“Minimal Clinically Important Difference of the Six Minute Walk Test in People with Stroke”

I never had the 6 minute walk test, almost every week I had the Timed Up and Go test. I thought it was useless since testing has nothing to do with recovery. It seemed the only reason for such tests was to deny therapy. Plateau. If you can walk for six minutes you are already at a high functioning level. This research told me nothing new.

https://jnptacceptedarticles.wordpress.com/2018/07/04/just-accepted-minimal-clinically-important-difference-of-the-six-minute-walk-test-in-people-with-stroke/
 The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:
“Minimal Clinically Important Difference of the Six Minute Walk Test in People with Stroke”
By
George Fulk, PT, PhD; Ying He, PhD
Provisional Abstract:
Background and Purpose: The 6-minute walk test (6MWT) is a commonly used outcome measure in people with stroke undergoing rehabilitation. The purpose of this study was to estimate the Minimal Clinically Important Difference (MCID) of the 6MWT in people 2 months post stroke undergoing outpatient rehabilitation using an anchor-based approach.
Methods: Secondary analysis of data from a large rehabilitation intervention trial. Participants underwent a physical therapy intervention between 2 and 6 months post stroke. The 6MWT was measured before and after the intervention. Two anchors of important change were used: the modified Rankin Scale (mRS) and Stroke Impact Scale (SIS). The MCID for the 6MWT was estimated using receiver operator characteristic curves with the mRS and SIS as anchors for the entire sample and for two subgroups based on initial walking function, gait speed <0.40 m/s and gait speed ≥0.40 m/s.
Results: For the entire sample, the estimated MCID of the 6MWT was 71m with the mRS as the anchor (area under the curve (AUC)=0.66), and 65m with the SIS as the anchor (AUC=0.59). For participants with initial gait speed <0.40 m/s, the estimated MCID was 44m with the mRS as the anchor (AUC=0.72) and 34m with the SIS as the anchor (AUC=0.62). For participants with initial gait speed ≥0.40 m/s, the estimated MCID was 71m with the mRS as the anchor (AUC=0.59) and 130m with the SIS as the anchor (AUC=0.56).
Discussion and Conclusion: Between 2 and 6 months post stroke, people whose initial gait speed is <0.40 m/s and experience a 44m improvement in the 6MWT after physical therapy may exhibit meaningful improvement in disability. However, we were not able to estimate an accurate MCID for the 6MWT in people whose initial gait speed was ≥0.40 m/s. Our findings illustrate the need to estimate MCID values in an outcome measure across different levels of function and different anchors of importance.
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