Chen Yueh-Chi, Chen Kun-Chung, Lu Li-Hua, Wu Yi-Liang, Lai Te-Jen, Wang Chun-Hou
Institute of Medicine.
Department of Physical Therapy, Chung Shan Medical University.
Medicine (Baltimore). 2018 Oct;97(42):e12925. doi: 10.1097/MD.0000000000012925.
The 6-minute walk test (6MWT) has been applied to assess postsurgical recovery in cardiac populations. This study mainly investigated whether the 6MWT could serve as an indicator for physical functioning in patients undergoing cardiac surgery.Participants completed the 6MWT and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) at baseline, discharge, and 3 months postoperatively, in order to analyze the construct validity and responsiveness of the 6MWT. The participants in this study were 125 patients (92 males and 33 females) with an average age of 65.1 ± 11.1 years. The mean 6MWT was 308.9 ± 77.3 m in the preoperative phase, decreased to 277.3 ± 85.7 m at discharge, and returned to 378.1 ± 95.2 m at 3-month follow-up. The results showed that the 6-minute walk distances at baseline and at 3-month follow-up were moderately to highly correlated with the physical functioning subscale of the SF-36 (rs = .44 and .54, respectively) and had weak correlation with the nonphysical functioning subscales. The recovery level of physical functioning is meaningfully associated with the 6MWT change from baseline to discharge and from baseline to 3-month follow-up. Patients with higher New York Heart Association (NYHA) Functional Classification levels had lower 6MWT. Additionally, the 6MWT was sensitive to change during the perioperative period (effect sizes from -0.51 to 1.72).The supporting evidence includes the construct validity and responsiveness of the 6MWT. This study supports the feasibility of the 6MWT as an evaluation tool of physical functioning for assessment of postcardiac surgical recovery.
6分钟步行试验(6MWT)已被用于评估心脏疾病患者术后的恢复情况。本研究主要探讨6MWT能否作为心脏手术患者身体功能的指标。参与者在基线、出院时和术后3个月完成6MWT和医学结局研究36项简短健康调查(SF-36),以分析6MWT的结构效度和反应性。本研究的参与者为125例患者(92例男性和33例女性),平均年龄65.1±11.1岁。术前阶段6MWT的平均距离为308.9±77.3米,出院时降至277.3±85.7米,3个月随访时恢复至378.1±95.2米。结果显示,基线和3个月随访时的6分钟步行距离与SF-36的身体功能分量表中度至高度相关(rs分别为0.44和0.54),与非身体功能分量表相关性较弱。身体功能的恢复水平与6MWT从基线到出院以及从基线到3个月随访的变化有显著关联。纽约心脏协会(NYHA)功能分级水平较高的患者6MWT较低。此外,6MWT在围手术期对变化敏感(效应大小从-0.51至1.72)。支持证据包括6MWT的结构效度和反应性。本研究支持6MWT作为评估心脏手术后恢复的身体功能评估工具的可行性。