6分間ステップ数試験（6MST）:COPDリハビリテーション前後評価：6分間歩行距離と同等評価可能、MID 20ステップ

６分間歩行距離試験（６MWD）に対して、 6-minute stepper test (6MST) は、耐忍性、再現性が良いという話

もともとの６MST:

Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients
https://www.dovepress.com/six-minute-stepper-test-a-valid-clinical-exercise-tolerance-test-for-c-peer-reviewed-fulltext-article-COPD

Six-minute stepper test

A step was defined as a single complete movement of raising one foot and putting it down. The stepper (Go Sport®, Grenoble, France)16 was placed on the ground facing a wall to allow patients to maintain their balance by placing their fingers on the wall. The step height was set at 20 cm. Before starting the test, patients got accustomed to the stepper for 2 minutes. The protocol included a 3-minute rest period and a 6-minute stepping period. Patients received standardized instructions adapted from the 6MWT ATS instructions,15 advising them to make the most number of steps they could in 6 minutes. The number of steps performed in 6 minutes was recorded. Monitoring of heart rate and SpO2 by a pulse oximeter (Oxymontre 3100; Nonin) was performed each minute. An investigator, a member of the paramedical team, remained behind the patient throughout the test.

パテント臭がする・・・標準化の折、機器限定して欲しくない




Responsiveness and Minimally Important Difference of the 6-Minute Stepper Test in Patients with Chronic Obstructive Pulmonary Disease
Respiration１Vol.　91:367-373 , 2016　(DOI:10.1159/000446517)
http://www.ncbi.nlm.nih.gov/pubmed/27216848

背景: COPD患者での、6-minute stepper test (6MST) のvalidityとreproducibilityは報告されている。
目的: 呼吸リハビリテーション＜pulmonary rehabilitation (PR) ＞の反応性評価するための、６MSTのminimal important difference (MID) を評価し、６MWTと比較

方法: ６２名のSCOPD患者、前向き研究。
３週間入院PRプログラム施行
プライマリアウトカムは、PR前後の６MST中のステップ数変化i
セカンダリアウトカムは、６MWDパルスオキシメトリー、心拍、呼吸困難、下肢不快症状をPR前後で比較。
MIDは anchor-based and distribution approachで評価


結果: PR後、６MST中ステップ数T (22.5 steps; 95% CI 13.8-31.3; p < 0.0001) 、６MWD (26.6 m; 95% CI 17.6-35.5; p < 0.0001）増加
6MST と 6MWTはそれぞれ10.1％、6.5％改善
6MST中のステップ数は6MWDとPR前後 (PR前：r = 0.72; p < 0.0001、PR後：r = 0.66; p < 0.0001).とも有意相関

MID 推定、約 20 ステップ

結論: COPD患者の呼吸リハビリテーション中の機能的改善効果評価のための6MST は、６MWTと同様の反応性判定を示すようだ
６MSTは低コスト評価で、スペースもいらない