Accuracy and Usability of a Self-Administered 6-Minute Walk Test Smartphone Application.

The 6-minute walk test (6MWT) independently predicts congestive heart failure severity, death, and heart failure hospitalizations, but must be administered in clinic by qualified staff on a premeasured course. As part of the Health eHeart Study, an app was developed to validate a self-administered 6MWT mobile application (SA-6MWTapp) for independent use at home by patients. A validation study of an SA-6MWTapp in 103 participants. In phase 1 (n=52), an distance-estimation algorithm for the SA-6MWTapp was developed by comparing step counts from an Actigraph and measured distance on a premeasured 6MWT course with step counts and estimated distance obtained simultaneously from the SA-6MWTapp (best estimation algorithm, r=0.89 [95% confidence interval 0.78-0.99]). In phase 2, 32 participants (including those with congestive heart failure and pulmonary hypertension) used the SA-6MWTapp independently in clinic, and the distance estimated by the SA-6MWTapp was compared with the measured distance (r=0.83 [95% confidence interval 0.79-0.92]). In phase 3, 19 patients with congestive heart failure and pulmonary hypertension consecutively enrolled from clinic performed 3.2±1 SA-6MWTapp tests per week at home over 2 weeks. Distances estimated from the SA-6MWTapp during home 6MWTs were highly repeatable (coefficient of variation =4.6%) and correlated with in-clinic-measured distance (r=0.88 [95% confidence interval 0.87-0.89]). Usability surveys performed during the second (in-clinic) and third (at-home) phases demonstrated that the SA-6MWTapp was simple and easy to use independently.

An SA-6MWTapp is easy to use and yields accurate repeatable measurements in the clinic and at home.

Shoulder Assessment

Review shoulder examination with this online course that covers orthopaedic special tests, the types and implications of shoulder pain and relevant outcome measures and diagnostic imaging.