Self-Administered Six-Minute Walk Test Using a Free Smartphone App in Asymptomatic Adults: Reliability and Reproducibility

Background: The 6-min walk test (6MWT) is a simple, inexpensive, reliable, and reproducible test that provides a reasonable estimate of the cardiorespiratory fitness (CRF). We aimed to assess the reliability and reproducibility of a self-administered 6MWT in asymptomatic adults using a free smartphone app. Methods: In the 1st phase, 93 participants underwent a supervised 6MWT (6MWTsup) in a 30 m indoor corridor, using a triaxial accelerometer and their smartphones to compare the total step counts and to develop a 6-min walk distance (6MWD) prediction equation. In the 2nd phase, 25 participants performed the 6MWTsup and two self-administered 6MWTs outdoors (6MWTsa1 and 6MWTsa2, at least 48 h apart) using a free smartphone app. Results: The agreement between accelerometer- and app-based total step counts was limited (mean difference, -58.7 steps (-8.7%): 95% confidence interval, -326.5 (-46.8%) to 209.1 (29.3%)). The best algorithm for predicting the 6MWTsup(m) included: 795.456 + (0.815 height(m) app-steps) - (1.620 age(years)) - (3.005 weight(kg)) - (1.155 app-steps), R-2 = 0.609). The intraclass correlation coefficient between 6MWTsa2 and 6MWTsa1 was excellent (0.91: 0.81-0.96). The coefficient of variation was 6.4%. The agreement between the two self-administered tests was narrow (-1.9 (0.2%) meters: -57.4 (-9.5%) to 61.3 (9.9%)). Conclusions: The self-administered 6MWT has excellent reliability and reproducibility in asymptomatic adults, being a valuable tool for assessing CRF in community-based interventions.