Study: 6-Minute Walking Test Best at Predicting Mobility After Stroke

A recent study found that the 6-minute walk test, rather than gait speed, is a better predictor of walking activity in patients after a stroke. The results also showed that gait speed, which is typically used in assessing post-stroke walking activity, may actually overestimate patients' ability.

For their study, the researchers performed a secondary analysis of the comfortable and fast gait speeds of 441 participants from 2 stroke trials. The participants were categorized as home (100-2499 steps/d), most-limited community (2500-4499 steps/d), least-limited community (5000-74,999 steps/d), and full community (7500 or more steps/d); they were categorized using participants' comfortable and fast gait speeds, the 6-minute walk test, the Berg Balance Scale, the Fugl Meyer Assessment, and Stroke Impact Scale to predict walking categories. 
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Multivariate analyses analyzed and identified significant variables associated with walking categories. The bootstrap method was used to select the most stable model, and the receiver-operating characteristic (ROC) curve was used to identify cutoff values.

Analysis showed that the 6-minute walk test, Fugl Meyr Assessment, and Berg Balance Scale combined were the strongest predictors of home vs community and limited vs unlimited community ambulators who had had a stroke.

In addition, the 6-minute walk test was the strongest predictor of home vs community and limited vs full community ambulators.

“A comfortable gait speed of 0.49 m/s discriminated between home and community [ambulators,] and a comfortable gait speed of 0.93 m/s discriminated between limited community and full community ambulators,” the researchers wrote.

Their findings suggest that gait speed values commonly used to distinguish between walking categories may overestimate walking activity between home and community, and the 6-minute walk test was better able to distinguish between walking categories of patients post-stroke.

—Melissa Weiss

Reference:

Fulk GD, He Y, Boyne P, Dunning K. Predicting home and community walking activity poststroke [published online January 5, 2017]. Stroke. https://doi.org/10.1161/STROKEAHA.116.015309.