Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2013

01-11-2013 | Knee

Reliability of the 6-min walk test after total knee arthroplasty

Authors: Thomas Linding Jakobsen, Henrik Kehlet, Thomas Bandholm

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2013

Login to get access

Abstract

Purpose

The 6-min walk test is a simple clinical outcome measure, which has been used frequently to assess functional performance in many different patient groups, including patients with total knee arthroplasty (TKA). The 6-min walk test measures the maximal distance a subject is able to walk in 6 min. The reliability is unknown in patients with TKA. Therefore, the purpose of the study was to assess the reliability of the 6-min walk test in patients with recent TKA.

Methods

Thirty-four patients with TKA performed 2 test trials the same day, separated by a 1-h seated rest. To assess reliability, intra-class correlation coefficient (ICC2,1), standard error of measurement (SEM), and smallest real difference (SRD) were calculated.

Results

The patients walked on average 14.1 m longer at the second (397.2 m) compared to the first (383.1 m) test trial. The ICC2,1, SEM, and SRD were 0.97, 13.0, and 36.1 m, respectively.

Conclusions

The intra-tester reliability of the 6-min walk test was high in patients with TKA. The thresholds of the 6-min walk test to detect a real change are acceptable in research (SEM) and clinical settings (SRD). We recommend that the longest distance walked in 2 supervised test trials should be used.

