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 6 minute walk test?
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Bonnielu
Member

79 Posts

Posted - May 20 2011 :  12:19:55 PM  Show Profile  Reply with Quote
In preparation for rehab i had a 6 minute walk test...on a treadmill as, they do not have the walk area...and my first time ever on a treadmill...anyways..the 6 minute ended up being...5 minutes...after 3 minutes..i had to take a break..because of leg weakness...no really bad SOB...but the question is this...the therapists after the test said...everything was good...i asked how low had my ox gone. She said the lowest number was 95...and that it actually went up...I told her that I noticed that also...(when I was at home...with my oximeter...)I asked her why would this be....she did not have a answer for me....do any of you guys ( sorry ladies) have any ideas?

Dave-OH
Administrator

USA
3380 Posts

Posted - May 20 2011 :  12:41:01 PM  Show Profile  Reply with Quote
Your ability to use O2 - defuse it - is not back. Your FEV1 and your fitness are the issues. When you are fit, you will be more able to do the 6 minutes. Your lungs are doing a decent job of transferring the O2 to the blood and moving CO2 out.

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Bonnielu
Member

79 Posts

Posted - May 20 2011 :  12:51:33 PM  Show Profile  Reply with Quote
quote:
Originally posted by Dave-OH

Your ability to use O2 - defuse it - is not back. Your FEV1 and your fitness are the issues. When you are fit, you will be more able to do the 6 minutes. Your lungs are doing a decent job of transferring the O2 to the blood and moving CO2 out.


so Dave ...does that mean that my sat should go down...during exercise or exertion...I am confused I guess...and thnx for answering so fast..
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CarolCA
Contributing Member

USA
3156 Posts

Posted - May 20 2011 :  2:59:29 PM  Show Profile  Reply with Quote
Your heart is pumping harder to keep you O2 up. If it stays up or gets higher you have nothing to worry about and your heart and lungs are still good. Also, you are breathing deeper than when you are just sitting. As COPD progresses the heart has a harder time keeping your sats up and that is when you need O2.
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Bonnielu
Member

79 Posts

Posted - May 20 2011 :  3:05:25 PM  Show Profile  Reply with Quote
thanks Carol
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thehappyman
Member

USA
159 Posts

Posted - May 25 2011 :  8:55:51 PM  Show Profile  Reply with Quote
I was diagnosed with Emphysema 11 years ago - Ive been getting a PFT every year and a lung x-ray every two. Is it a little strange that my PUL Doc has never requested a walking test like the one mentioned above ????
I suppose I could request one. How fast do they run the treadmill ????
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thehappyman
Member

USA
159 Posts

Posted - May 25 2011 :  8:56:59 PM  Show Profile  Reply with Quote
And why 6 minutes - Why not 5 or 10 ????????
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bluzman
Member

181 Posts

Posted - May 25 2011 :  10:21:31 PM  Show Profile  Reply with Quote
i don't know but it only took me 2 or 3 min to get seriously SOB....n one time i walked in place for about 1 1/2min to get my O2 down to 88......d'oh
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Dave-OH
Administrator

USA
3380 Posts

Posted - May 25 2011 :  11:43:57 PM  Show Profile  Reply with Quote
My doctors use both a 6 minute and 10 minute walk. I think they found that 6 minutes was an optimal length.

The American Thoracic Society has issued guidelines for the 6-minute walk test (6MWT). The 6MWT
is safer, easier to administer, better tolerated, and better reflects activities of daily living than other walk
tests (such as the shuttle walk test). The primary measurement is 6-min walk distance (6MWD), but
during the 6MWT data can also be collected about the patientís blood oxygen saturation and perception
of dyspnea during exertion.

Dave, Forum Administrator
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CarolCA
Contributing Member

USA
3156 Posts

Posted - May 26 2011 :  12:06:35 AM  Show Profile  Reply with Quote
I have never had a 6 minute walk. All the doctor had to see was what my sats were when I came into the office to prescribe O2.Prior to that I had an overnight and was using it just at night then last year I had a drop where I was having a hard time keeping my sats up doing very normal things so he prescribed it for walking and exertion. Now I am back to just needing it at night for some strange reason. Waiting for he allergy season to kick in to see if I will be back on it come July.
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jmrommes
Contributing Member

1204 Posts

Posted - May 26 2011 :  10:11:36 AM  Show Profile  Reply with Quote
The six minute walk test is a very specific test designed to determine how far a person with COPD can walk in six minutes. It's designed to be used to demonstrate that some intervention (PR, surgery, a drug, etc.) makes a difference in what the person with COPD can do as a result of the intervention. The American Thoracic Society has very specific protocols for this test. Here's the link if anyone's interested: http://www.thoracic.org/statements/resources/pfet/sixminute.pdf

That said, it appears that Medicare has tightened the requirements for determining the need for supplemental O2, and that they have co-opted what they think of as "the six minute walk" for that purpose. I remember eight years ago when I went on O2 for the first time, my doc simply walked me up and down the hall for about 30 seconds (that's how long it took my sats to plummet into the high 70's) and told me to stop at the Apria office before I went back to work. Before lunch was over, I had a concentrator in my office, one at home and lots of small tanks for in between.

Fast forward to a month and a half ago when I asked my doc for O2 for exercise. He couldn't do what was required; I had to go to the hospital, see an RT, who walked me up and down the hall until my sats got below 88 and then gave me a clunky old E tank and carrier to haul around while I finished the walk to show that O2 made a difference. She timed the whole thing and at six minutes I could quit. This was documented and I took the paperwork form back to my doc's office, who called Lincare and we were in business. Sure was easier the old way!

