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The 6-min walking distance: long-term follow up in patients with COPD

¹ Respiratory Research Institute, and ² Pulmonary Dept, Hospital Universitario La Candelaria, Tenerife, and ⁴ Pulmonary Dept, Hospital Miguel Servet, Zaragoza, Spain. ⁵ Pulmonary Dept, Hospital Jose I Baldo, Caracas, Venezuela. ³ Pulmonary Dept, Bay Pines Veterans Affairs Medical Center, St Petersburg, FL, and ⁶ Pulmonary and Critical Care Dept, Caritas–St Elizabeth's Medical Center, Boston, MA, USA.

CORRESPONDENCE: C. Casanova, Universidad de La Laguna , Respiratory Research Institute, Pulmonary Dept, Hospital Universitario La Candelaria, Carretera del Rosario s/n, 38010-Santa Cruz de Tenerife, Spain. Fax: 34 922600562. E-mail: ccasanova{at}canarias.org

Keywords: Chronic obstructive pulmonary disease, 6-min walking distance

Received: May 30, 2006
Accepted November 6, 2006

The 6-min walking distance (6MWD) test is used in clinical practice and research into patients with chronic obstructive pulmonary disease (COPD). However, little is known about natural long-term change in this parameter.

The 6MWD was measured at baseline and then annually for 5 yrs in 294 patients with COPD and its annual rate of decline was determined. Forced expiratory volume in one second (FEV₁) was also measured and the relationship between changes in both markers was explored.

At baseline, the median 6MWD was 380 m (range 160–600 m). It declined by 19% (16 m·yr^-1) over the 5 yrs compared with baseline in patients with American Thoracic Society/European Respiratory Society stage III COPD (FEV₁ 30–50% predicted) and by 26% (15 m·yr^-1) in patients with stage IV COPD (FEV₁ <30% pred). Over the 5-yr follow-up, the proportion of patients with a minimal clinically significant decline of 54 m increased with the severity of the disease. It was 24% in stage II, 45% in stage III, and 63% in stage IV disease. In contrast, the rate of decline of FEV₁ was greater in patients with milder airflow obstruction and lesser in patients with lower absolute FEV₁ values.

In conclusion, the 6-min walking distance test provides increasingly useful information as the severity of chronic obstructive pulmonary disease increases.

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