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Clinical Usefulness of a Smartphone-Based 6-Minute Walk Test in a Hospital Outpatient Clinic Within the Constraints of the COVID-19 Pandemic: Mixed Methods Study
Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT). Malmö University, Sustainable Digitalisation Research Centre (SDRC).ORCID iD: 0000-0002-9203-1124
Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT). Malmö University, Sustainable Digitalisation Research Centre (SDRC).ORCID iD: 0000-0002-4261-281X
Cardiac Physiology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.ORCID iD: 0000-0001-8752-2140
Department of Cardiology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.ORCID iD: 0000-0003-3597-115X
2025 (English)In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 9, p. e70495-e70495, article id e70495Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The 6-minute walk test (6MWT) measures exercise capacity in cardiorespiratory, neurological, and musculoskeletal conditions. It consists of observing how far a patient can walk in 6 minutes and is usually performed in a corridor in a clinic. During the COVID-19 pandemic, as health care systems cancelled nonurgent outpatient appointments, many tests were conducted online. At Oxford University Hospitals National Health Service Foundation Trust, patients followed up on by cardiovascular outpatient clinics were asked to use the open-source Timed Walk app to perform the 6MWT in their community as a substitute for the regular tests in the clinic.

OBJECTIVE: This study aimed to assess the clinical usefulness of the app within the context of the pandemic.

METHODS: Consented patients were invited to perform a 6MWT outdoors using the app at least once a month and report the results through periodic telephone calls and visits. Clinical decisions made for the same cohort were registered, with a focus on the effect of the app in supporting decision-making. Data collected through the app during the study period were compared with 6MWTs performed in the prepandemic period.

RESULTS: This study was conducted between October 2021 and December 2022. A total of 55 participants consented (n=25, 45% female; mean age 44.80, SD 17.49 y). In total, 741 events were logged. A total of 51 medical decisions were made for 25 patients; in 41% (21/51) of the decisions, the app played a role, affecting 44% (11/25) of the patients. Between 2018 and 2022, a cohort of 49 patients for whom data were available performed 63 6MWTs in the clinic (18 in 2021), whereas the same patients performed 605 tests using the app in 2022 (ie, October 2021 to December 2022).

CONCLUSIONS: The use of the Timed Walk app for remote 6MWTs allowed clinicians to obtain frequent and objective indications of the status of the patients during the pandemic, compensating for the absence of regular clinic appointments and providing 33 times more tests than in the prepandemic period. These tests supported approximately half of the clinical decisions made regarding the consented patients, showing that the app is useful in clinical practice.

Place, publisher, year, edition, pages
JMIR Publications Inc. , 2025. Vol. 9, p. e70495-e70495, article id e70495
Keywords [en]
Humans, COVID-19 / epidemiology, Female, Male, Middle Aged, Smartphone, Walk Test / methods / statistics & numerical data, SARS-CoV-2, Adult, Mobile Applications, Aged, Outpatient Clinics, Hospital, Pandemics, 6-minute walk test, 6MWT, Timed Walk app, mixed methods, mobile health, physical capacity, technology acceptance, usability
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:mau:diva-80016DOI: 10.2196/70495ISI: 001639350600014PubMedID: 41071986Scopus ID: 2-s2.0-105018230927OAI: oai:DiVA.org:mau-80016DiVA, id: diva2:2006301
Available from: 2025-10-14 Created: 2025-10-14 Last updated: 2026-01-07Bibliographically approved

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Salvi, DarioOlsson, Carl Magnus

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