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Accompanied versus unaccompanied walking for continuous oxygen saturation measurement during 6-min walk test in COPD: a randomised cross-over study

Thomas F. Riegler, Anja Frei, Sarah R. Haile, Thomas Radtke
ERJ Open Research 2021; DOI: 10.1183/23120541.00921-2020
Thomas F. Riegler
1Berner Reha Zentrum AG, Heiligenschwendi, Switzerland
2Institute for Physiotherapy, Zurich University of Applied Sciences, Zurich, Switzerland
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  • For correspondence: thomasf.riegler@gmail.com
Anja Frei
3Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Sarah R. Haile
3Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Thomas Radtke
3Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Abstract

Study question Is there i a difference in the 6-Min Walk Test (6 MWT) distance when the assessor accompanies the patient to continuously measure oxygen saturation (SpO2) compared to the patient walking unaccompanied?

Methods We conducted a prospective randomised cross-over study to evaluate the impact of the assessor walking with the patient during 6 MWT (6 MWTwith) versus patient walking alone (6 MWTwithout). At the end of a pulmonary rehabilitation programme, each patient performed two 6 MWTs in random order and separated by 30 min rest.

Results 49 COPD patients (GOLD II-IV) were included. In a regression model adjusting for period and subject, accompanying the patient resulted in a lower walking distance (mean difference −9.1 m, [95%CI, −13.9 to −4.3], p=0.0004). Notably, six patients walked more than 30 m further (minimal important difference, MID) in one of the two conditions (6 MWTwith: n=1, 6 MWTwithout: n=5). There were no between-sequence-group differences in heart rate, dyspnoea and leg-fatigue, and SpO2. The median (interquartile range) number and duration of SpO2 signal artefacts were high but not different between the experimental conditions (6 MWTwith: 17 [4, 24], 34 s [7, 113], 6 MWTwithout: 11 [3, 26], 24 s [4, 62]).

Answer to the question On a study population level, we observed a statistically significant difference in 6 MWT distance between the two experimental conditions, however, the magnitude of difference is small and may not be considered clinically relevant. Nevertheless, in a clinical setting, unaccompanied walking resulted in a substantially higher walking distance pointing towards strictly standardised testing methodology, in particular in pre-post study designs.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Mr. Riegler has nothing to disclose.

Conflict of interest: Dr. Frei has nothing to disclose.

Conflict of interest: Dr. Haile has nothing to disclose.

Conflict of interest: Dr. Radtke has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received December 7, 2020.
  • Accepted March 13, 2021.
  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Accompanied versus unaccompanied walking for continuous oxygen saturation measurement during 6-min walk test in COPD: a randomised cross-over study
Thomas F. Riegler, Anja Frei, Sarah R. Haile, Thomas Radtke
ERJ Open Research Jan 2021, 00921-2020; DOI: 10.1183/23120541.00921-2020

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Accompanied versus unaccompanied walking for continuous oxygen saturation measurement during 6-min walk test in COPD: a randomised cross-over study
Thomas F. Riegler, Anja Frei, Sarah R. Haile, Thomas Radtke
ERJ Open Research Jan 2021, 00921-2020; DOI: 10.1183/23120541.00921-2020
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