Smartphone-based physical fitness test comparable to standardized clinic test

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The study was partially funded by a PhD grant from the Special Research Fund of Hasselt University. The authors report no relevant financial disclosures.

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A smartphone-based free walk in the park 6-minute walking test showed results similar to standardized tests performed in a clinic, researchers reported in the European Journal of Preventive Cardiology.

“This is the first trial showing that a free walk in the park 6-minute walking test is comparable with a traditional 6-minute walking test in predicting peak oxygen consumption in cardiac rehabilitation patients,” Martijn Scherrenberg, MD, a PhD candidate of digital health in cardiology at Jessa Hospital in Hasselt, Belgium, and colleagues wrote. “Based on present results, a free walk in the park 6-minute walking test is a valid alternative for a traditional 6-minute walking test. Therefore, free walk in the park 6-minute walking test allows an easy determination and follow-up of submaximal exercise capacity. This could be used in a cardiac telerehabilitation programs to monitor and motivate participants.”

Using a previous study’s finding that the best algorithm in terms of accuracy and reliability is based on the Google Fit step count paired with a smartphone attached to the participant’s arm, Scherrenberg and colleagues performed a subanalysis based on this result.

Researchers conducted a cardiopulmonary exercise test (CPET), and from that, 76 participants were selected to carry out two more physical fitness tests to assess a tool to test their submaximal exercise capacity by themselves.

The first one involved a 6-minute walking test (6MWT) on a flat, straight and fixed 30-m path in a park. The second one was a free walk in the park 6-minute walking test (FWP-6MWT) in which there was no path for participants to follow. In both tests, a researcher and a smartphone worn by the participant measured their distance walked.

The association between the FWP-6MWT and peak oxygen consumption (VO₂) was the primary outcome.

Researchers found FWP-6MWT distance was moderately associated with peak VO₂ (r = 0.558; P < .001), VO₂ at ventilatory threshold 2 (r = 0.55; P < .001) and peak power (r = 0.596; P < .001).

Variance in VO₂ max was observed in multiple linear regression analysis, but the free walk smartphone-registered 6MWT distance, gender, diagnosis of diabetes and HDL level may clarify 58.1% of the variance in VO₂ max found.

The findings from this smartphone-based FWP-6MWT shows a “comparable direct correlation with CPET results,” which take place in cardiac rehabilitation programs and measure maximal exercise capacity, the researchers wrote.

“This study demonstrates that reliable and valid technology is now also available to allow patients to perform standardized tests for physical fitness themselves in a non-standardized home-based setting,” Scherrenberg and colleagues wrote. “Free-walking 6MWTs could be part of a future in which patients start a cardiac rehabilitation program in a hospital-based setting, transition to a hybrid home-based and hospital-based cardiac rehabilitation program, and then transition to a full, long-term telerehabilitation program in which little intervention by caregivers is needed. In such a manner, the right technology together with adequate patient empowerment can lead to cost-effective, high-quality, home-based care.”