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Interpretation of treatment changes in 6-minute walk distance in patients with COPD

M. A. Puhan, M. J. Mador, U. Held, R. Goldstein, G. H. Guyatt, H. J. Schünemann
European Respiratory Journal 2008 32: 637-643; DOI: 10.1183/09031936.00140507
M. A. Puhan
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M. J. Mador
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U. Held
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R. Goldstein
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G. H. Guyatt
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H. J. Schünemann
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  • Fig. 1—
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    Fig. 1—

    Estimates for important effects in 6-min walk distance based on the standard error of measurement (sem). Data come from 305 chronic obstructive pulmonary disease patients enrolled in seven randomised trials of respiratory rehabilitation. The overall estimate is based on all patients whereas the results are also shown for the individual studies. Bootstrapped 95% confidence intervals are given. Values of n for each study can be found in table 2⇓.

  • Fig. 2—
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    Fig. 2—

    Estimates for important effects in 6-min walk distance based on the standard error of measurement stratified (sem) for forced expiratory volume in one second (FEV1), sex and age. Data are presented with bootstrapped 95% confidence intervals. Values for n for each groups are as follows. FEV1 ≥50% predicted: n = 54; 35–50% pred: n = 107; <35% pred: n = 140; females: n = 79; males: n = 226; aged 70–80 yrs: n = 137; 60–70 yrs: n = 104; 50–60 yrs: n = 33.

Tables

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  • Table 1—

    Characteristics of included trials

    First author [Ref.]CountryIntervention group 1Intervention group 2Subjects nAge yrsMales %Mean FEV1Baseline 6MWD
    Puhan 11SwitzerlandRespiratory rehabilitation (continuous exercise)Respiratory rehabilitation (interval exercise)9868.9±9.16734.3±8.4323±109
    Goldstein 21CanadaRespiratory rehabilitationUsual care8966.0±7.24934.7±13.2366±99
    Puhan 20SwitzerlandRespiratory rehabilitation7167.5±8.46645.1±15.4360±122
    Mador 22USARespiratory rehabilitation2469.9±9.59244.3±17.1326±105
    Mador 19USARespiratory rehabilitation (endurance exercise)Respiratory rehabilitation (strength exercise)2871.1±6.110042.0±14.7378±119
    Mador 18USARespiratory rehabilitation (endurance and hyperpnea)Respiratory rehabilitation (endurance exercise)2970.3±7.410044.8±16.6435±98
    Krauza 23USARespiratory rehabilitation (interval exercise)Respiratory rehabilitation (continuous exercise)4171.1±7.69843.1±13.1431±104
    Mador, unpublished resultsUSARespiratory rehabilitation (endurance and upper arm exercise)Respiratory rehabilitation (endurance exercise)1773.9±7.010036.7±13.6383±79
    Schünemann 33CanadaRespiratory rehabilitation6369.8±8.35438.9±14.5334±104
    All46068.9±8.37139.2±14.1361±112
    • Data are presented as mean±sd, unless otherwise stated. FEV1: forced expiratory volume in one second; 6MWD: 6-min walk distance.

  • Table 2—

    Standard error of measurement

    First author [Ref.]Patients with 2 6MWDs at baseline nIntraclass correlation coefficientsd (baseline 6MWD)sem (95% CI)
    All studies3050.9011135 (30–42)
    Puhan 11900.8911137 (29–53)
    Goldstein 21890.889935 (29–45)
    Mador 22130.9310829 (21–41)
    Mador 19260.9412030 (22–40)
    Mador 18290.839841 (21–59)
    Krauza 23410.9610420 (16–26)
    Mador, unpublished results170.887927 (17–35)
    • 6MWD: 6-min walk distance; CI: confidence interval.

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Interpretation of treatment changes in 6-minute walk distance in patients with COPD
M. A. Puhan, M. J. Mador, U. Held, R. Goldstein, G. H. Guyatt, H. J. Schünemann
European Respiratory Journal Sep 2008, 32 (3) 637-643; DOI: 10.1183/09031936.00140507

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Interpretation of treatment changes in 6-minute walk distance in patients with COPD
M. A. Puhan, M. J. Mador, U. Held, R. Goldstein, G. H. Guyatt, H. J. Schünemann
European Respiratory Journal Sep 2008, 32 (3) 637-643; DOI: 10.1183/09031936.00140507
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