Six-minute walk test protocol variations in low-resource settings - A scoping review.
Brittany L Fell, Susan Hanekom, Martin Heine
PMID 34230901WHAT IT FOUND
In low-resource settings, 24 studies adapted the six-minute walk test, most by changing course length or layout, often because space was limited.
Reporting was poor, so adapted distances may not be comparable.
Key findings
01Twenty-four studies were included, and the most common adaptation was course length, reported by 21 studies (88%) and ranging from 10 m to 85 m per lap.
02Space constraints were the most common stated reason for adapting the test, and only eight studies gave a specific rationale.
03The review could not determine how adaptations affected the six-minute walk distance because the included studies were too heterogeneous.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only English-language studies were included, so relevant work in other languages could be missing. Many included studies did not clearly report how the six-minute walk test was conducted. Some studies said they followed the American Thoracic Society guideline but may still have made unreported changes. The review excluded case studies, case series, studies using the standard guideline and studies that did not report methods, so it may not capture all real-world variations. The definition of low-resource setting sometimes relied on wording in the study and author discussion, which may make inclusion less consistent. The impact of protocol changes on walk distance could not be calculated because the studies were too different. The review did not examine changing the test duration, such as using a two-minute walk test.
The easy way to misread this
Do not conclude that adapted six-minute walk tests are interchangeable or clinically equivalent. The review found wide protocol differences and poor reporting, and it could not determine how those changes affected walk distance.