Article

OBJECTIVE: To estimate the minimal clinically important difference (MCID) for the
6-minute walk test (6MWT) and the 200-m fast-walk test (FWT) in patients with
coronary artery disease (CAD) during a cardiac rehabilitation program. DESIGN:
Prospective study using distribution- and anchor-based methods. SETTING:
Outpatients from a cardiac rehabilitation unit. PARTICIPANTS: Stable patients
with CAD (N=81; 77 men; mean+/-SD age, 58.1+/-8.7y) enrolled 31+/-12.1 days after
an acute coronary syndrome (ACS). INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: 6MWT and 200-m FWT results before and after an 8-week cardiac
rehabilitation program and at the 6th and 12th sessions. Patients and
physiotherapists who supervised the training were asked to provide a global
rating of perceived change in walking ability while blinded to changes in walk
test performances. RESULTS: Mean change in 6MWT distance (6MWD) in patients who
reported no change was -6.5m versus 23.3m in those who believed their performance
had improved (P<.001). This result was consistent with the MCID determined by
using the distribution method (23m). Considering a 25-m cutoff, positive and
negative predictive values were 0.9 and .63, respectively. Conversely, there was
no difference in 200-m FWT performance between these 2 groups (0.1 vs -1.4s,
respectively). There was poor agreement with the physiotherapist's perceived
change. CONCLUSIONS: The MCID for 6MWD in patients with CAD after ACS was 25m.
This result will help physicians interpret 6MWD change and help researchers
estimate sample sizes in further studies using 6MWD as an endpoint.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS