JMIR Publications

ABSTRACT

Background:

The 6-minute walk test (6MWT) is a common method to assess the exercise capacity of people with many health conditions, including persistent pain. However, it is conventionally performed with in-person supervision in a hospital or clinic, therefore requiring staff resources. It may also be difficult when in-person supervision is unavailable, such as during the COVID-19 pandemic or when the person is geographically remote.

Objective:

This study aimed to assess the validity of a GPS-based smartphone app to measure walking distance as an alternative to the conventional 6MWT, in a persistent pain population.

Methods:

People with persistent pain (n=36) were recruited to complete: 1) a conventional 6MWT and 2) 6MWT measured by a smartphone app using the global positioning system (GPS). Tests were performed in random order, separated by a 15-minute rest. The 95% limits of agreement were calculated using the Bland-Altman method, with a specified maximum allowable difference of 100m.

Results:

The mean 6MWD measured by the GPS-based smartphone app was 13.2m higher (SD 46, 95%CI [−2.7, 29.1]) than the 6MWD assessed in the conventional manner. The 95% limits of agreement were 103.9m (95%CI [87.4, 134.1]) and −77.6m (95%CI [−107.7, −61.0]), which exceeded the maximum allowable difference.

Conclusions:

In individuals with persistent pain, the two methods of assessing 6MWT may not be interchangeable due to limited validity. Future research is needed to improve the accuracy of the GPS-based approach. Despite its limitations, the GPS-based 6MWT may still have value as a tool for remote monitoring that could allow individuals with persistent pain to self-administer frequent assessments of their functional capacity in their home environment.