Interrater Reliability of the 6-Minute Walk Test in Women With Hip Fracture

Jan Arnholtz Overgaard, Camilla Marie Larsen, Steffen Holtze, Kenneth Ockholm, Morten Tange Kristensen

Research output: Contribution to journalJournal articleResearchpeer-review


Background and Purpose: The 6-minute walk test (6MWT) is widely used as a clinical outcome measure. However, the reliability of the 6MWT is unknown in individuals who have recently experienced a hip fracture. The aim of this study was to evaluate the relative and absolute interrater reliability of the 6MWT in individuals with hip fracture. Methods: Two senior physical therapy students independently examined a convenience sample of 20 participants in a randomized order. Their assessments were separated by 2 days and followed the guidelines of the American Thoracic Society. Hip fracture-related pain was assessed with the Verbal Ranking Scale. Results: Participants (all women) with a mean (standard deviation) age of 78.1 (5.9) years performed the test at a mean of 31.5 (5.8) days postsurgery. Of the participants, 10 had a cervical fracture and 10 had a trochanteric fracture. Excellent interrater reliability (intraclass correlation coefficient [ICC 2.1] = 0.92; 95% confidence interval, 0.81-0.97) was found, and the standard error of measurement and smallest real difference were calculated to be 21.4 and 59.4 m, respectively. Bland-Altman plots revealed no significant difference (mean of 3.2 [31.5] m, P =.83) between the 2 raters, and no heteroscedasticity was observed (r =-0.196, P =.41). By contrast, participants walked an average of 21.7 (22.5) m longer during the second trial (P =.002). Participants with moderate hip fracture-related pain walked a shorter distance than those with no or light pain during the first test (P =.04), but this was not the case during the second test (P =.25). Conclusion: The interrater reliability of the 6MWT is excellent, and changes of more than 21.4 m (group level) and 59.4 m (individual participants with hip fracture) indicate a real change in the 6MWT. Measuring hip fracture-related pain during testing is recommended for individuals with hip fracture who undergo the 6MWT.

Original languageEnglish
JournalJournal of Geriatric Physical Therapy
Issue number3
Pages (from-to)158–166
Publication statusPublished - 2017


  • 6-minute walk test
  • absolute reliability
  • hip fracture
  • interrater reliability
  • pain
  • Reproducibility of Results
  • Humans
  • Physical Therapy Modalities/standards
  • Walking
  • Exercise Test
  • Walk Test/standards
  • Aged, 80 and over
  • Female
  • Aged
  • Outcome Assessment, Health Care
  • Observer Variation
  • Hip Fractures/rehabilitation


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