Comparison of two 6-minute walk tests to assess walking capacity in polio survivors

Merel Anne Brehm*, Suzan Verduijn, Jurgen Bon, Nicoline Bredt, Frans Nollet

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Objective: To compare walking dynamics and testretest reliability for 2 frequently applied walk tests in polio survivors: the 6-minute walk test (6MWT) to walk as far as possible; and the 6-minute walking energy cost test (WECT) at comfortable speed. Design: Observational study. Participants: Thirty-three polio survivors, able to walk ≥ 150 m. Methods: On the same day participants performed a 6MWT and a WECT, which were repeated 1-3 weeks later. For each test, distance walked, heart rate and reduction in speed were assessed. Results: The mean distance walked and mean heart rate were significantly higher in the 6MWT (441 m (standard deviation) (SD 79.7); 118 bpm (SD 19.2)) compared with the WECT (366 m (SD 67.3); 103 bpm (SD 14.3)); p < 0.001. Furthermore, during the 6MWT, patients continuously slowed down (-6%), while during the WECT speed dropped only slightly during the first 2 min, by -1.8% in total. Test-retest reliability of both tests was excellent (intraclass correlation coefficient (ICC) ≥ 0.95; lower bound 95% confidence interval (95% CI) ≥ 0.87). The smallest detectable change for the walked distance was 42 m (9.7% change from the mean) and 50 m (13.7%) on the 6MWT and WECT, respectively. Conclusion: Both the 6MWT and the WECT are reliable to assess walking capacity in polio survivors, with slightly superior sensitivity to detect change for the 6MWT. Differences in walking dynamics confirm that the tests cannot be used interchangeably. The 6MWT is recommended for measuring maximal walking capacity and the WECT for measuring submaximal walking capacity.

Original languageEnglish
Pages (from-to)732-737
Number of pages6
JournalJournal of Rehabilitation Medicine
Issue number9
Publication statusPublished - 1 Nov 2017
Externally publishedYes


  • 6-minute walk test
  • Poliomyelitis
  • Reproducibility of results
  • Walking
  • Walking energy cost test


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