Characteristics of People With Chronic Lung Disease Who Rest During the Six-Minute Walk Test

OBJECTIVES: To examine the incidence of resting during the 6-minute-walk test (6MWT) in patients with chronic lung disease (CLD) and to explore differences in functional exercise capacity and response to pulmonary rehabilitation (PR) between resters and nonresters. DESIGN: Retrospective chart review. SETTING: Inpatient PR program. PARTICIPANTS: Individuals (N=211) who performed the 6MWT at admission and discharge from PR. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Primary outcomes were total distance walked (6-minute walk distance [6MWD]) and rest frequency and duration. Secondary outcomes were walking speed, end-test dyspnea, and the Chronic Respiratory Questionnaire (CRQ). RESULTS: At admission, 45 people (21%) rested 1 to 4 times during the 6MWT (total duration, 105±80s) and 166 people walked continuously. At discharge, 9 people continued to rest (total duration, 28±55s). At admission, nonresters walked 315±93m, whereas resters walked 197±83m (P<.0001), and 6MWD increased in both groups after PR (P<.0001). Nonresters increased their walking speed at discharge, but resters did not (interaction P<.001). At admission, the mastery domain of the CRQ was 0.8 point lower in resters (3.7±1.2) compared with nonresters (4.5±1.7; P=.01). Resters' end-test dyspnea scores decreased from 5.7±0.3 to 4.3±0.2 from admission to discharge, whereas nonresters' end-test dyspnea scores did not significantly change from 4.5±0.2 to 4.2±0.2 at discharge (interaction P<.05). CONCLUSIONS: One in 5 individuals with CLD rest during the 6MWT. Decreasing rest duration or increasing walking speed reflects different strategies used to improve 6MWD after rehabilitation, both suggesting a positive effect of PR. This may be related to improvements in an individual's sense of control over dyspnea. Future work should investigate potential factors related to resting during the 6MWT.