My guess is that when you have to be re-certified by Medicare to continue using O2, you'll go through much the same process. Maybe some PCP's will figure this out and still do in in their offices using your own O2 to re-certify.

Jean

Exercise not only lets me live, it enables me to have a life.
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CarolCA
Contributing Member

USA
3156 Posts

Posted - May 26 2011 :  1:35:42 PM  Show Profile  Reply with Quote
Much of it is going to depend on your doctor and how strict he is with adhering exactly to the Medicare rules. I was told by the O2 rep that it had to be done the way that Jean says hers was done but when I talked to my doctor and told him he didn't make me do that. He couldn't do what was required now in his office, he said, and getting an appointment at the hospital could have taken a very long time and I needed it then. He knew that my sats were below 88 because they were when I came in that day, it was a no brainer that they were going to be above that with O2. He is usually a stickler for rules but I guess there are sometimes he feels that just maybe common sense should prevail.
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bluzman
Member

181 Posts

Posted - May 26 2011 :  9:29:29 PM  Show Profile  Reply with Quote
just a few months ago to get portable O2 --i walked in place took about 1 1/2 min for O2 to go to 88 ----and i was good to go....

is there a big difference when using a conserver---?? are there pros and cons .....?
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CarolCA
Contributing Member

USA
3156 Posts

Posted - May 27 2011 :  1:30:59 PM  Show Profile  Reply with Quote
the main difference is that you are not getting O2 except when you breathe in and sometimes that is not enough for people and they have to use continuous.
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PennyPA
Contributing Member

USA
4632 Posts

Posted - May 27 2011 :  6:47:50 PM  Show Profile  Reply with Quote
The secondary difference is that a tank of O2 will last longer.

****************************************************************

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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Carolyn-Mi
Administrator

604 Posts

Posted - May 27 2011 :  8:34:47 PM  Show Profile  Reply with Quote
And may I add, that most conserving devices will switch to full time, not all but all that I have used in the past.

COPD Support
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PennyPA
Contributing Member

USA
4632 Posts

Posted - May 27 2011 :  10:46:45 PM  Show Profile  Reply with Quote
And I will add to that that they usually only go to 2/lpm on continuous. :-)

****************************************************************

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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Carolyn-Mi
Administrator

604 Posts

Posted - May 28 2011 :  07:00:54 AM  Show Profile  Reply with Quote

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Sam-Tx
Senior Member

523 Posts

Posted - May 28 2011 :  11:59:37 AM  Show Profile  Reply with Quote
Bonnielu, The few COPD rehab programs that I have seen use the 6 minute walk test, as Dave mentioned earlier, as a distance marker. At the designated end of your rehab program, they will want you to do another one in order to have a way of gauging how well their rehab program has done.
If you activily stay with their program for you, I bet you'll see a marked improvement by the end. Good luck!
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Bonnielu
Member

79 Posts

Posted - May 28 2011 :  12:21:11 PM  Show Profile  Reply with Quote
Thank You Sam-Tx...
I have started a rehab program...2 days a week!
quote:
Originally posted by Sam-Tx

Bonnielu, The few COPD rehab programs that I have seen use the 6 minute walk test, as Dave mentioned earlier, as a distance marker. At the designated end of your rehab program, they will want you to do another one in order to have a way of gauging how well their rehab program has done.
If you activily stay with their program for you, I bet you'll see a marked improvement by the end. Good luck!

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PennyPA
Contributing Member

USA
4632 Posts

Posted - May 28 2011 :  1:03:28 PM  Show Profile  Reply with Quote
2 days a week is better than nothing but to get the most out of exercising, you should be going a minimum of 3 days and preferably 5. I know it's hard to find a good rehab program but if they can't accommodate you for 3 days, then see if you can find a local gym where you can exercise. How long are the sessions at rehab?

****************************************************************

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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Bonnielu
Member

79 Posts

Posted - May 28 2011 :  6:18:38 PM  Show Profile  Reply with Quote
Penny I have only had two sessions so far first one was 10 on bike.10 mon some other type of bike and 5 on the treadmill...Second was 10 on each again...but the treadmill the girl put a slight grade on it
and Penny my sats go up when I exercise...I was wondering if this is usual?
quote:
Originally posted by PennyPA

2 days a week is better than nothing but to get the most out of exercising, you should be going a minimum of 3 days and preferably 5. I know it's hard to find a good rehab program but if they can't accommodate you for 3 days, then see if you can find a local gym where you can exercise. How long are the sessions at rehab?

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CarolCA
Contributing Member

USA
3156 Posts

Posted - May 28 2011 :  8:50:39 PM  Show Profile  Reply with Quote
It is not unusual for sats to go up. You are breathing deeper and your heart is pumping harder and faster so that is all good. It is when your sats go down that you have to worry or stop. It may be that if you stayed on longer you might see them decrease some though.
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PennyPA
Contributing Member

USA
4632 Posts

Posted - May 28 2011 :  9:03:45 PM  Show Profile  Reply with Quote
Bonnielu, only a 25-minute session??? What arm exercises do they have you do? Maybe they will increase your time as they see if you can do it or not. You want to stay on the level on the TM until you can walk at a moderate speed for 30 minutes.

It is normal for your sats to go up when exercising because you're taking in deeper breaths (more O2) and exhaling harder.

Is this a pulmonary rehab or a cardiac rehab? When I went to my first one, it was really a cardiac rehab but they worked us pretty well. Of course, the one at Duke was GREAT!!! 3 hours a day of exercise, 5 days a week. Loved it.

Stick with it Bonnielu; hopefully they'll start the upper body exercises soon. If not, get yourself some 3 lb weights at Walmart and do them yourself. The upper body exercises help strengthen your breathing muscles.

****************************************************************

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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