Validity And Reliability Of The 6-minute Walk Test In A Cardiac Rehabilitation Population Pdf

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But the 6MWD studied in Thailand trended to have shorter lengths than of western countries. It could not be applied to Thais. And the data regarding 6MWD after surgery of the elderly patients in Thailand was lacking.

Validity and reliability of the 6-minute walk test in a cardiac rehabilitation population

Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Medicine , 01 Oct , 97 42 : e DOI: The 6-minute walk test 6MWT has been applied to assess postsurgical recovery in cardiac populations.

This study mainly investigated whether the 6MWT could serve as an indicator for physical functioning in patients undergoing cardiac surgery. The participants in this study were patients 92 males and 33 females with an average age of The mean 6MWT was The recovery level of physical functioning is meaningfully associated with the 6MWT change from baseline to discharge and from baseline to 3-month follow-up. The supporting evidence includes the construct validity and responsiveness of the 6MWT.

This study supports the feasibility of the 6MWT as an evaluation tool of physical functioning for assessment of postcardiac surgical recovery. To date, no consistent indicators regarding postsurgical recovery have been established because recovery is a complex construct that includes multiple domains and timeframes.

In addition, based on their concept, and to develop a new measurement tool, the expected measure for recovery should be validated before being accepted as an indicator. Postoperative fatigue and pain may deteriorate QoL, which includes both physical and psychological function during recovery. Although CPET is the most widely accepted method of measuring functional capacity, special equipment for gas analysis and personnel training are required.

In addition, safety during testing must be specially monitored. Therefore, the 6-minute walk test 6MWT might be a worthy alternative. The QoL questionnaire, a common evaluation tool, covers physical, psychological, economic, social, and many other dimensions, so it is widely applied in research related to cardiac surgery. In contrast, the 6MWT conforms to the locomotion performance commonly used in daily activities, and it also has the advantages of convenience and efficiency.

In addition, unlike a questionnaire, the 6MWT requires no reading ability. However, the 6MWT should be validated as an evaluation instrument of postoperative recovery, as there is a lack of research on the applicability of the 6MWT to patients who have received cardiac surgery. If the validation result of the 6MWT is feasible, it will contribute to the evaluation of recovery after cardiac surgery.

The main objective of this study was to investigate whether the 6MWT can be utilized to evaluate physical functioning and thus serve as an effective indicator postoperatively. However, considering the lack of a recognized gold standard on the measure of physical functioning, no so-called criterion standard test has been formulated to evaluate the degree of recovery.

Therefore, concurrent criterion validity inspection cannot be conducted on the 6MWT. To address the above issue, this study developed evidence regarding the construct validity including convergent, discriminant, and known-groups validity and responsiveness of the 6MWT, and probed into the possibility of applying the 6MWT as a measure of physical functioning. The study was conducted in a medical center and recruited patients who were scheduled for cardiac surgery as the participants.

After the research staff clarified the research process and objective for the participants, they agreed to participate in the study and signed a written consent form. The inclusion criteria for participation in the study were receipt of elective cardiac surgery, adequate awareness, and independent ambulation.

Patients who were scheduled for surgery while juveniles and those diagnosed with cognitive disorders, mental disease, central nervous system diseases, peripheral arterial obstructive diseases, or muscle skeletal system issues of the lower limbs were excluded.

During the perioperative period, one physiotherapist measured and collected the data. The preoperative data were defined as the baseline.

All subjects were assessed with the 6MWT at the baseline, discharge, and 3 months after surgery. In addition, self-administered quality-of-life questionnaires were completed at baseline and 3 months after surgery.

At admission, the study patients were provided an orientation on the perioperative rehabilitation program. Prior to discharge, all the subjects met with the physical therapist to receive phase I cardiopulmonary rehabilitation, including daily coughing training, deep-breathing exercise, and functional training. In phase II, the subjects carried out a home-based exercise prescription taught to them previously by a physical therapist. The 6MWT measures the walking distance of subjects within a fixed time to quantify the functional capacity of the subjects, which refers to the total distance the subjects walked within 6 minutes.

