Abstract
BackgroundThe 6-minute walk test (6MWT) in a regular hallway is commonly used to assess functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, treadmill walking might provide additional advantages over overground walking, especially if virtual reality and self-paced treadmill walking are combined. Therefore, this study aimed to assess the reproducibility and validity of the 6MWT using the Gait Real-time Analysis Interactive Lab (GRAIL) in patients with COPD and healthy elderly.Methodology/ResultsSixty-one patients with COPD and 48 healthy elderly performed two 6MWTs on the GRAIL. Patients performed two overground 6MWTs and healthy elderly performed one overground test. Differences between consecutive 6MWTs and the test conditions (GRAIL vs. overground) were analysed. Patients walked further in the second overground test (24.8 m, 95% CI 15.2–34.4 m, p<0.001) and in the second GRAIL test (26.8 m, 95% CI 13.9–39.6 m). Healthy elderly improved their second GRAIL test (49.6 m, 95% CI 37.0–62.3 m). The GRAIL 6MWT was reproducible (intra-class coefficients = 0.65–0.80). The best GRAIL 6-minute walk distance (6MWD) in patients was shorter than the best overground 6MWD (-27.3 ± 49.1 m, p<0.001). Healthy elderly walked further on the GRAIL than in the overground condition (23.6 ± 41.4 m, p<0.001). Validity of the GRAIL 6MWT was assessed and intra-class coefficient values ranging from 0.74–0.77 were found.ConclusionThe GRAIL is a promising system to assess the 6MWD in patients with COPD and healthy elderly. The GRAIL 6MWD seems to be more comparable to the 6MWDs assessed overground than previous studies on treadmills have reported. Furthermore, good construct validity and reproducibility were established in assessing the 6MWD using the GRAIL in patients with COPD and healthy elderly.
Highlights
Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease affecting about 10% of adults above the age of 40 [1]
Good construct validity and reproducibility were established in assessing the 6-minute walk distance (6MWD) using the Gait Real-time Analysis Interactive Lab (GRAIL) in patients with COPD and healthy elderly
Patients and healthy elderly subjects were comparable in age, height, weight and body mass index (BMI)
Summary
Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease affecting about 10% of adults above the age of 40 [1]. COPD affects respiratory function of patients and has systemic consequences as well, including peripheral muscle dysfunction and weakness, which contributes to exercise limitation and impaired quality of life [2, 3]. The 6-minute walk test (6MWT) is a method of obtaining the 6-minute walk distance (6MWD) and is used to evaluate functional exercise capacity. Treadmill walking tests offer advantages over overground walking tests, as limited space is needed, providing a safe environment without obstructions [5] and subjects do not have to turn, leading to an increase in walking distance [6]. The 6-minute walk test (6MWT) in a regular hallway is commonly used to assess functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess the reproducibility and validity of the 6MWT using the Gait Real-time Analysis Interactive Lab (GRAIL) in patients with COPD and healthy elderly
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