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September 1, 2012Cardiopulmonary Physical Therapy JournalOpen Access

Triangulating Clinically Meaningful Change in the Six-minute Walk Test in Individuals with Chronic Heart Failure: A Systematic Review

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Key result

A change in six-minute walk test distance of approximately 45 meters exceeds measurement error and is associated with significant changes in aerobic capacity and health-related quality of life in patients with chronic heart failure.

Why the study?

What is the clinically meaningful change in six-minute walk test distance (Δ6MWT) in individuals with chronic heart failure?

Population

Individuals with chronic heart failure from 13 articles reporting intraclass correlation coefficient and 18…

Comparison

Exercise-based intervention vs Control group

Design

Systematic_review

Authors

MSMichael J ShoemakerACAmy CurtisEVEric Vangsnes

Discussion

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Overview

Supports 45 m Δ6MWT as clinically meaningful in chronic HF; extends MCID evidence beyond measurement error.

Study Design

Type

Systematic Review

Structured PICO

What is the clinically meaningful change in six-minute walk test distance (Δ6MWT) in individuals with chronic heart failure?

P
Population
A systematic review of 13 reliability studies and 18 randomized controlled trials evaluating the clinically meaningful change in six-minute walk test distance among individuals with chronic heart failure.
I
Intervention
Exercise-based intervention
C
Comparator
Control group
O
Outcome
Clinically meaningful change in six-minute walk test distance (Δ6MWT)surrogate

Main Result

Effect estimate: AUC 0.935 (95% CI 0.855-1.015)

p-value: p=0.009

A change of approximately 45 meters in the six-minute walk test represents a clinically meaningful improvement in patients with chronic heart failure.

Limitations

  • Calculation of the MDD95% values for several studies required use of the baseline standard deviation for the entire sample because it was not reported for the subsample.
  • The analysis relies on the underlying assumption that the 6MWT is associated with aerobic capacity and HRQL and that these variables are responsive to exercise interventions.

Cite This Study

Shoemaker et al. (2012) conducted a systematic review in Chronic heart failure. Exercise-based intervention vs. Control/Usual care was evaluated on Clinically meaningful change in six-minute walk test distance (∆6MWT) discriminating between intervention and control groups (AUC 0.935, 95% CI 0.855-1.015, p=0.009). A change in six-minute walk test distance of approximately 45 meters exceeds measurement error and is associated with significant changes in aerobic capacity and health-related quality of life in patients with chronic heart failure.

synapsesocial.com/papers/6a6ec022f44fa9f079dc5252https://doi.org/10.1097/01823246-201223030-00002
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Six minute corridor walk test as an outcome measure for the assessment of treatment in randomized, blinded intervention trials of chronic heart failure: a systematic review2005 · 287 citations
  2. 2Comprehensive Local Muscle Training Increases Aerobic Working Capacity and Quality of Life and Decreases Neurohormonal Activation in Patients with Chronic Heart Failure2001 · 120 citations
  3. 3Randomised Controlled Trial of Cardiac Rehabilitation in Elderly Patients with Heart Failure2005 · 250 citations
  4. 4The Effect of Physical Training in Chronic Heart Failure2005 · 167 citations
  5. 5Does Aerobic Training Lead to a More Active Lifestyle and Improved Quality of Life In Patients with Chronic Heart Failure?2004 · 98 citations