In addition, the majority of research subjects can withstand the test, including relatively physically weak patients. To compensate for a possible learning effect, the patients completed the 6MWT twice, and the higher distance was selected. Physical functioning is the ability to perform a variety of physical activities ranging from light to vigorous activities that require increasing levels of mobility, strength, or endurance. The 8 subscales focusing on these domains can be measured separately, or they can be integrated into 2 major component summaries, including the physical component summary PCS and the mental component summary MCS.

To determine whether or not the changes in physical functioning were associated with the changes in the 6MWT, this study defined the changes in the SF physical functioning subscale from baseline to 3-month follow-up to determine the recovery level of physical functioning after cardiac surgery.

In accordance with the manual, if the physical functioning subscale at baseline is lower than 40, the minimum clinically important difference MCID is 2 points; if it is higher than 40, the MCID is 3 points. When the absolute change of the physical functioning subscale was within the range of the MCID, the research subjects were categorized as unchanged. If the change was positive and its absolute value was larger than the MCID, the subjects were categorized as better.

If the change was negative and its absolute value was larger than the MCID, the subjects were categorized as worse.

Descriptive statistics were calculated for demographic and medical variables. The Kolmogorov—Smirnov test was used to test the normality of the data distribution. For convergent validity, we examined the correlations between SF physical functioning subscales and the 6MWT. In contrast, the other subscales of the SF, which are not related to physical functioning, were examined for discriminant validity.

Then Pearson's correlation coefficient r and Spearman's rank correlation coefficient r s were applied to evaluate their correlations. This study referred to the classification of Lacasse: a coefficient between 0 and. This study anticipated that, due to surgical factors, the 6MWT prior to discharge would be lower than that at baseline, and the 6MWT at 3-month follow-up might approach or even exceed that of the baseline.

Therefore, this study calculated the effect sizes among the 3 time points to examine the responsiveness of the 6MWT. We calculated the effect size d by dividing the mean change scores by the standard deviation of the change scores in the same subjects.

In reference to the categorization of Cohen, responsiveness between 0. From March to March , patients scheduled for cardiac surgery were recruited for this study.

The predicted percentages of the 6MWT at the 3 time points were In contrast, no or weak correlations were found between the 6MWT and the other subscales. This difference indicated that the recovery level was associated with the change in the 6MWT.

The measures of characteristics, which included the preoperative and postoperative data, mostly had weak correlations with the SF physical functioning at baseline and at 3 months after surgery.

The relationships between recovery levels by change in physical functioning of SF and 6MWT from baseline to 3-month follow-up.

During their hospital stays, 11 patients experienced 13 postoperative complications, including heart failure 2 , cardiac tamponade 1 , respiratory failure 7 , infection 1 , and bleeding 2. However, no statistically significant differences were found in the 6MWT between the patients with and without complications at discharge or at 3-month follow-up. Among the 3 time points, the 6MWT changes in each recovery level were also sensitive to change. Studies on cardiac populations have presented the acceptable psychometric properties of the 6MWT.

In the present study, we provide evidence in support of the construct validity and responsiveness of the 6MWT in cardiac surgery patients. Some research has pointed out that the walk test is associated with the physical functioning subscale of the SF Brooks et al. In addition, the correlations are comparable to that of the study by Brooks et al.

For responsiveness, the effect size showed that the 6MWT is sensitive to change from the preoperative period to the short-term postoperative period, and finally, to the long-term postoperative period.

This seems to imply the importance of measuring the 6MWT soon after cardiac surgery. This effect of the surgery would explain why the 6MWT at discharge was not different between the 2 groups. The relative reliability at discharge approximated that of the research by Olper et al [ 29 ] ICCs of.

However, it had higher absolute reliability, which was referred to as the standard error of measurements of It indicates that the 6MWT will descend significantly from baseline to discharge and then rise significantly from discharge to 3-month follow-up. This pattern is in agreement with a study by Brooks et al. Comparatively speaking, the distance presented in this study is close to the values of these prior studies, but slightly lower, possibly due to differences in demographic characteristics such as ethnicity, height, and leg length.

