Why the Six-Minute Walking Test Matters
THE SIX-MINUTE walking test offers an objective, low-cost assessment of postoperative recovery after pancreatic surgery. In a prospective cohort at 30 days, distance walked was significantly greater in five of six groups expected to recover better, supporting construct validity. The only hypothesis not confirmed was a higher distance in younger patients, which did not distinguish recovery. The six-minute walking test also demonstrated moderate positive correlations with the Duke Activity Status Index and the PROMIS-29 Physical Health Summary Score, indicating alignment with patient-reported function.
Study Design and Key Results
Following COSMIN guidance, investigators analyzed patients who completed the six-minute walking test before surgery and again at 30 days after resection. Recovery validity was tested across clinical strata: higher versus lower physical status, distal versus proximal pancreatectomy, laparoscopic versus open resection, shorter versus longer length of stay, and absence versus presence of severe complications. In these comparisons, the six-minute walking test differentiated recovery in most strata, reinforcing its role as a meaningful outcome. Correlations with the Duke Activity Status Index and PROMIS-29 Physical Health Summary Score were moderate, further substantiating that six-minute walking test performance reflects functional recovery as perceived by patients.
Clinical Implications for Practice and Research
For surgical teams and rehabilitation services, the six-minute walking test can standardize 30-day functional follow-up after pancreatectomy and help identify patients who may benefit from targeted physical therapy or enhanced recovery pathways. For researchers, the six-minute walking test provides a pragmatic outcome measure for trials evaluating perioperative interventions in pancreatic surgery, with evidence of construct validity and convergence with patient-reported outcomes. These findings support incorporating the six-minute walking test into postoperative assessment frameworks and study endpoints when measuring functional recovery after pancreatectomy.
Reference: Bonomi B et al. Validation of the six-minute walking test as a measure of postoperative recovery after pancreatic surgery. Updates Surg. 2025. doi: 10.1007/s13304-025-02437-1.
