Advanced Lung Disease and Transplant Program, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA.
Advanced Lung Disease and Transplant Program, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA.
Chest. 2013 Dec;144(6):1900-1905. doi: 10.1378/chest.13-0287.
The goal of the 6-min walk test (6MWT) is to enable patients to walk "as far as possible" as a measure of their functional ability. The impact of the specific walk instructions on patient 6MWT performance is unknown.
Patients with pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis (IPF), and other forms of interstitial lung disease (ILD) were recruited to perform four identical 6MWTs with one differing instructional phrase. The standard instruction to walk "as far as possible" was substituted in random order with "as fast as possible," "at your normal pace," or "at a leisurely pace."
Twenty-four patients (10 with PAH, eight with IPF, six with other ILD) were enrolled and completed all four 6MWTs. Patients attained the greatest distance with the fast instruction, exceeding the standard instruction distance by a mean of 52.7 m (P < .001). The mean difference between the fast and standard walks was 41.5 m in the PAH group, 66.5 m in the IPF group, and 53 m in the other ILD group.
Patients do not walk as far as they are able with the standard American Thoracic Society instruction for 6MWT. Changing the wording from "far" to "fast" may facilitate a better effort and greater distance during the test. It is possible that this modified 6MWT instruction may result in improved accuracy and reproducibility, thereby enhancing its clinical and research trial usefulness.
6 分钟步行测试（6MWT）的目的是让患者尽可能远地行走，以此作为其功能能力的衡量标准。目前尚不清楚特定的行走指令对患者 6MWT 表现的影响。
招募了患有肺动脉高压（PAH）、特发性肺纤维化（IPF）和其他形式的间质性肺疾病（ILD）的患者，让他们进行四次完全相同的 6MWT，其中一次使用不同的指导短语。将“尽可能远地走”的标准指令随机替换为“尽可能快地走”、“以正常速度走”或“悠闲地走”。
共有 24 名患者（10 名 PAH、8 名 IPF、6 名其他ILD）入组并完成了所有 4 次 6MWT。患者在快速指令下走得最远，比标准指令距离超出平均 52.7 米（P<0.001）。PAH 组的快速和标准行走之间的平均差异为 41.5 米，IPF 组为 66.5 米，其他ILD 组为 53 米。
患者在进行 6MWT 时，并未按照美国胸科学会的标准指令尽可能远地行走。将措辞从“远”改为“快”可能会促进患者在测试中更努力、走得更远。这种修改后的 6MWT 指令可能会提高其准确性和可重复性，从而增强其在临床和研究试验中的实用性。
