Six-minute walk distance and work relationship with incremental treadmill cardiopulmonary exercise test in COPD

• Published in: The clinical respiratory journal Vol. 7; no. 2; pp. 145 - 152
• Main Authors: Poersch, Karla, Berton, Danilo C., Canterle, Daversom Bordin, Castilho, Juliano, Lopes, André L., Martins, Jocelito, Oliveira, Alvaro R., Teixeira, Paulo José Zimermann
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2013; John Wiley & Sons, Inc
• Subjects: Aged; COPD; Cross-Sectional Studies; exercise test; Exercise Test - methods; Exercise Tolerance; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Oxygen Consumption; Pulmonary Diffusing Capacity; Pulmonary Disease, Chronic Obstructive - metabolism; Pulmonary Disease, Chronic Obstructive - physiopathology; Spirometry; walking; Walking - physiology; Work Capacity Evaluation
• ISSN: 1752-6981; 1752-699X
• DOI: 10.1111/j.1752-699X.2012.00295.x

Introduction:  Cardiopulmonary exercise testing (CPET) is increasingly used to evaluate the overall impact of the illness on patients with chronic obstructive pulmonary disease (COPD). While laboratory tests of exercise performance are costly, the 6‐min walk test (6‐MWT) can be more easily performed. Although the main outcome commonly used in this field test is the distance walked in 6 min (6‐MWD), this measure does not account for differences in body weight. Previous studies showed a good correlation between the work performed during the 6‐MWT with incremental cycling CPET, an exercise modality more associated with quadriceps fatigability and with lower peak oxygen consumption than incremental walking tests. Objective:  Evaluate the correlation between the 6‐MWD and its derivative body weight–walking distance product, an estimation of the work performed during the 6‐MWT, with peak from a treadmill CPET. Methods:  Thirty COPD patients [forced expiratory volume in 1 s (FEV1) =  39 ± 13%; peak predicted] performed CPET to the limit of tolerance on a treadmill and 6‐MWT, 48 h apart.6‐MWD and work were correlated to resting and exercise functional variables. Results:  The work of walking during the 6‐MWT provided greater associations with peak than observed with 6‐MWD. This was the case for FEV1, forced vital capacity, inspiratory capacity, lung diffusion capacity for carbon monoxide, peak , carbon dioxide output, minute ventilation and double product (r = 0.57, r = 0.57, r = 0.73, r = 0.7, r = 0.75, r = 0.65, r = 0.51 and r = 0.4, respectively; all P < 0.05). Conclusion:  A better association was found between the work estimated from the 6‐MWT and peak achieved during CPET, in this case with a treadmill, than the 6‐MWD alone. Please cite this paper as: Poersch K, Berton DC, Canterle DB, Castilho J, Lopes AL, Martins J, Oliveira AR and Teixeira PJZ. Six‐minute walk distance and work relationship with incremental treadmill cardiopulmonary exercise test in COPD. Clin Respir J 2013; 7: 145–152.