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Reliability of the Six-minute Walk Test in Individuals with Transtibial Amputation


Affiliations
1 National Institute for Orthopaedically Handicapped (NIOH), Bon Hooghly, Kolkata, India
     

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Objective

To determine inter- and intra-rater reliability of the Six-minute walk test (6MWT) in individuals with Transtibial Amputation.

Design

Prospective; test-retest method by a pair of physical therapists.

Setting

Indoor Physical Therapy department of the National Institute for the Orthopaedically Handicapped (NIOH), Kolkata.

Participants

Twenty one subjects (16 men, 5 women; mean age + mean standard error: 42.95 + 3.02 year) with transtibial amputation, who had completed two weeks of prosthetic training in the Inpatient Rehabilitation set up.

Interventions

Each subject performed a total of four 6MWTs, one test for each rater, on two consecutive days at approximately the same time of day. Subjects were given at least a 20 minutes rest between tests. The order of raters were randomized on the first day and reversed for the next day. The walk tests were performed in the same enclosed corridors with the same starting point for all tests. Subjects were allowed to walk with a mobility aid of their choice. Raters used a digital stopwatch to time the tests and the distance walked was measured in meters with the help of measuring tape. The raters were blinded to each other's scores.

Main Outcome Measure

Distance walked in 6 minutes (in meters).

Results

Within-rater reliability was good, with ICCs ranging from 0.79 to 0.83. Between-rater reliability was also high, with ICCs ranging from 0.81 to 0.88. A 2-way repeated-measures ANOVA showed significant differences (P<0.001) both within raters and between raters. It was seen that the proportion of variation within raters was more for the second rater whereas the proportion of variation between raters were more on the first day i.e day 1 of the test. Regardless of the tester, distances walked on day 2 were greater than on day1.

Conclusion

Although the 6 MWT showed good evidence of inter and intra rater reliability in individuals with unilateral below knee amputation, the distances walked in 6 minutes continued to improve over time. This improvement was mainly the result of training and learning effect.


Keywords

Amputation, Prosthetic Training, Walk Test
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  • Paul l. Enright and Duane l. Sherrill. Reference Equations for the Six-Minute Walk in Healthy Adults, Respiratory Sciences Center, University of Arizona, Arizona. American Journal of Respiratory and Critical Care Medicine. 1998; 158:1384–1387.
  • Lipkin DP, Scriven AJ, Crake T, Poole-Wilson PA. Six minute walking test for assessing exercise capacity in chronic heart failure. Br Med J (Clin Res Ed) 1986, 292:653-655.
  • American Thoracic Society ATS Statement. Guidelines for the Six-Minute Walk Test American Journal of Respiratory and Critical Care Medicine 2002; 166.
  • Treweek SP,Condie ME. Three measures of functional outcome for lower limb amputees: a retrospective review. Prosthet Orthot Int 1998; 22:178-85.
  • Robert S.Gailey et al.The Amputee Mobility Predictor:An Instrument to Assess Determinants of the Lower-Limb Amputee’s Ability to Ambulate. Arch Phys Med Rehabil May 2002; 83.
  • Phil Stevens et al. Clinically Relevant Outcome Measures in Orthotics and Prosthetics. Advancing Orthotic and Prosthetic Care Through Knowledge Feb 2009; 5.
  • Dina Brooks et al. The 2-Minute Walk Test as a measure of functional improvement in persons with lower limb amputation. Arch Phys Med Rehabil 2001; 82.
  • Norman GR, Streiner DL. Biostatistics: the bare essentials. Hamilton (Ont): BC Decker; 1998.
  • Masanic CA, Bayley MT. Interrater reliability of neurologic soft signs in an acquired brain injury population. Arch Phys Med Rehabil 1998; 79:811-5.
  • Frank R. Larkey & Jennifer L. Knight. Test-Retest Reliability and The Birkman Method; 2002.
  • Dina Brooks et al. Reliability of the Two-Minute Walk Test in Individuals with Transtibial Amputation. Arch Phys Med Rehabil 2002; 83.
  • Upton CJ, Tyrrell JC, Hiller EJ. Two minute walking distance in cystic fibrosis. Arch Dis Child 1988; 63:1444-8.
  • Guyatt GH, Pugsley SO, Sullivan MT, et al. Effect of encouragement on walking test performance. Thorax 1984; 39:818-22.
  • Solway S, Brooks D, Lacasse Y, Thomas S. A qualitative systematic review of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest 2001; 119:256-70.
  • Guyatt GH, Sullivan MJ, Thompson PJ, et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. CMAJ 1985; 132:919-23.
  • McDowell I, Newell C. Measuring health: a guide to treating scales and questionnaires. New York: Oxford Univ Pr; 1987.

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  • Reliability of the Six-minute Walk Test in Individuals with Transtibial Amputation

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Authors

Sangeeta Lahiri
National Institute for Orthopaedically Handicapped (NIOH), Bon Hooghly, Kolkata, India
Pooja Ghosh Das
National Institute for Orthopaedically Handicapped (NIOH), Bon Hooghly, Kolkata, India

Abstract


Objective

To determine inter- and intra-rater reliability of the Six-minute walk test (6MWT) in individuals with Transtibial Amputation.

Design

Prospective; test-retest method by a pair of physical therapists.

Setting

Indoor Physical Therapy department of the National Institute for the Orthopaedically Handicapped (NIOH), Kolkata.

Participants

Twenty one subjects (16 men, 5 women; mean age + mean standard error: 42.95 + 3.02 year) with transtibial amputation, who had completed two weeks of prosthetic training in the Inpatient Rehabilitation set up.

Interventions

Each subject performed a total of four 6MWTs, one test for each rater, on two consecutive days at approximately the same time of day. Subjects were given at least a 20 minutes rest between tests. The order of raters were randomized on the first day and reversed for the next day. The walk tests were performed in the same enclosed corridors with the same starting point for all tests. Subjects were allowed to walk with a mobility aid of their choice. Raters used a digital stopwatch to time the tests and the distance walked was measured in meters with the help of measuring tape. The raters were blinded to each other's scores.

Main Outcome Measure

Distance walked in 6 minutes (in meters).

Results

Within-rater reliability was good, with ICCs ranging from 0.79 to 0.83. Between-rater reliability was also high, with ICCs ranging from 0.81 to 0.88. A 2-way repeated-measures ANOVA showed significant differences (P<0.001) both within raters and between raters. It was seen that the proportion of variation within raters was more for the second rater whereas the proportion of variation between raters were more on the first day i.e day 1 of the test. Regardless of the tester, distances walked on day 2 were greater than on day1.

Conclusion

Although the 6 MWT showed good evidence of inter and intra rater reliability in individuals with unilateral below knee amputation, the distances walked in 6 minutes continued to improve over time. This improvement was mainly the result of training and learning effect.


Keywords


Amputation, Prosthetic Training, Walk Test

References