Previous studies have demonstrated that postoperative 6MWT can provide prognostic information after cardiac surgery. We used m as the cut-off point for our study because previous research had established a walking distance of meters as having a good ability to discriminate patients with different risks. Routine measurement of the 6MWT at discharge after cardiac surgery would screen out patients at risk of re-hospitalization and death 2 years after cardiac surgery. The SF, which covers both mental and physical components, is applied in the evaluation of post cardiac surgical recovery.

First, considering that walking is a fundamental human activity and plays a key role in the participation of patients, it covers the majority of activities of daily living as its evaluation content. Second, surgical intervention leads to physical stress, such as cardiopulmonary impairment, pain, fatigue, and muscle weakness. Therefore, the 6MWT should be reasonably used as a postoperative recovery indicator.

In addition, according to a literature report on chronic heart failure, the clinically meaningful change of the 6MWT is about 32 m. These results indicate that the change in the 6MWT of the majority of patients exceeded the clinically meaningful change. Mobility will decrease in the early stage, but it will tend to improve in the recovery period subsequent to discharge.

On the whole, recovery progress is evident at 3-month follow-up. In addition, the 6MWT has the advantage of execution convenience and thus is an easily managed evaluation tool. The patients are informed of the evaluation results in the early postoperative period, so the difference between the actual result and the originally anticipated distance can be compared.

Because of the physical limitations soon after surgery, it is necessary to use a suitable and validated measure for supervising the recovery. This study is the first to verify the validity of the 6MWT as a measure of physical functioning after cardiac surgery. Unlike a questionnaire score, which relies on subjective perceptions of health, depends on reading ability to fill in the QoL questionnaire, and requires more time, the 6MWT directly measures actual walking performance, which conforms to daily activities and is administratively efficient.

Therefore, the 6MWT can achieve quick quantification of postsurgical recovery. This aspect is attractive to clinicians and researchers.

In addition, the 6MWT has standardized implementation methods and is widely applied in clinics worldwide. However, this study has some limitations. First, the exercise and rehabilitation frequency of the participants from discharge to 3-month follow-up were not recorded, possibly leading to bias in the results.

Efficacy of six-minute walk test on cardiac rehabilitation program

The journal publishes 6 issues per year, mainly about respiratory system diseases in adults and clinical research. This work can range from peer-reviewed original articles to review articles, editorials, and opinion articles. The journal is printed in English, and is freely available in its web page as well as in Medline and other databases. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years. CiteScore measures average citations received per document published.

Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Medicine , 01 Oct , 97 42 : e DOI: The 6-minute walk test 6MWT has been applied to assess postsurgical recovery in cardiac populations. This study mainly investigated whether the 6MWT could serve as an indicator for physical functioning in patients undergoing cardiac surgery. The participants in this study were patients 92 males and 33 females with an average age of

Toll-Free U. From high-quality clinical care and groundbreaking research to community programs that improve quality of life, philanthropic support drives our mission and vision. Instrument Details. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process. The 6MWT demonstrated significant differences depending on the length of track used.

Request PDF | Validity and Reliability of the 6-Minute Walk Test in a Cardiac Rehabilitation Population | Although the 6-minute walk test is.

Six-Minute Walk Test in Thai Cardiac-Surgery Elderly at Queen Sirikit Heart Center of the Northeast

Background: Few data are available on the capacity for functional exercise after cardiac rehabilitation in patients who have undergone coronary artery bypass graft CABG surgery. The aim of this study was to determine the clinical and biochemical factors that affect the 6-minute walk test 6MWT results in patients who have undergone CABG. Methods: Data were prospectively collected from 56 patients consecutively admitted at our hospital between January and May for a 3-month cardiac rehabilitation program. Data were analysed retrospectively up to 90 days after cardiac surgery. In addition to clinical and biochemical parameters, the functional capacity of patients was evaluated by an exercise 6-minute walking test and echocardiography.

