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· DOS Abstracts
Inter-rater reliability and agreement of the 6-minute
walk test in females with hip fractures
Jan Arnholtz Overgaard, Camilla Marie Larsen, Morten Tange Kristensen
Department of Rehabilitation and Physical Medicine and Rehabilitation
Research - Copenhagen (PMR-C), Municipality of Lolland; Research Unit of
Musculoskeletal Function and Physiotherapy, Institute of Sports Science and
Clinical Biomechanics, University of Southern Denmark; Physical Medicine
and Rehabilitation Research - Copenhagen (PMR-C), Departments of
Physiotherapy and, Hvidovre University Hospital
Background:
The 6-minute walk test (6MWT) is widely used as a clinical out-
come measure. However, the reliability and agreement of the 6MWT is unknown
in individuals with hip fractures.
Purpose / Aim of Study:
To evaluate the relative inter-rater reliability and
agreement of the 6MWT in individuals with hip fractures.
Materials and Methods:
Two senior physiotherapy students independently
examined (randomized order) a convenient sample of 20 participants; their as-
sessments were separated by two days, and testing followed instructions from
the American Thoracic Society. Hip pain was assessed with the Verbal Ranking
Scale.
Findings / Results:
Participants (all women) with a mean (SD) age of 78.1 ±
5.9 years performed the test within a mean of 31.5 ± 5.8 days post-surgery;
10 had a cervical and 10 a trochanteric fracture. Excellent inter-rater reliabil-
ity; ICC2.1 = 0.92 (95% CI, 0.81 - 0.97) was found, and the standard error of
measurement (SEM) and smallest real difference (SRD) were calculated as 21.4
meters and 59.4 meters, respectively. Bland-Altman plots revealed no signifi-
cant difference (mean of 3.2 ± 31.5 meters, P = 0.83) between the two raters,
and no heteroscedasticity was seen (r = -0.196, P = 0.41). On the contrary,
participants walked a mean of 21.7 ± 22.6 meters longer, at the second trial
(P = 0.002). Participants with moderate hip fracture- related pain walked a
shorter distance than those with no or light pain during the first test (P = 0.04),
while this was not the case during the second (P = 0.25).
Conclusions:
Excellent inter-rater reliability was found with a low level of mea-
surement error, particularly for a group of participants with hip fractures, as a
change of 22 meters can be considered a real change. The importance of mea-
suring hip fracture-related pain during testing seems important when individu-
als with hip fracture perform the 6MWT.
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