Improvements in Six-Minute Walk Distance and Functional Status following Phase II Cardiac Rehabilitation

Abstract

Objectives: To evaluate changes in 6-minute walk distance (6MWD) and New York Heart Association (NYHA) functional class (FC) among patients participating in an outpatient phase II cardiac rehabilitation (CR) program Study design: Retrospective analytic study Setting: Maharat Nakhon Ratchasima Hospital, a tertiary care hospital in Thailand Participants: A total of 112 patients enrolled in the CR program between January 2022 and September 2024 and who had at least two 6MWD results available were included. Patients with incomplete data were excluded. Methods: Demographics and clinical data were collected from the medical records of the patients. The 6MWD and the FC were assessed before and after CR program. The program also included exercise prescription, lifestyle and risk-factor modification. Results: 97 patients (86.6%) had coronary artery disease, and 14 (12.5%) had congestive heart failure. Overall, 61.6% (95% CI: 52.4, 70.1) showed a ≥ 10% improvement in 6MWD from baseline. Prior to the outpatient phase II CR program, 18 patients were in FC I, 78 were in FC II, and 16 were in FC III. After the implementation of the CR program, 83 patients were classified as FC I, and none remained in FC III. In a modified Poisson regression analysis, intermediate-risk patients were 1.6 times more likely to improve than low-risk patients, while a baseline 6MWD < 300 m was independently associated with greater improvement (adjusted prevalence ratio, 1.7). Conclusions: Participation in a structured CR program was associated with significant improvements in 6MWD and FC, with 61.6% of patients achieving ≥ 10% improvement in 6MWD from baseline. Patients with lower baseline 6MWD (< 300 m) and moderate risk stratification appeared to derive greater improvements.