Evaluating the benefit of performing two 6-min walk tests after pulmonary rehabilitation to improve assessment of functional capacity

Objective The 6-min walk test (6MWT) is an essential test during pulmonary rehabilitation. The significant learning effect of the 6MWT involves performing two tests. However, when tests are repeated three months later, the learning effect appears smaller in magnitude. Consequently, in clinical practice, only one test is performed after a pulmonary rehabilitation program. The aim of this study was to determine whether there is a benefit of performing two 6MWTs after pulmonary rehabilitation. Design Prospective, single center, noninterventional study. Setting Pulmonary Rehabilitation Unit of the Centre Hospitalier des Pays de Morlaix (Morlaix, France) from 24 March 2023 to 19 March 2024. Participants Patients aged 18 and older with moderate to very severe chronic obstructive pulmonary disease (COPD), admitted to a four-week pulmonary rehabilitation program. Intervention Subjects performed two 6MWTs at the end of the program. Main measures The primary outcome was the distance covered during the walk test. Secondary outcomes included oxygen saturation, heart rate, and lower limb fatigue. Results One hundred seventy-six patients were included. Results revealed a significant difference ( p < .05) in distance walked between the two 6MWT. Seventy-eight percent of patients ( n = 135) walked further on the second test with a mean improvement of 14 m. The second test allowed an additional 15% ( n = 26) to be classified as “responders” to the program regarding exercise capacity. Conclusion The significant improvement in distance on the second test supports the value of performing two 6MWTs at the end of pulmonary rehabilitation in patients with COPD. Research is needed to extend findings to populations other than COPD.