The Effects of Guarding on the Outcomes of the Six Minute Walk Test

Introduction: The American Thoracic Society recommends not walking with the patient or client during the Six Minute Walk Test (6MWT). However, this recommendation raises safety concerns for individuals at increased risk of falls. Given the recommendations and concerns, the effects of guarding during the 6MWT has not been investigated. Purpose: The purpose of this study was to determine if guarding during the 6MWT affected gait speed and distance walked. Methods: Participants were randomized into a 'guarded first' vs 'guarded second' condition. Data were analyzed using a one-sample t-test, Pearson Correlation Coefficients, Intraclass Correlation Coefficients (ICC), and Bland Altman plots to assess differences and relationships for gait speed and distance walked between the guarded and unguarded trials.

Inclusion criteria

Young Group

• Between 18 and 50 years of age
• Independent with ambulation such that no physical assistance was required during the 6MWT
• No pertinent acute or chronic medical conditions.

Older adult group

• 50 years of age or older Ambulatory without requiring physical assistance Intact cognition as determined by achieving a score of 24 on the Mini Mental Status Exam
• Stable balance by scoring a minimum of 18cm (7 inches) on the Functional Reach Test

Exclusion criteria

• All Participants:
• Unstable angina
• History of myocardial infarction 30 days prior to the study
• Resting heart rate greater than 120 beats per minute
• Resting systolic blood pressure greater than 180 mmHg
• Resting diastolic blood pressure greater than 100 mmHg
• Symptoms were reported or observed that were consistent with low blood pressure
• Recent injury, surgery or medical procedure.
• Older Participants:
• Functional Reach Test (<18cm or 7 inches)
• Mini Mental Exam (score < 24).