title: Repeat six-minute walk tests in patients with chronic heart failure: are they clinically necessary?
abstract: BACKGROUND
  Owing to a reported learning effect in patients with chronic cardiopulmonary disease, performance of at least two six-minute walk tests (6MWT) are recommended as standard practice. Patients with chronic heart failure (CHF) are typically elderly and frail and it is unknown whether current guidelines are practical in a clinical setting.
  
  
  OBJECTIVE
  The aim of this study was to determine whether repeat performance of 6MWTs in patients with CHF is related to between-test interval or baseline performance.
  
  
  METHODS
  This was a multisite observational study enrolling participants entering into heart failure rehabilitation programmes. Participants performed two 6MWTs with randomly allocated inter-test intervals between 15 and 90 minutes. Distance walked in the second test was compared with the first test using a paired t test.
  
  
  RESULTS
  Eighty-eight participants (45 females, age 65 ± 14 years) with stable CHF were enrolled. Mean distance walked increased from 301 metres in test 1 to 313 metres in test 2 (p < 0.001). No significant change was recorded between test 1 and test 2 for those whose baseline distance was <300 metres. The interval between tests had no significant effect on the distance walked.
  
  
  CONCLUSIONS
  The change in 6MWT distance was significantly associated with better baseline performance but not with the interval between tests.
authors: Heart Failure Service, Royal Brisbane and Women's Hospital, Brisbane, Australia. Julie_adsett@health.qld.gov.au
authors: Julie
authors: J
authors: Adsett
authors: Robert
authors: R
authors: Mullins
authors: Rita
authors: R
authors: Hwang
authors: Amy
authors: A
authors: Hogden
authors: Ellen
authors: E
authors: Gibson
authors: Kylie
authors: K
authors: Houlihan
authors: Michael
authors: M
authors: Tuppin
authors: Dariusz
authors: D
authors: Korczyk
authors: Kylie-Ann
authors: KA
authors: Mallitt
authors: Alison
authors: A
authors: Mudge
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011793:Queensland; D013997:Time Factors; D019564:Unnecessary Procedures; D016138:Walking