Effects of Guarding on the Outcomes of the 6-Minute Walk Test

Introduction:The American Thoracic Society recommends not walking with the client during the 6-minute walk test (6MWT). This recommendation raises safety concerns for individuals at increased risk of falls. To date, the effects of guarding during the 6MWT have not been investigated.Purpose:The purpose of this study was to determine whether guarding during the 6MWT affected gait velocity and distance walked.Methods:This multicenter study collected data from healthy younger (n = 103, 24.2 ± 3.4 yr) and older adults (n = 102, 71.1 ± 11.3 yr) who performed 2 consecutive 6MWT trials. Participants were randomized into a "guarded first"versus "guarded second"condition. Data were analyzed using a one-sample t test, intraclass correlation coefficients (ICCs), and Bland-Altman plots.Results:Guarding significantly decreased (P <.001) the distance walked (mean difference = 13.5 ± 40.3 m, 95% limits of agreement [LOA] = 65.5 and -92.4 m) and gait velocity (mean difference = 0.04 ± 0.11 m/sec, 95% LOA = 0.26 and -0.18 m/sec). Guarding decreased distance walked and velocity when divided into an older and younger group as well but had a more significant impact in the younger grouping.Conclusions:Guarding during the 6MWT influenced walking distance. Findings suggest that the measurements under the 2 walking conditions are not interchangeable.