Current data confirm that the 6MWT , ISWT and ESWT are valid , reliable and responsive to change with some interventions .
However , results are sensitive to small changes in methodology .
Field walking tests are commonly employed to evaluate exercise capacity , assess prognosis and evaluate treatment response in chronic respiratory diseases .
In recent years , there has been a wealth of new literature pertinent to the conduct of the 6-min walk test ( 6MWT ) , and a growing evidence base describing the incremental and endurance shuttle walk tests ( ISWT and ESWT , respectively ) .
The aim of this document is to describe the st and ard operating procedures for the 6MWT , ISWT and ESWT , which can be consistently employed by clinicians and research ers .
Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease.
OBJECTIVE To establish the minimal important difference ( MID ) for the six-minute walk distance ( 6MWD ) in persons with chronic obstructive pulmonary disease ( COPD ) . DESIGN Analysis of data from an observational study using distribution- and anchor-based methods to determine the MID in 6MWD . SETTING Outpatient pulmonary rehabilitation program at 2 teaching hospitals . PARTICIPANTS Seventy-five patients with COPD ( 44 men ) in a stable clinical state with mean age 70 years ( SD 9 y ) , forced expiratory volume in one second 52 % ( SD 21 % ) predicted and baseline walking distance 359 meters ( SD 104 m ) . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Participants completed the  six-minute walk test  before and after a 7-week pulmonary rehabilitation program . Participants and clinicians completed a global rating of change score while blinded to the change in 6MWD . RESULTS The mean change in 6MWD in participants who reported themselves to be unchanged was 17.7 meters , compared with 60.2 meters in those who reported small change and 78.4 meters in those who reported substantial change ( P=.004 ) . Anchor-based methods identified an MID of 25 meters ( 95 % confidence interval 20 - 61 m ) . There was excellent agreement with distribution-based methods ( 25.5 - 26.5 m , kappa=.95 ) . A change in 6MWD of 14 % compared with baseline also represented a clinical ly important effect ; this threshold was less sensitive than for absolute change ( sensitivity .70 vs .85 ) . CONCLUSIONS The MID for 6MWD in COPD is 25 meters . Absolute change in 6MWD is a more sensitive indicator than percentage change from baseline . These data support the use of 6MWD as a patient-important outcome in research and clinical practice
Current data confirm that the 6MWT , ISWT and ESWT are valid , reliable and responsive to change with some interventions .
However , results are sensitive to small changes in methodology .
Field walking tests are commonly employed to evaluate exercise capacity , assess prognosis and evaluate treatment response in chronic respiratory diseases .
In recent years , there has been a wealth of new literature pertinent to the conduct of the 6-min walk test ( 6MWT ) , and a growing evidence base describing the incremental and endurance shuttle walk tests ( ISWT and ESWT , respectively ) .
The aim of this document is to describe the st and ard operating procedures for the 6MWT , ISWT and ESWT , which can be consistently employed by clinicians and research ers .