Research Article| Volume 58, P28-33, March 2023

Is the six-minute step test able to reflect the severity and symptoms based on cat score?

Published:November 10, 2022DOI:


      • This is the first study to investigate the performance of the 6MST in COPD patients separated into different symptomatology groups based on the CAT questionnaire score.
      • Our study highlights the importance of the 6SMT associated with the CAT score, through the highlighted cut- off points (CAT 10 - 20), an important easy-to-apply tool that can be used in all cardiorespiratory rehabilitation environments and also help health professionals.
      • The 6MST can be useful to objectively assess the capability of new interventions (pharmacological and nonpharmacological) and assist in targeting specific assessments and optimal treatment during clinical practice by healthcare professionals.



      This is the first study to investigate the performance of 6MST in COPD patients divided into different symptom severity groups based on the CAT questionnaire score.


      To evaluate the relationship between the degree symptomatology using the chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) with the six- minute step test (6MST) in COPD patients. METHODS: This is a cross-sectional study in which 59 patients with COPD were evaluated. The groups were stratified according to the subsequent cutoff points: CAT <10 (little impact) n= 22; CAT 11-20 (moderate impact) n=20; CAT <20 (large impact) n=17. During 6MST the individuals were instructed to go up and down a single step with a height of 20 centimeters (cm).


      Comparing the groups in relation to performance on the 6MST, the number of climbs on the step were significantly higher in the CAT group <10 when compared to the CAT group >20, the variation in HR between rest and peak exercise (∆ HRpeak- rest) was lower in the CAT>20 group compared to the CAT<10 group and the CAT 11- 20 group. We found direct relationships between the number of ascents and descents in the 6MST vs the CAT score (r=0.35, p=0.007); and 6MST vs degree of obstruction of %FEV1 (r-0.46, p=0.002) We verified a linear regression model in which the FEV1 (L) and the CAT score influenced 29% in the performance of the 6MST.


      The COPD severity represented by the FEV1 and the CAT score are associated and influenced by 29% the performance of 6-minute step test. Our findings may have important implications for the clinical evaluation of these patients as well as for rehabilitation.


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