A modified six-minute walk test (6MWT) for low-resource settings-a cross-sectional study

Background: The 6 min walk test (6MWT) is a validated tool used to assess functional capacity in a variety of patient populations. Space constraints often limit the practicality of the 6MWT according to the standard (2002) American Thoracic Society protocol, and therefore, adaptations to this protocol are common with potential implications for research and clinical practice. Furthermore, such implications for research and clinical practice may be augmented in low-resourced settings. Objectives: To determine the agreement between the 6 min walk distance (6MWD) achieved on the standard 30 m (6MWT30), and a straight 10 m (6MWT10), or 10 m figure-of-eight (6MWTF8) configuration, respectively. Methods: A cross-sectional study was conducted in a socioeconomic challenged community. A heterogeneous sample of adults (n = 27) with non-communicable disease were randomized into performing the 6MWT10 (n = 15) or 6MWTF8 (n = 12), in addition to the standard 6MWT30. Pairwise comparison and concordance correlation coefficients were used to assess agreement. Results: The mean (SD) 6MWD30 was 437(42) meters, while the mean 6MWD10 was 371(57). The mean difference (SE; p-value) between the 6MWD30 and 6MWD10 was 67 m (8.6; p .01). The mean 6MWD30 was 424(67) meters, while the mean 6MWDF8 was 347(58). The mean difference between the 6MWD30 and 6MWDF8 was 77 m (6.0; p .01). Moderate concordance was found between the 6MWT30 and 6MWTF8 or 6MWD10, respectively. Conclusions: The present data suggest that, independent of configuration, using a shorter pathway significantly reduced the 6MWD. Low-resource settings may benefit from contemporary measures of functional capacity more conducive to resource constraints, or standardization of the test when used in such settings.