Reproducibility and Validity of the 6-Minute Stationary Walk Test Associated With Virtual Reality in Subjects With COPD

• Published in: Respiratory care Vol. 64; no. 4; p. 425
• Main Authors: Frade, Maria Cm, Dos Reis, Ivanize Mm, Basso-Vanelli, Renata P, Brandão, Alexandre F, Jamami, Mauricio
• Format: Journal Article
• Language: English
• Published: United States 01.04.2019
• Subjects: Exercise Tolerance; Female; Humans; Male; Middle Aged; Oxygen Consumption; Physical Functional Performance; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - metabolism; Pulmonary Disease, Chronic Obstructive - physiopathology; Reproducibility of Results; Virtual Reality; Walk Test - methods; virtual reality; criterion validity; exercise test; reproducibility; reliability; COPD
• ISSN: 1943-3654
• DOI: 10.4187/respcare.06237

The importance of evaluating the functional capacity of patients with COPD is well known, and there is a wide range of tests described in the literature. The 6-min stationary walk test associated with virtual reality (STVR-6) was created in light of the current limitations of evaluation tests. It does not require a large physical space or sophisticated equipment, and it is not costly; furthermore, it can be performed by a single rater. The objective of this study was to evaluate intra- and inter-rater reproducibility and to verify the criterion validity of the STVR-6. 50 subjects with COPD were evaluated over the course of 3 d. The execution order of the tests was randomized; the STVR-6 was performed over 2 d, and the 6-min walk test was performed in 1 d. The 6-min walk distance variables and number of steps in the STVR-6 were obtained with a gas analysis performed for both tests. Relative reproducibility was found for intraclass correlation coefficient values (0.57-0.94, < .001) between the number of steps and the highest value of oxygen consumption during the test (V̇ peak), intra- and inter-rater. In terms of absolute reproducibility, the standard error of measurement and minimum detectable difference values were verified. In the Bland-Altman analysis, the intra- and inter-rater mean difference values were 21 and 17 steps and 0.002 and 0.242 mL/min/kg, respectively. Pearson correlation values were 0.57-0.75 ( < .001) between the number of steps and V̇ peak. STVR-6 had excellent intra-rater reproducibility and excellent to good inter-rater reproducibility, but the high values of error measures demonstrated that there is a learning effect and a need to perform at least 2 tests. In addition, there was high to moderate correlation between the STVR-6 and the 6-min walk test. Therefore, the STVR-6 proved to be reproducible and valid for evaluating the functional capacity of subjects with COPD.