• Merel-Anne Brehm, Suzan Verduijn, Jurgen Bon, Nicoline Bredt, and Frans Nollet.
• Department of Rehabilitation , Academic Medical Center, University of Amsterdam, PO 22660, 1100 DD Amsterdam, The Netherlands. m.a.brehm@amc.uva.nl.
• J Rehabil Med. 2017 Nov 21; 49 (9): 732-737.

ObjectiveTo compare walking dynamics and test-retest reliability for 2 frequently applied walk tests in polio survivors: the 6-minute walk test (6MWT) to walk as far as possible; and the 6-minute walking energy cost test (WECT) at comfortable speed.DesignObservational study.ParticipantsThirty-three polio survivors, able to walk ≥ 150 m.MethodsOn the same day participants performed a 6MWT and a WECT, which were repeated 1-3 weeks later. For each test, distance walked, heart rate and reduction in speed were assessed.ResultsThe mean distance walked and mean heart rate were significantly higher in the 6MWT (441 m (standard deviation) (SD 79.7); 118 bpm (SD 19.2)) compared with the WECT (366 m (SD 67.3); 103 bpm (SD 14.3)); p< 0.001. Furthermore, during the 6MWT, patients continuously slowed down (-6%), while during the WECT speed dropped only slightly during the first 2 min, by -1.8% in total. Test-retest reliability of both tests was excellent (intraclass correlation coefficient (ICC) ≥ 0.95; lower bound 95% confidence interval (95% CI) ≥ 0.87). The smallest detectable change for the walked distance was 42 m (9.7% change from the mean) and 50 m (13.7%) on the 6MWT and WECT, respectively.ConclusionBoth the 6MWT and the WECT are reliable to assess walking capacity in polio survivors, with slightly superior sensitivity to detect change for the 6MWT. Differences in walking dynamics confirm that the tests cannot be used interchangeably. The 6MWT is recommended for measuring maximal walking capacity and the WECT for measuring submaximal walking capacity.

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