Level of evidence

I.
Literature
1.
go back to reference American Thoracic Society (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166:111–117CrossRef American Thoracic Society (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166:111–117CrossRef
2.
go back to reference Bade MJ, Kohrt WM, Stevens-Lapsley JE (2010) Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther 40:559–567PubMedCrossRef Bade MJ, Kohrt WM, Stevens-Lapsley JE (2010) Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther 40:559–567PubMedCrossRef
3.
go back to reference Batterham AM, George KP (2003) Reliability in evidence-based clinical practice: a primer for allied health professionals. Phys Ther Sport 4:122–128CrossRef Batterham AM, George KP (2003) Reliability in evidence-based clinical practice: a primer for allied health professionals. Phys Ther Sport 4:122–128CrossRef
4.
go back to reference Beckerman H, Roebroeck ME, Lankhorst GJ, Becher JG, Bezemer PD, Verbeek AL (2001) Smallest real difference, a link between reproducibility and responsiveness. Qual Life Res 10:571–578PubMedCrossRef Beckerman H, Roebroeck ME, Lankhorst GJ, Becher JG, Bezemer PD, Verbeek AL (2001) Smallest real difference, a link between reproducibility and responsiveness. Qual Life Res 10:571–578PubMedCrossRef
5.
go back to reference Bernstein ML, Despars JA, Singh NP, Avalos K, Stansbury DW, Light RW (1994) Reanalysis of the 12-minute walk in patients with chronic obstructive pulmonary disease. Chest 105:163–167PubMedCrossRef Bernstein ML, Despars JA, Singh NP, Avalos K, Stansbury DW, Light RW (1994) Reanalysis of the 12-minute walk in patients with chronic obstructive pulmonary disease. Chest 105:163–167PubMedCrossRef
6.
go back to reference Borg G (1970) Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 2:92–98PubMed Borg G (1970) Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 2:92–98PubMed
7.
go back to reference Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM (1982) Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed) 284:1607–1608CrossRef Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM (1982) Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed) 284:1607–1608CrossRef
8.
go back to reference de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA (2008) Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res 466:2201–2208PubMedCrossRef de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA (2008) Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res 466:2201–2208PubMedCrossRef
9.
go back to reference Denegar CR, Ball DW (1993) Assessing reliability and precision of measurement: an introduction to intraclass correlation and standard error of measurement. J Sport Rehabil 2:35–42 Denegar CR, Ball DW (1993) Assessing reliability and precision of measurement: an introduction to intraclass correlation and standard error of measurement. J Sport Rehabil 2:35–42
10.
go back to reference Eliasziw M, Young SL, Woodbury MG, Fryday-Field K (1994) Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example. Phys Ther 74:777–788PubMed Eliasziw M, Young SL, Woodbury MG, Fryday-Field K (1994) Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example. Phys Ther 74:777–788PubMed
11.
go back to reference Farquhar S, Snyder-Mackler L (2010) The Chitranjan Ranawat Award: the nonoperated knee predicts function 3 years after unilateral total knee arthroplasty. Clin Orthop Relat Res 468:37–44PubMedCrossRef Farquhar S, Snyder-Mackler L (2010) The Chitranjan Ranawat Award: the nonoperated knee predicts function 3 years after unilateral total knee arthroplasty. Clin Orthop Relat Res 468:37–44PubMedCrossRef
12.
go back to reference Gibbons WJ, Fruchter N, Sloan S, Levy RD (2001) Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil 21:87–93PubMedCrossRef Gibbons WJ, Fruchter N, Sloan S, Levy RD (2001) Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil 21:87–93PubMedCrossRef
13.
go back to reference Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D (2005) Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 6:3PubMedCrossRef Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D (2005) Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 6:3PubMedCrossRef
14.
go back to reference Kennedy DM, Stratford PW, Hanna SE, Wessel J, Gollish JD (2006) Modeling early recovery of physical function following hip and knee arthroplasty. BMC Musculoskelet Disord 7:100PubMedCrossRef Kennedy DM, Stratford PW, Hanna SE, Wessel J, Gollish JD (2006) Modeling early recovery of physical function following hip and knee arthroplasty. BMC Musculoskelet Disord 7:100PubMedCrossRef
15.
go back to reference Liaw LJ, Hsieh CL, Lo SK, Chen HM, Lee S, Lin JH (2008) The relative and absolute reliability of two balance performance measures in chronic stroke patients. Disabil Rehabil 30:656–661PubMedCrossRef Liaw LJ, Hsieh CL, Lo SK, Chen HM, Lee S, Lin JH (2008) The relative and absolute reliability of two balance performance measures in chronic stroke patients. Disabil Rehabil 30:656–661PubMedCrossRef
16.
go back to reference Mizner RL, Petterson SC, Clements KE, Zeni JA Jr, Irrgang JJ, Snyder-Mackler L (2011) Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplast 26:728–737CrossRef Mizner RL, Petterson SC, Clements KE, Zeni JA Jr, Irrgang JJ, Snyder-Mackler L (2011) Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplast 26:728–737CrossRef
17.
go back to reference Moffet H, Collet JP, Shapiro SH, Paradis G, Marquis F, Roy L (2004) Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Arch Phys Med Rehabil 85:546–556PubMedCrossRef Moffet H, Collet JP, Shapiro SH, Paradis G, Marquis F, Roy L (2004) Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Arch Phys Med Rehabil 85:546–556PubMedCrossRef
18.
go back to reference Parent E, Moffet H (2002) Comparative responsiveness of locomotor tests and questionnaires used to follow early recovery after total knee arthroplasty. Arch Phys Med Rehabil 83:70–80PubMedCrossRef Parent E, Moffet H (2002) Comparative responsiveness of locomotor tests and questionnaires used to follow early recovery after total knee arthroplasty. Arch Phys Med Rehabil 83:70–80PubMedCrossRef
19.
go back to reference Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L (2009) Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthr Rheum 61:174–183CrossRef Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L (2009) Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthr Rheum 61:174–183CrossRef
20.
go back to reference Rejeski WJ, Ettinger WH Jr, Schumaker S, James P, Burns R, Elam JT (1995) Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthr Cartil 3:157–167PubMedCrossRef Rejeski WJ, Ettinger WH Jr, Schumaker S, James P, Burns R, Elam JT (1995) Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthr Cartil 3:157–167PubMedCrossRef
21.
go back to reference Shrout PE (1998) Measurement reliability and agreement in psychiatry. Stat Methods Med Res 7:301–317PubMedCrossRef Shrout PE (1998) Measurement reliability and agreement in psychiatry. Stat Methods Med Res 7:301–317PubMedCrossRef
22.
go back to reference Stillwell KM, Forman DE, McElwain D, Simpson C, Garber CE (1996) The 6 minute walk test for evaluation of functional capacity in elderly adults. Med Sci Sports Exerc 28:152CrossRef Stillwell KM, Forman DE, McElwain D, Simpson C, Garber CE (1996) The 6 minute walk test for evaluation of functional capacity in elderly adults. Med Sci Sports Exerc 28:152CrossRef
23.
go back to reference Wu G, Sanderson B, Bittner V (2003) The 6-minute walk test: how important is the learning effect? Am Heart J 146:129–133PubMedCrossRef Wu G, Sanderson B, Bittner V (2003) The 6-minute walk test: how important is the learning effect? Am Heart J 146:129–133PubMedCrossRef
24.
go back to reference Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L (2008) Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol, Avon) 23:320–328CrossRef Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L (2008) Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol, Avon) 23:320–328CrossRef
Metadata
Title
Reliability of the 6-min walk test after total knee arthroplasty
Authors
Thomas Linding Jakobsen
Henrik Kehlet
Thomas Bandholm
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2054-y

Other articles of this Issue 11/2013

Knee Surgery, Sports Traumatology, Arthroscopy 11/2013 Go to the issue