Last Updated on November 1, 2025 10:17 pm by INDIAN AWAAZ
Dr Surya Kant,
The 6-minute walk test (6MWT) is safe for adults with severe asthma, according to a study published in the November 2025 issue of the journal Respiratory Medicine.1 However, they should receive a bronchodilator before undergoing the test and stop when peripheral oxygen desaturation (SpO2) is below 85%, the study further adds.
This study primarily examined the safety of 6MWT in 175 individuals with severe asthma vis-à-vis 64 people with non-severe asthma, 99 with chronic obstructive pulmonary disease (COPD), and 65 healthy non-smoking controls. Adverse events, limiting factors, and physiological responses during the 6MWT were compared. The study also sought to assess the outcomes of the 6MWT adults with severe asthma receiving monoclonal antibody (mAb) therapy and compare them with those not receiving mAb.
Individuals with a history of unstable angina/MI in the preceding month, resting systolic blood pressure >180 mmHg or diastolic >100 mmHg, resting oxygen saturation <88 % on room air and Resting heart rate >125 beats per minute after 10 min rest were excluded from the study.
Participants with severe asthma were mostly women (65%) with a median age of 60 years [45–69] and BMI of 31 kg/m2. Those with respiratory diseases were administered a bronchodilator prior to the test.
No adverse events occurred during the 6MWT among persons with severe asthma, regardless of monoclonal antibody therapy. Resting during the 6MWT was comparable in those with severe asthma (10%) and non-severe asthma (9%). On the other hand, COPD patients were more likely to rest during the test (23%). Respiratory symptoms were the major reason for the participants to pause during the test (48%), followed by musculoskeletal discomfort (40%), leg fatigue (13%), technical problems (15%), cardiac concerns (4%), and miscellaneous reasons (4%). While leg fatigue among asthma patients was lower than in the COPD group, they reported greater musculoskeletal limitations compared with controls.
Patients with severe asthma experienced significantly more breathlessness during the test than individuals with non-severe asthma or healthy controls (p < 0.001). Fewer participants (3%) with severe asthma experienced a drop in SpO₂ to below 85% compared with those with COPD (14%) (p < 0.05). The 6MWD was comparable between severe asthma participants receiving mAb therapy and those who were not (p = 0.13). Those on mAb treatment did not report respiratory limitations during the test.
While this study demonstrates the safety of the 6MWT in patients with severe asthma, it also highlights the need for a comprehensive, multidimensional evaluation of these patients. Musculoskeletal issues are prevalent in these patients, as also shown in the present study, which may have an impact on test performance.
Reference
1. Oliveira JM, et al. Safety of the 6-min walk test in adults with severe asthma. Respir Med. 2025 Nov;248:108316. doi: 10.1016/j.rmed.2025.108316.
Dr Surya Kant is Professor and Head, Dept. of Respiratory Medicine, KGMU, UP, Lucknow. National Vice Chairman IMA-AMS