Remote 6-Minute-Walk Testing in Patients with Pulmonary Hypertension: A Pilot Study

Lapatra, T.; Baird, Grayson L.; Goodman, R.; Pinder, Diane; Gaffney, Maeve; Klinger, James R.; Palevsky, Harold I.; Fritz, J.S.; Mullin, Christopher J.; Mazurek, Jeremy A.; Kawut, Steven M.; Ventetuolo, Corey E.

doi:10.1164/rccm.202110-2421le

Cited by 14 publications

(15 citation statements)

References 9 publications

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“…The data confirm and extend our previous finding that cardiac effort is less variable than distance walked by showing that it "levels the field" between in-clinic and remote 6MWT, correcting for multiple factors, including extra turns with a shorter walking space and/or reduced effort (no staff). Like LaPatra et al, 12 we found that remote 6MWT in the home was safe and feasible for motivated patients with functional class II PAH, but we did ours without a team member supervising the walk. Our study was conducted during inclement weather months in Rochester, New York, and relied on modified walking spaces indoor, which increases the generalizability.…”

Section: Discussionmentioning

confidence: 70%

“…The traditional 6MWT is staff supervised within an unobstructed 30-m hallway 22 ; especially indoors, most patients will not be able to replicate this hallway at home. Others have reported different strategies for remote 6MWT including algorithms developed to estimate walk distance based on wearables 20,25 or smartphones 19,[25][26][27][28] ; global positioning system (GPS)-enabled devices can estimate walk distance outdoors, 19,29 and LaPatra et al 12 used remote observation. These different approaches were tested in a wide variety of individuals including healthy control subjects 27 and patients with strokes, 29 pulmonary hypertension, 12 peripheral vascular disease, 26 and coronary artery disease 26 ; the courses were also variable.…”

Section: Discussionmentioning

confidence: 99%

“…In non-PAH cohorts, remote 6MWTs have been studied using mobile phones 19 and accelerometers 20 ; a recent two-center publication sheds light on this in patients with PAH. 12 These previous studies have shown correlation with directly observed walk distance.…”

mentioning

confidence: 85%

“…The difficulty of doing in-clinic hallway walks complicated efforts to restart therapeutic research after the first wave, and the absence of 6MWT data made risk assessment in clinical practice less meaningful. Masking during the 6MWT appears to decrease walk distance in patients with PAH, 12 which makes interpreting changes in walk distance challenging. Activity trackers capable of remote monitoring seem like an appealing alternative.…”

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confidence: 99%

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Cardiac Effort to Compare Clinic and Remote 6-Minute Walk Testing in Pulmonary Arterial Hypertension

Lachant¹,

Kennedy²,

Derenze³

et al. 2022

Chest

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 85%

mentioning

confidence: 99%

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Cardiac Effort to Compare Clinic and Remote 6-Minute Walk Testing in Pulmonary Arterial Hypertension

Lachant¹,

Kennedy²,

Derenze³

et al. 2022

Chest

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“…В 2022 г. на фоне пандемии COVID-19 T. La Patra и соавт. [61] для клинически стабильных пациентов с ЛАГ и ХТЭЛГ разработали удаленный метод оценки 6МХ, по достоверности не уступающий (по мнению авторов) выполняемому в медицинском учреждении.…”

Section: динамика дистанции 6мх в качестве стандартизирующего рки пок...unclassified

Dynamics of 6-Minute Walk Distance as a Predictor of Efficiency Specific Pulmonary Vasodilators

Шмальц

2022

Racionalʹnaâ farmakoterapiâ v kardiologii

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Pulmonary hypertension is a severe and often rapidly progressive disease with a fatal outcome. Approved specific therapy with five classes of drugs – prostanoids, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, soluble guanylate cyclase stimulators and prostacyclin receptor agonists has significantly improved the prognosis of patients. An accessible and reproducible criterion of exercise tolerance – a distance walked in six-minute walk test (6MXD) – occupies one of the central places among the performance indicators (clinical, echocardiographic and hemodynamic) of specific pulmonary vasodilators. Reflecting the clinical severity of pulmonary hypertension and, according to some data, its long-term prognosis, the dynamics of 6MXD is an integral component of the combined primary endpoints of randomized controlled trials. In the CHEST-2019 recommendations, the dynamics of the 6MXD was used to standardize the randomized controlled trials. The 6MXD is indispensable for dynamic observation and decisionmaking on further treatment tactics

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Remote exercise testing in pulmonary hypertension (PHRET)

Stubbs,

Lua,

Ingram

et al. 2023

Pulm. circ.

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Remote exercise tests for patients with pulmonary hypertension (PH) would improve the telemedicine strategies in this disease. The PHRET study assessed the validity and feasibility of four remote exercise tests performed by PH patients at home. Participants undergoing diagnostic assessment for PH were included. At baseline, patients completed a 6MWT followed by a range of study tests including a Timed Up and Go (TUG) test, a Sit‐to‐Stand (STS), a Step Test (ST), and a tele‐6MWT (T6MWT) performed outside using a GPS‐enabled smartphone. Patients performed these tests at home following discharge and at first follow‐up. Analysis focused on comparing the results of study tests to the standard 6MWT. The discontinuation rate was 15%. Ninety‐seven percent of patients were able to complete a TUG, 92% a STS, 73% a ST, and 49% a T6MWT. At baseline, correlation between the standard 6MWT and study tests, respectively, was T6MWT 0.93, ST 0.78, STS 0.71, and TUG −0.76 (p < 0.001). Direction of change in the study test agreed with the standard 6MWT in 68% of the follow‐up ST, 68% of the STS, 71% of the TUG, and 79% of the T6MWT. Patients were able to complete the tests at home, there were no adverse incidents and ≥92% of patients were happy to continue performing home tests. Remote exercise testing is feasible. The T6MWT was a valid remote measure of exercise capacity, but could only be performed by a limited number of patients. The high discontinuation rate may impact the utility of remote tests.

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Remote 6-Minute-Walk Testing in Patients with Pulmonary Hypertension: A Pilot Study

Cited by 14 publications

References 9 publications

Cardiac Effort to Compare Clinic and Remote 6-Minute Walk Testing in Pulmonary Arterial Hypertension

Cardiac Effort to Compare Clinic and Remote 6-Minute Walk Testing in Pulmonary Arterial Hypertension

Dynamics of 6-Minute Walk Distance as a Predictor of Efficiency Specific Pulmonary Vasodilators

Remote exercise testing in pulmonary hypertension (PHRET)

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