Interrater Reliability of the 6-Minute Walk Test in Women With Hip Fracture

Camilla Marie Larsen, Jan Overgaard, Steffen Holtze, Kenneth Ockholm, Morten Tange Kristensen

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Background and Purpose: The 6-minute walk test (6MWT)
is widely used as a clinical outcome measure. However, the
reliability of the 6MWT is unknown in individuals who have
recently experienced a hip fracture. The aim of this study was
to evaluate the relative and absolute interrater reliability of the
6MWT in individuals with hip fracture.
Methods: Two senior physical therapy students independently
examined a convenience sample of 20 participants in a randomized
order. Their assessments were separated by 2 days and
followed the guidelines of the American Thoracic Society. Hip
fracture-related pain was assessed with the Verbal Ranking Scale.
Results: Participants (all women) with a mean (standard
deviation) age of 78.1 (5.9) years performed the test at a
mean of 31.5 (5.8) days postsurgery. Of the participants, 10
had a cervical fracture and 10 had a trochanteric fracture.
Excellent interrater reliability (intraclass correlation coeffi cient
[ICC 2.1] = 0.92; 95% confi dence interval, 0.81-0.97) was
found, and the standard error of measurement and smallest real difference were calculated to be 21.4 and 59.4 m, respectively.
Bland-Altman plots revealed no signifi cant difference
(mean of 3.2 [31.5] m, P = .83) between the 2 raters, and no
heteroscedasticity was observed ( r = −0.196, P = .41). By
contrast, participants walked an average of 21.7 (22.5) m
longer during the second trial ( P = .002). Participants with
moderate hip fracture-related pain walked a shorter distance
than those with no or light pain during the fi rst test ( P = .04),
but this was not the case during the second test ( P = .25).
Conclusion: The interrater reliability of the 6MWT is excellent,
and changes of more than 21.4 m (group level) and
59.4 m (individual participants with hip fracture) indicate a
real change in the 6MWT. Measuring hip fracture-related pain
during testing is recommended for individuals with hip fracture
who undergo the 6MWT.
TidsskriftJournal of Geriatric Physical Therapy
StatusUdgivet - 2016