Safety of early performance of the six-minute walk test following acute myocardial infarction: a cross-sectional study.
Lívia S Diniz, Victor R Neves, Ana C Starke and 3 others
PMID 28473280WHAT IT FOUND
Early six-minute walk tests after uncomplicated heart attacks were completed by all 152 patients.
Severe complications occurred in 3.9%, but none led to death, and the up to 4 days and after 4 days groups did not differ.
Key findings
01In 152 patients with uncomplicated acute myocardial infarction, 3.9% had a severe complication during the six-minute walk test, and none led to a clinically significant complication or death.
02The severe complication rate was 2.6% in patients tested up to 4 days after the event and 1.3% in patients tested after 4 days, and the groups did not differ significantly.
03Patients walked a mean distance of 442.4 m, which the paper reports as 85% of the expected 515.7 m.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The patients were not randomly assigned to timing groups; they were grouped by how many days had passed since the event. The study included only uncomplicated cases, mostly with up to 2 injured coronary arteries and no significant left ventricular dysfunction, so it does not show safety for more severe patients. Holter monitoring was available only for the last 105 candidates, and 98 recordings were analysed, so electrocardiographic safety is not complete. Data collection was not completely uninterrupted. Most patients were taking beta-blockers, which may have limited the rise in heart rate and blood pressure during exertion. Some patients did not walk at their maximum tolerated speed because they feared exertion, so the distance may underestimate functional capacity.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read this as proof that early walking tests are safe for every patient after myocardial infarction. The study enrolled only uncomplicated cases, and 3.9% of 152 patients had a severe complication during the test.