I am a physiotherapist in HK. I encounter a problem in using 6MWT for assessing exercise capacity of SARS patient but also with avascular necrosis (AVN). As the patient gradually develop AVN in hip and knee after SARS, the patient should be advised that they should not walk too fast in order to reduce the joint loading. However, in 6MWT, we instruct patient to walk as far as possible to exert themselves (according to ATS guideline). Does it contraindicate? Can we continue to use this test for this type of patient especially for the symptomless but diagnosis by MRI with AVN? Because if they have joint and bone pain, they will self limited by pain. But if they have no pain, they may walk as far as possible and cause risk to their AVN. Thank you for advice and comment.

-- So CW (so_cw@hotmail.com), November 28, 2003

Answers

For testing purposes, I am not aware of any studies indicating that this would speed up AVN in the hips/knees. I do not believe that the 6 min test would be contraindicated in the population stated.

-- Mesfin A. Lemma, M.D. (mlemma2@jhmi.edu), January 05, 2004.