6MWT and ISWT: Levels of Agreement Between Different In-Person and Remote Testing Procedures in Lung Transplant Candidates

Rationale: Remote field-based walk tests may provide an alternative method of assessing exercise capacity for tele-rehabilitation programs. Objectives: Evaluate the level of agreement in distance walked between in-person x remote 6-minute walk tests (6MWT) and incremental shuttle walk test (ISWT). Methods: Adult lung transplant (LTx) candidates underwent 4 visits: i) an in-person standard 6MWT (30 m corridor) and a treadmill 6MWT, ii) a remote 6MWT (10m corridor), iii) two in-person standard ISWTs (10m corridor) and iv) a remote ISWT (10m corridor). A medical-grade oximeter measured heart rate and oxygen saturation each minute. A Bland-Altman analysis was performed. Results: 18 LTx candidates completed all visits (4 (22%) women; 62±10 years; 12 (67%) ILD; 6 (33%) COPD; exertional FiO2 0.43±0.1). There was agreement between the ISWTs but not the 6MWTs Figure 1. Greater walking distances were achieved with standard procedures: in-person 6MWT x treadmill 6MWT (346±72 x 273±115, p=0.001), in-person x remote 6MWT (346±72 x 289±87, p=0.001), and in-person x remote ISWT (217±57 x 197±63, p=0.07). Conclusion: Lower distances on the remote and treadmill 6MWTs were likely associated with different track lengths and walking surfaces. Despite an agreement between in-person and remote ISWT, a mean of 19 m is clinically relevant and should be considered when repeating this test in a different setting.