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(Chest. 2005;128:55-61.)
© 2005 American College of Chest Physicians

Encouraged 6-min Walking Test Indicates Maximum Sustainable Exercise in COPD Patients*

Alejandro Casas, MD; Jordi Vilaro, PT; Roberto Rabinovich, MD; Anamaria Mayer, PT; Joan Albert Barberà, MD; Robert Rodriguez-Roisin, MD, FCCP and Josep Roca, MD

* From Servei de Pneumologia (Drs. Casas, Rabinovich, Barberà, Rodriguez-Roisin, and Roca, and Ms. Mayer), Hospital Clínic, IDIBAPS, Universitat de Barcelona; and EUIF Blanquerna (Dr. Vilaro), Universitat Ramon Llull, Barcelona, Spain.

Correspondence to: Josep Roca, MD, Servei de Pneumologia, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; e-mail: jroca{at}clinic.ub.es

Study objectives: In patients with moderate-to-severe COPD, an encouraged 6-min walking test (6MWT) is a high-intensity submaximal exercise protocol that shows an oxygen uptake (O2) plateau after the third minute of the test. This last feature prompted the hypothesis that self-paced walking speed is set to achieve "maximal" sustainable O2, namely "critical power" or "critical speed."

Patients and methods: Eight patients with moderate-to-severe COPD (mean age, 68 ± 7 years [± SD]; FEV1, 50 ± 13% predicted; PaO2, 69 ± 8 mm Hg) underwent the following tests on different days in order: (1) encouraged 6MWT; (2) standard incremental shuttle test to identify peak walking speed; (3) four different high-intensity, constant walking speed tests to exhaustion to calculate critical walking speed; and (4) timed walking test at critical walking speed (CWS) to examine sustainability of the exercise.

Results: 6MWT and CWS showed similar results (mean of last 3 min): O2 (1,605 ± 304 mL/min vs 1,584 ± 319 mL/min), minute ventilation (47 ± 12 L/min vs 48 ± 11 L/min), respiratory exchange ratio (0.89 ± 0.1 vs 0.90 ± 0.1), heart rate (130 ± 18 beats/min vs 131 ± 16 beats/min), Borg dyspnea score (5.4 ± 1.3 vs 5.5 ± 2.4), and walking speed (1.49 ± 0.1 m/s vs 1.44 ± 0.1 m/s, respectively).

Conclusion: This study supports that 6MWT indicates maximum sustainable exercise that might be related with its predictive value in COPD patients.

Key Words: COPD • critical power • exercise testing • exercise tolerance • 6-min walking test • sustainable submaximal exercise




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C. G. Cote, V. Pinto-Plata, K. Kasprzyk, L. J. Dordelly, and B. R. Celli
The 6-Min Walk Distance, Peak Oxygen Uptake, and Mortality in COPD
Chest, December 1, 2007; 132(6): 1778 - 1785.
[Abstract] [Full Text] [PDF]


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