Article

OBJECTIVES: To examine the incidence of resting during the 6-minute-walk test
(6MWT) in patients with chronic lung disease (CLD) and to explore differences in
functional exercise capacity and response to pulmonary rehabilitation (PR)
between resters and nonresters. DESIGN: Retrospective chart review. SETTING:
Inpatient PR program. PARTICIPANTS: Individuals (N=211) who performed the 6MWT at
admission and discharge from PR. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Primary outcomes were total distance walked (6-minute walk distance
[6MWD]) and rest frequency and duration. Secondary outcomes were walking speed,
end-test dyspnea, and the Chronic Respiratory Questionnaire (CRQ). RESULTS: At
admission, 45 people (21%) rested 1 to 4 times during the 6MWT (total duration,
105+/-80s) and 166 people walked continuously. At discharge, 9 people continued
to rest (total duration, 28+/-55s). At admission, nonresters walked 315+/-93m,
whereas resters walked 197+/-83m (P<.0001), and 6MWD increased in both groups
after PR (P<.0001). Nonresters increased their walking speed at discharge, but
resters did not (interaction P<.001). At admission, the mastery domain of the CRQ
was 0.8 point lower in resters (3.7+/-1.2) compared with nonresters (4.5+/-1.7;
P=.01). Resters' end-test dyspnea scores decreased from 5.7+/-0.3 to 4.3+/-0.2
from admission to discharge, whereas nonresters' end-test dyspnea scores did not
significantly change from 4.5+/-0.2 to 4.2+/-0.2 at discharge (interaction
P<.05). CONCLUSIONS: One in 5 individuals with CLD rest during the 6MWT.
Decreasing rest duration or increasing walking speed reflects different
strategies used to improve 6MWD after rehabilitation, both suggesting a positive
effect of PR. This may be related to improvements in an individual's sense of
control over dyspnea. Future work should investigate potential factors related to
resting during the 6MWT.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

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