Corrêa FCCR, Nader ISTP, Riolino MRS, Silva E. Intra-rater reliability of the 6-min walk test in people with liver cirrhosis. World J Hepatol 2025; 17(11): 110331 [DOI: 10.4254/wjh.v17.i11.110331]
Corresponding Author of This Article
Fabiana Coelho Couto Rocha Corrêa, PhD, Professor, Department of Physiotherapy, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora 36036-900, Minas Gerais, Brazil. fabianacoelhocrcorrea@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 27, 2025 (publication date) through Dec 4, 2025
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Journal Information of This Article
Publication Name
World Journal of Hepatology
ISSN
1948-5182
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Corrêa FCCR, Nader ISTP, Riolino MRS, Silva E. Intra-rater reliability of the 6-min walk test in people with liver cirrhosis. World J Hepatol 2025; 17(11): 110331 [DOI: 10.4254/wjh.v17.i11.110331]
Fabiana Coelho Couto Rocha Corrêa, Elirez Silva, Institute of Physical Education and Sports, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-900, Brazil
Fabiana Coelho Couto Rocha Corrêa, Isabella Scarlatelli Telles Pires Nader, Maria Rita Silva Riolino, Department of Physiotherapy, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora 36036-900, Minas Gerais, Brazil
Author contributions: Corrêa FCCR designed and conducted the study, wrote the paper, and conducted the analysis; Nader ISTP and Riolino MRS provided clinical advice; Silva E supervised the study; All authors read and approved the final manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (Approval No. 6.183.626).
Informed consent statement: All volunteers signed the informed consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data can be shared in the format as presented in the article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabiana Coelho Couto Rocha Corrêa, PhD, Professor, Department of Physiotherapy, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora 36036-900, Minas Gerais, Brazil. fabianacoelhocrcorrea@gmail.com
Received: June 6, 2025 Revised: August 11, 2025 Accepted: October 24, 2025 Published online: November 27, 2025 Processing time: 176 Days and 8 Hours
Abstract
BACKGROUND
Liver cirrhosis often leads to significant impairments in functional capacity, which are associated with disease severity and prognosis. Simple, reliable, and low-cost tests are essential to monitor these patients in clinical practice. The 6-min walk test (6MWT) is widely used in other chronic conditions, but its measurement properties in cirrhosis remain underexplored.
AIM
To assess the reliability of the 6MWT in patients with liver cirrhosis (LC).
METHODS
This cross-sectional study was conducted at a teaching hospital in Juiz de Fora-Minas Gerais. Patients diagnosed with LC at any stage of the disease and under clinical follow-up were included. Patients with grade 2 or higher encephalopathy, respiratory, and/or musculoskeletal diseases or who did not understand the test were excluded. Initially, anamnesis and anthropometric evaluation were performed, followed by the 6MWT. After 24 h the test was repeated. Descriptive statistics were used to present the data. Continuous variables were tested for normality using the Shapiro-Wilk test. The reliability of the 6MWT was tested through Bland-Altman analysis, typical error of measurement, and intraclass correlation coefficient (ICC) as well as a one-sample t-test. A paired Student’s t-test was used to check for differences between means, and Pearson’s correlation coefficient was used to verify the relationship between the two moments [first 6MWT (6MWT-1) and second 6MWT (6MWT-2)].
RESULTS
The mean difference between 6MWT-2 and 6MWT-1 was -18.9 m; the lower limit of the Bland-Altman agreement was -83.5 m, and the upper limit was 45.7 m. One participant was excluded from further analyses for being outside these limits. The typical error of measurement was 18.9 m. The ICC showed excellent reliability between the two tests (ICC = 0.97, 95% confidence internal: 0.90-0.99, P < 0.001). The Student’s one-sample t-value was -2.35 (P = 0.03). The paired t-value was 2.35 (P = 0.03). Pearson’s correlation coefficient between the 6MWT-1 and 6MWT-2 was r = 0.98 (P = 0.0001).
CONCLUSION
The 6MWT is a test with excellent reliability. It is safe, easy to administer, inexpensive, and can be introduced into routine practice without loss of diagnostic precision in estimating the functional capacity of patients with LC.
Core Tip: This study highlighted the clinical applicability of the 6-min walk test (6MWT) in individuals with liver cirrhosis. By evaluating its intra-rater reliability, the research demonstrated that the 6MWT is a safe, simple, and low-cost tool suitable for routine hepatology assessment. Its excellent reproducibility supports the use of the 6MWT to estimate functional capacity in patients with cirrhosis, facilitating objective monitoring and improving the understanding of disease-related physical limitations.
