymal lung disease
Respir Med
Methods to explain the clinical significance of health status measures
Mayo Clin Proc
Measurement of fatigue. determining minimally important clinical differences
J Clin Epidemiol
Six minute walking test for assessing exercise capacity in chronic heart failure
Br Med J
The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure
Can Med Assoc J
The 200-m fast-walk test compared with the 6-min walk test and the maximal cardiopulmonary test: a pilot study
Am J Phys Med Rehabil
Clinical reliability of the 6 minute corridor walk test performed within a week of a myocardial infarction
Int Heart J
Reproducibility and responsiveness of quality of life assessment and six minute walk test in elderly heart failure patients
Heart
Comparative analysis of oxygen uptake in elderly subjects performing two walk tests: the six-minute walk test and the 200-m fast walk test
Clin Rehabil
Effects of a one-year exercise training program in adults over 70 years old: a study with a control group
Aging Clin Exp Res
High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease
Eur J Cardiovasc Prev Rehabil
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