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Respiratory Medicine

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Small changes in six-minute walk distance are important in diffuse parenchymal lung disease - 07/08/11

Doi : 10.1016/j.rmed.2009.04.024 
Anne E. Holland a, b, ⁎ , Catherine J. Hill c, d, Matthew Conron e, Prue Munro b, Christine F. McDonald d, f
a School of Physiotherapy, La Trobe University, Bundoora 3086, Australia 
b Department of Physiotherapy, Alfred Hospital, Commercial Road, Melbourne 3004, Australia 
c Department of Physiotherapy, Austin Health, Studley Road, Heidelberg 3084, Australia 
d Institute for Breathing and Sleep, Studley Road, Heidelberg 3084, Australia 
e Department of Respiratory Medicine, St Vincent’s Hospital, Victoria Parade Fitzroy 3065, Australia 
f Department of Respiratory and Sleep Medicine, Austin Health, Studley Road, Heidelberg 3084, Australia 

Corresponding author. Department of Physiotherapy, Alfred Hospital, Commercial Road, Melbourne 3004, Australia. Tel.: +61 3 9076 3450; fax: +61 3 9076 2702.

Summary

The aim of this study was to determine the minimal important difference for the six-minute walk distance in people with diffuse parenchymal lung disease.

Methods

Forty-eight subjects (24 idiopathic pulmonary fibrosis) undertook the six-minute walk test before and after an 8-week exercise program. The minimal important difference was calculated using a distribution-based and an anchor-based method. A global rating of change scale was used as the external criterion to judge patients as clinically unchanged or changed.

Results

The mean change in six-minute walk distance in improved subjects was 50.0m, compared to 4.0m in unchanged subjects and a reduction of 64.3m in those classified as worse (p<0.001). The receiver operating characteristic curve indicated a cut-off value for meaningful change of 30.5m (area under the curve 0.89, 95% confidence interval 0.81–0.98) whilst the standard error of the mean method indicated a value of 33m. Similar values were obtained when only subjects with idiopathic pulmonary fibrosis were included (29 and 34m, respectively).

Conclusions

Small differences in six-minute walk distance, in the range 29–34m, may be clinically significant for people with diffuse parenchymal lung disease.

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Keywords : Exercise test, Outcome assessment, Pulmonary fibrosis


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© 2009  Elsevier Ltd. Tous droits réservés.
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Vol 103 - N° 10

P. 1430-1435 - octobre 2009 Retour au numéro
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