Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis

Importance The minimum important difference (MID) for field walking tests aims to improve interpretation of outcomes, but the volume and heterogeneity of MIDs for these tests is challenging. We aimed to determine the MID for the 6-min walk distance (6MWD), incremental shuttle walk test (ISWT) and en...

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Main Authors: Enya Daynes, Ruth E. Barker, Amy V. Jones, Jessica A. Walsh, Claire M. Nolan, William D-C. Man, Sally J. Singh, Neil J. Greening, Linzy Houchen-Wolloff, Rachael A. Evans
Format: Article
Language:English
Published: European Respiratory Society 2025-05-01
Series:European Respiratory Review
Online Access:http://err.ersjournals.com/content/34/176/240198.full
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author Enya Daynes
Ruth E. Barker
Amy V. Jones
Jessica A. Walsh
Claire M. Nolan
William D-C. Man
Sally J. Singh
Neil J. Greening
Linzy Houchen-Wolloff
Rachael A. Evans
author_facet Enya Daynes
Ruth E. Barker
Amy V. Jones
Jessica A. Walsh
Claire M. Nolan
William D-C. Man
Sally J. Singh
Neil J. Greening
Linzy Houchen-Wolloff
Rachael A. Evans
author_sort Enya Daynes
collection DOAJ
description Importance The minimum important difference (MID) for field walking tests aims to improve interpretation of outcomes, but the volume and heterogeneity of MIDs for these tests is challenging. We aimed to determine the MID for the 6-min walk distance (6MWD), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with long-term conditions. Methods This systematic review included studies that generated a MID using an anchor-based approach in patients with long-term conditions for the 6MWD, ISWT or ESWT field walking tests. Studies were screened and data extracted by independent reviewers. Meta-analyses were performed using RevMan. Results 42 studies were included in the analyses, involving n=13 949 participants. Of these, 12 studies involving exercise as an intervention were included in the meta-analyses to produce MIDs, presented as mean (95% confidence interval). The MID for the 6MWD was 25 m (24–26 m) for respiratory conditions, 23 m (8–37 m) for cardiac conditions and 37 m (26–49 m) for neurological/musculoskeletal conditions. The MID for the ISWT was 48 m (39–57 m) for respiratory conditions and 70 m (55–85 m) for cardiac conditions. The MID for ESWT in COPD was 159 s (94–224 s). The pooled MID across conditions within exercise interventions was 26 m (22–40 m) for the 6MWD and 53 m (44–62 m) for the ISWT, with reasonable heterogeneity (I2=48% and I2=47%, respectively). Conclusion We propose new MIDs for exercise interventions using anchor-based methodology in long‑term conditions for the 6MWD, ISWT and ESWT. These can be used internationally for meta‑analyses where studies have used different field walking tests, to optimise trial sample size calculations, and for clinical service benchmarking.
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spelling doaj-art-a56048e481ed4b3fb0817cda8ce2ea822025-08-20T03:14:49ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172025-05-013417610.1183/16000617.0198-20240198-2024Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysisEnya Daynes0Ruth E. Barker1Amy V. Jones2Jessica A. Walsh3Claire M. Nolan4William D-C. Man5Sally J. Singh6Neil J. Greening7Linzy Houchen-Wolloff8Rachael A. Evans9 Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre–Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK Harefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St Thomas’ NHS Foundation Trust, London, UK Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre–Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK Harefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St Thomas’ NHS Foundation Trust, London, UK Harefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St Thomas’ NHS Foundation Trust, London, UK Harefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St Thomas’ NHS Foundation Trust, London, UK Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre–Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre–Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre–Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre–Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK Importance The minimum important difference (MID) for field walking tests aims to improve interpretation of outcomes, but the volume and heterogeneity of MIDs for these tests is challenging. We aimed to determine the MID for the 6-min walk distance (6MWD), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with long-term conditions. Methods This systematic review included studies that generated a MID using an anchor-based approach in patients with long-term conditions for the 6MWD, ISWT or ESWT field walking tests. Studies were screened and data extracted by independent reviewers. Meta-analyses were performed using RevMan. Results 42 studies were included in the analyses, involving n=13 949 participants. Of these, 12 studies involving exercise as an intervention were included in the meta-analyses to produce MIDs, presented as mean (95% confidence interval). The MID for the 6MWD was 25 m (24–26 m) for respiratory conditions, 23 m (8–37 m) for cardiac conditions and 37 m (26–49 m) for neurological/musculoskeletal conditions. The MID for the ISWT was 48 m (39–57 m) for respiratory conditions and 70 m (55–85 m) for cardiac conditions. The MID for ESWT in COPD was 159 s (94–224 s). The pooled MID across conditions within exercise interventions was 26 m (22–40 m) for the 6MWD and 53 m (44–62 m) for the ISWT, with reasonable heterogeneity (I2=48% and I2=47%, respectively). Conclusion We propose new MIDs for exercise interventions using anchor-based methodology in long‑term conditions for the 6MWD, ISWT and ESWT. These can be used internationally for meta‑analyses where studies have used different field walking tests, to optimise trial sample size calculations, and for clinical service benchmarking.http://err.ersjournals.com/content/34/176/240198.full
spellingShingle Enya Daynes
Ruth E. Barker
Amy V. Jones
Jessica A. Walsh
Claire M. Nolan
William D-C. Man
Sally J. Singh
Neil J. Greening
Linzy Houchen-Wolloff
Rachael A. Evans
Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis
European Respiratory Review
title Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis
title_full Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis
title_fullStr Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis
title_full_unstemmed Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis
title_short Determining the minimum important differences for field walking tests in adults with long–term conditions: a systematic review and meta-analysis
title_sort determining the minimum important differences for field walking tests in adults with long term conditions a systematic review and meta analysis
url http://err.ersjournals.com/content/34/176/240198.full
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