A more effective alternative to the 6-minute walk test for the assessment of functional capacity in patients with pulmonary hypertension.

Marsico A; Dal Corso S; Farah de Carvalho E; Arakelian V; Phillips S; Stirbulov R; Polonio I; Navarro F;
Consolim-Colombo F; Cahalin LP; Malosa Sampaio LM;

European journal of physical and rehabilitation medicine [Eur J Phys Rehabil Med] 2021 Feb 23. Date of Electronic Publication: 2021 Feb 23.

Background: The prognosis of Pulmonary Hypertension (PH) is directly correlated with the functional capacity (FC). The most common FC test is the 6-Minute Walk Test (6MWT), however, there is evidence to suggest that the 6MWT does not reflect the real FC in PH patients.
Objective: To compare physiological responses among three field walk tests and cardiopulmonary exercise testing (CPET) in patients with pulmonary hypertension (PH), and to determine the determinants of distance walked in the field walk tests.
Design: Cross sectional.
Setting: Outpatient clinic.
Participants: 26 volunteers (49.8 ± 14.6 years), WHO functional class II-III and a mean pulmonary artery pressure of 45 mmHg.
Interventions: Patients underwent three field walk test: 6MWT, incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) and CPET on different, nonconsecutive days.
Main Outcome Measures: Heart rate and perception of effort at the peak of exercise.
Results: The ISWT achieved maximum levels of effort without significant difference in any physiologic response compared to CPET. The physiological responses during ISWT were significantly higher than 6MWT and ESWT responses.
Conclusions: The ISWT produced the greatest physiologic response of the field tests safely for which reason it appears to be the most effective test to assess FC of PH patients.