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Eur Respir J 2006, doi:10.1183/09031936.00071506
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ORIGINAL ARTICLE |
The six-minute walk distance: long-term follow up in patients with COPD
1 Respiratory Research Institute and; and Pulmonary Dept., Hospital Universitario La Candelaria, Tenerife, Spain
2 Pulmonary Dept., Bay Pines VA Medical Center, St Petersburg FL, U.S.A
3 Pulmonary Dept., Hospital Miguel Servet, Zaragoza, Spain
4 Respiratory Research Institute and
5 Pulmonary Dept., Hospital Jose I Baldo, Caracas, Venezuela
6 Pulmonary Dept., Hospital Universitario La Candelaria, Tenerife, Spain
7 Pulmonary and Critical Care Dept., Caritas-St Elizabeth's Medical Center, Boston MA, U.S.A
* To whom correspondence should be addressed. E-mail: ccasanova{at}canarias.org.
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Abstract |
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The 6-minute walk distance (6MWD) test is used in clinical practice and research of patients with chronic obstructive pulmonary disease (COPD). However, little is known about its natural long-term change. At baseline and then yearly during five years we measured the 6MWD in meters (m) in 294 patients with COPD and determined its annual rate of decline. We also measured FEV1 to explore the relation between changes in both markers. At baseline, the median 6MWD was 380 m (range 160-600) and it declined by 19% (16 m·yr-1, p=0.006) compared with baseline in patients with ATS-ERS stage III (FEV1<50 but >30 % predicted) and by 26% (15 m·yr-1, p=0.005) in patients with stage IV (FEV1<30% predicted). Over 5 yr follow-up time the proportion of patients with a minimal clinical 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 (p=0.025). In contrast, the FEV1 rate of decline was greater in patients with milder airflow obstruction and lesser in patients with lower FEV1 values. The 6MWD test provides increasingly useful information as the severity of patients with COPD worsens.
Keywords: COPD, 6-minute walking distance
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