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

Maria Cm Frade; Ivanize Mm Dos Reis; Renata P Basso-Vanelli; Alexandre F Brandão; Mauricio Jamami

doi:10.4187/respcare.06237

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

Respir Care. 2019 Apr;64(4):425-433. doi: 10.4187/respcare.06237. Epub 2019 Jan 29.

Authors

Maria Cm Frade¹, Ivanize Mm Dos Reis¹, Renata P Basso-Vanelli², Alexandre F Brandão³, Mauricio Jamami⁴

Affiliations

¹ Spirometry and Respiratory Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
² Hospital Universitário of Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
³ Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
⁴ Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil. mjamami@gmail.com.

PMID: 30696755
DOI: 10.4187/respcare.06237

Abstract

Background: 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.

Methods: 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.

Results: Relative reproducibility was found for intraclass correlation coefficient values (0.57-0.94, P < .001) between the number of steps and the highest value of oxygen consumption during the test (V̇_O₂ 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 (P < .001) between the number of steps and V̇_O₂ peak.

Conclusions: 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.

Keywords: COPD; criterion validity; exercise test; reliability; reproducibility; virtual reality.

Publication types

Randomized Controlled Trial

MeSH terms

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*