Validity and reliability of automated treadmill six-minute walk test in patients entering exercise-based cardiac rehabilitation

Ann Med. 2023;55(2):2304664. doi: 10.1080/07853890.2024.2304664. Epub 2024 Jan 17.

Abstract

Introduction: The six-minute walk test (6MWT) is a well-established tool for assessing submaximal functional capacity for cardiac patients, but space limitations challenge its implementation. Treadmill-based (TR) 6MWT is a promising alternative, but it requires patients to complete a familiarization test to adapt treadmill speed regulation. With the advancement of sensors, it is possible to automatically control speed for individual patients and thus overcome the space limitation or the speed control difficulty on the treadmill for each patient.Methods: This study investigated the validity and interchangeability of automated speed TR6MWT and standard hallway (HL) 6MWT. Eighteen patients were assessed at baseline of the 12-week cardiac rehabilitation program. Fourteen of them were assessed after rehabilitation. All patients performed three TR6MWTs and three HL6MWTs at baseline and one of each test after the program.Results: Patients well tolerated the TR6MWT. There was a strong correlation between both test methods (r = 0.79). However, patients performed significantly better in HL6MWT (514.8m ± 59.7m) than in TR6MWT (447.2 ± 79.1m) with 95% CI, 40.4-94.6m, p < 0.05. Both tests showed high test-retest reliability (intraclass correlation coefficient of 0.86). The TR6MWT showed a valuable comparison of the effect of the cardiac rehabilitation program (20% increase, effect size 1.1) even though it is not interchangeable with the HL6MWT.Conclusion: The automated speed TR6MWT appears to be an acceptable tool with adequate validity, reliability, and responsiveness for assessing functional capacity in patients utilizing cardiac rehabilitation programs.

Keywords: Six minute walk test; automatized treadmill; cardiac rehabilitation; functional capacity; technology-assisted assessment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Rehabilitation*
  • Exercise Test / methods
  • Humans
  • Reproducibility of Results
  • Walk Test
  • Walking / physiology

Grants and funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the Ministry of Health, Czech Republic; conceptual development of research organization [FNBr, 65269705].