Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20679
Title: Should the 6-minute walk test be stopped if oxyhemoglobin saturation falls below 80%?
Austin Authors: Afzal, Sumbla;Burge, Angela T ;Lee, Annemarie L;Bondarenko, Janet;Holland, Anne E 
Affiliation: Alfred Hospital, Melbourne, Australia
Austin Health, Heidelberg, Victoria, Australia
Fauji Foundation Hospital, Rawalpindi, Pakistan
La Trobe University, Melbourne, Australia
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Nov-2018
metadata.dc.date: 2018-08-18
Publication information: Archives of Physical Medicine and Rehabilitation 2018; 99(11): 2370-2372
Abstract: To examine the occurrence of adverse events in patients undergoing assessment for pulmonary rehabilitation when a 6-minute walk test (6MWT) continues despite desaturation below 80%. Objective: To examine the occurrence of adverse events in patients undergoing assessment for pulmonary rehabilitation when a 6-minute walk test (6MWT) continues despite desaturation below 80%. Design: Retrospective audit following REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement. Setting: Large teaching hospital. Participants: All patients assessed for pulmonary rehabilitation (September 2005 to January 2016). Interventions: The standardized tests were conducted by experienced cardiorespiratory physiotherapists. Oxyhemoglobin saturation was monitored continuously using a pulse oximeter (lowest value used for analysis). Medical records were reviewed, and adverse events defined as tachycardia, bradycardia, chest pain or other sign/symptom necessitating cessation. Main outcome measure: 6MWT. Results: Data from 672 walk tests were included (55% men, mean age 69 (standard deviation 11) years) with mean distance 369 (124) meters. The main diagnoses were chronic obstructive pulmonary disease (70%), interstitial lung disease (14%) and bronchiectasis (8%). Sixty individuals (11%) recorded desaturation below 80% without adverse events. Two adverse events were recorded during tests without desaturation; in one instance, chest pain with no evidence of cardiorespiratory compromise and in another, the patient stopped due to concern regarding blood sugar levels (11.5 mmol/L when tested). Independent predictors of desaturation to less than 80% were resting oxyhemoglobin saturation < 95% (odds ratio 3.82, 95% confidence interval 2.06 to 7.08) and a diagnosis of interstitial lung disease or pulmonary arterial hypertension (OR 5.24, 2.59 to 10.58). Conclusions: This study found that desaturation to less than 80% during a 6MWT was not associated with adverse events in a large cohort of patients referred to pulmonary rehabilitation and assessed by experienced physiotherapists, suggesting that test cessation due to desaturation in stable patients may be unwarranted.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20679
DOI: 10.1016/j.apmr.2018.07.426.
ORCID: 0000-0003-2061-845X
PubMed URL: 30130517
Type: Journal Article
Subjects: Exercise test
Lung diseases
Pulmonary disease
chronic obstructive
Rehabilitation
Appears in Collections:Journal articles

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