Variability in performance of timed walk tests in pulmonary rehabilitation programs

Study objective: To describe variability in the conduct of walk tests in pulmonary rehabilitation programs. Design: Analysis of information obtained by means of a structured written questionnaire. Setting: Outpatient pulmonary rehabilitation programs in the United States and Canada. Participants: Clinical coordinators of 75 pulmonary rehabilitation programs. Interventions: None Results: Timed walk tests were obtained in 71 of 99 programs sun eyed. Considerable variability in all aspects of testing practices was evident. Fifty-seven respondents (80%) based results on a single walk. Walk tests were completed in a hallway (73%), on a walking track (9%), and on a treadmill (7%), In 29 programs (44%), a walk supervisor carried or pulled the oxygen source, while in 25 programs (38%), the oxygen was carried or pulled by the patient. Informal nonstandardized instructions were provided to patients prior to walking in 41 programs (58%), In 53 programs (76%), the walk supervisor could direct a patient to speed up, to slow down, or to rest. Evaluations of breathlessness and perceived exertion were measured during the walk by 73% and 16% of programs, respectively. Conclusions: Practices regarding performance of timed walk tests are poorly standardized among pulmonary rehabilitation programs. Further research is needed to evaluate the impact of certain variations in testing practices on test results.