6 Minute Walk Test

Cardiac Rehabilitation pp Cite as. Exercise testing is a key component of the initial patient assessment performed when a patient enrolls in a cardiac rehabilitation program, and change in functional capacity has become a common clinical outcome in cardiac rehabilitation programs 1.

Role of the 6-Minute Walk Test in Cardiac Rehabilitation

Background: The 6-minute walk test 6MWT is a common outcome measurement in cardiac rehabilitation. However, a search of the literature found no established guidelines for use of the 6MWT in cardiac rehabilitation. Objectives: Systematic review of the validity, reliability and responsiveness of the 6MWT in cardiac rehabilitation. Eligibility criteria: Studies using 6MWTs in subjects with coronary artery disease undergoing cardiac rehabilitation on an outpatient basis, published in English, were included.

I Pulmonologist. Correspondence to. Over the last few years, the use of exercise tests has come to be recognized as a convenient method of evaluating respiratory function, because the reserves of the various systems in the human body should be known in order to provide a more complete portrayal of the functional capacities of the patient.

Intra- and intertester reliability of the 6MWT and its validity in patients undergoing cardiac Request Full-text Paper PDF. To read of the physically disabled population (Supplementary File 1) [29, 30, [34][35][36][38][39][40].

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 Че-че-го же вы хотите? - выдавил он заикаясь.  - Я ничего не знаю. Беккер зашагал по комнате. - На руке умершего было золотое кольцо. Я хочу его забрать. - У м-меня его .

Такие серверы весьма популярны среди пользователей Интернета, желающих скрыть свои личные данные. За небольшую плату они обеспечивают анонимность электронной почты, выступая в роли посредников. Это все равно что номерной почтовый ящик: пользователь получает и отправляет почту, не раскрывая ни своего имени, ни адреса. Компания получает электронные сообщения, адресованные на подставное имя, и пересылает их на настоящий адрес клиента. Компания связана обязательством ни при каких условиях не раскрывать подлинное имя или адрес пользователя.

Стратмор хмыкнул. Мысль Сьюзан показалась ему достойной внимания. - Неплохо, но есть одно .

Мне кажется, я должен вам сказать… что это не случайный набор букв. Все на подиуме воскликнули: - Что. В голосе Беккера слышались извиняющиеся нотки: - Простите, но это определенно осмысленные слова. Они выгравированы очень близко одно к другому и на первый взгляд кажутся произвольным набором букв, но если присмотреться повнимательнее, то… становится ясно, что надпись сделана по-латыни.

Дайте ему минутку прийти в. - Н-но… - Сьюзан произнесла слова медленно.  - Я видела сообщение… в нем говорилось… Смит кивнул: - Мы тоже прочитали это сообщение. Халохот рано принялся считать цыплят. - Но кровь… - Поверхностная царапина, мадам.

В тот год аналогичное приглашение получили еще сорок кандидатов. Двадцативосьмилетняя Сьюзан оказалась среди них младшей и к тому же единственной женщиной.

Выходит, Стратмор был зрителем теннисного матча, следящим за мячом лишь на одной половине корта. Поскольку мяч возвращался, он решил, что с другой стороны находится второй игрок. Но Танкадо бил мячом об стенку.

Дэвид, - сказал наконец Стратмор мрачным голосом, - обнаружение этого кольца - вопрос национальной безопасности. Я возлагаю эту задачу на. Не подведите .

 - Мы очень заняты. Беккер старался говорить как можно официальнее: - Дело весьма срочное. Этот человек сломал запястье, у него травма головы. Он был принят сегодня утром. Его карточка должна лежать где-то сверху.

 - Стратмор начал спокойно излагать свой план.  - Мы сотрем всю переписку Хейла с Танкадо, уничтожим записи о том, что я обошел систему фильтров, все диагнозы Чатрукьяна относительно ТРАНСТЕКСТА, все данные о работе компьютера над Цифровой крепостью, одним словом -. Цифровая крепость исчезнет бесследно.


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