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PubMed1999

Mobility-related function in older adults: assessment with a 6-minute walk test.

OBJECTIVE: To determine the usefulness of the 6-minute walk test as an integrated measure of mobility in older adults. DESIGN: Observational study. SETTING: Community centers and retirement homes in the Los Angeles area. PATIENTS: Eighty-six older adults without significant disease. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Assessments included the 6-minute walk, chair stands, standing balance, gait speed, body mass index, and self-reported physical functioning and general health perceptions. RESULTS: One-week test-retest reliability of the 6-minute walk was .95. As hypothesized, the 6-minute walk distance was significantly greater for active than for inactive older adults (p < .0001), moderately correlated with chair stands (r = .67), standing balance (r = .52), and gait speed (r = -.73). It had a low correlation with body mass index (r = -.07). The correlation of the 6-minute walk with self-reported physical functioning was .55, and its correlation with general health perceptions was .39. Self-report and performance measures explained 69% of the variance in 6-minute walk scores. CONCLUSIONS: The 6-minute walk test is reliable and is valid in relation to the performance and self-reported indicators of physical functioning tested in this study. It could serve as a useful integrated measure of mobility.

Activities of Daily Living↗

PubMed2003

Predictors of 6-minute walk test results in lean, obese and morbidly obese women.

The aim of this study was first, to assess the presence of medical conditions that might interfere with walking; second, to assess the differences in walking capacity, perceived exertion and physical complaints between lean, obese and morbidly obese women; and third, to identify anthropometric, physical fitness and physical activity variables that contribute to the variability in the distance achieved during a 6-minute walk test in lean and obese women. A total of 85 overweight and obese females (18-65 years, body mass index (BMI) > or = 27.5 kg m(-2)), 133 morbidly obese females (BMI > or = 35 kg m-2) and 82 age-matched sedentary lean female volunteers (BMI < or = 26 kg m(-2)) were recruited. Patients suffering from severe musculoskeletal and cardiopulmonary disease were excluded from the study. Prior to the test, conditions that might interfere with walking and hours of TV watching were asked for. Physical activity pattern was assessed using the Baecke questionnaire. Weight, height, body composition (bioelectrical impedance method), isokinetic concentric quadriceps strength (Cybex) and peak oxygen uptake (peakVO2_bicycle ergometer) were measured. A 6-minute walk test was performed and heart rate, walking distance, Borg rating scale of perceived exertion (RPE) and physical complaints at the end of the test were recorded. In obese and particularly in morbidly obese women suffering from skin friction, urinary stress incontinence, varicose veins, foot static problems and pain, wearing insoles, suffering from knee pain, low back pain or hip arthritis were significantly more prevalent than in lean women (P < 0.05). Morbidly obese women (BMI > 35 kg m(-2)N = 133) walked significantly slower (5.4 km h(-1)) than obese (5.9 km h(-1)) and lean women (7.2 km h(-1), P < 0.05), were more exerted (RPE 13.3, 12.8 and 12.4, respectively, P < 0.05) and complained more frequently of dyspnea (9.1%, 4.7% and 0% resp., P < 0.05) and musculoskeletal pain (34.9%, 17.7% and 11.4% resp., P < 0.05) at the end of the walk. In a multiple regression analysis, 75% of the variance in walking distance could be explained by BMI, peakVO2, quadriceps muscle strength age, and hours TV watching or sports participation. These data suggest that in contrast with lean women, walking ability of obese women is hampered not only by overweight, reduced aerobic capacity and a sedentary life style, but also by perceived discomfort and pain. Advice or programs aimed at increasing walking for exercise also need to address the conditions that interfere with walking, as well as perceived symptoms and walking difficulties in order to improve participation and compliance.

Adolescent↗

PubMed2005

Encouraged 6-min walking test indicates maximum sustainable exercise in COPD patients.

STUDY OBJECTIVES: In patients with moderate-to-severe COPD, an encouraged 6-min walking test (6MWT) is a high-intensity submaximal exercise protocol that shows an oxygen uptake (Vo(2)) plateau after the third minute of the test. This last feature prompted the hypothesis that self-paced walking speed is set to achieve "maximal" sustainable Vo(2), namely "critical power" or "critical speed." PATIENTS AND METHODS: Eight patients with moderate-to-severe COPD (mean age, 68 +/- 7 years [+/- SD]; FEV(1), 50 +/- 13% predicted; Pao(2), 69 +/- 8 mm Hg) underwent the following tests on different days in order: (1) encouraged 6MWT; (2) standard incremental shuttle test to identify peak walking speed; (3) four different high-intensity, constant walking speed tests to exhaustion to calculate critical walking speed; and (4) timed walking test at critical walking speed (CWS) to examine sustainability of the exercise. RESULTS: 6MWT and CWS showed similar results (mean of last 3 min): Vo(2) (1,605 +/- 304 mL/min vs 1,584 +/- 319 mL/min), minute ventilation (47 +/- 12 L/min vs 48 +/- 11 L/min), respiratory exchange ratio (0.89 +/- 0.1 vs 0.90 +/- 0.1), heart rate (130 +/- 18 beats/min vs 131 +/- 16 beats/min), Borg dyspnea score (5.4 +/- 1.3 vs 5.5 +/- 2.4), and walking speed (1.49 +/- 0.1 m/s vs 1.44 +/- 0.1 m/s, respectively). CONCLUSION: This study supports that 6MWT indicates maximum sustainable exercise that might be related with its predictive value in COPD patients.

Aged↗

PubMed2003

Reliability, repeatability and sensitivity to change of externally and self-paced walking tests in COPD patients.

In COPD, several walking tests have been proposed to measure exercise tolerance but their relative merits are uncertain. We studied 57 moderate-to-severe, stable COPD patients (mean FEV1 35 +/- 12% predicted). Within a 2-month period, we compared reliability (inter-subject variability) and repeatability (intra-subject variability) of the most widely used 6-min walks (6MWD), with self-paced 2-min walks (2MWD) and externally paced, incremental shuttles (Shuttle). On 9 separate days either of the three 6MWD, 2MWD or Shuttles were performed (nine walks of each type). Then, each walk was performed before and after bronchodilators (BD) to assess sensitivity to change (mean change/standard deviation of change (sensitivity index--SI)). For all exercise tests, reliability was >90% (2MWD 95%, 6MWD 92% and Shuttle 91%). Repeatability was excellent (overall <10% intra-subject variation; for 2MWD 5%, 6MWD 8% and Shuttle 9%). On average, the first walking distance was significantly shorter, but there were no significant differences between second and third walks. Dyspnoea scores were much less reproducible. BD produced highly significant improvements in Shuttle (pre-BD 27 SD=11 --> post-BD 30 SD=11), 6MWD (424 m SD=115 --> 462 m SD=106) and 2MWD (153 m SD=35 --> 162 m SD=34), (P < 0.0001). SI was similar for all walks (6MWD 0.84, 2MWD 0.75 and Shuttle 0.76). In moderate-to-severe COPD, 2MWDs are as informative as 6MWDs without their disadvantages. Self-paced walks are as useful as externally paced Shuttles.

Aged↗

PubMed2007

Six-minute walk test for the evaluation of pulmonary disease severity in scleroderma patients.

BACKGROUND: Pulmonary involvement is the leading cause of systemic sclerosis (SSc)-related deaths. A simple test to evaluate exercise capacity is the 6-min walk test (6MWT), and the walk distance is used as a primary outcome in clinical trials. Hemoglobin desaturation during a 6MWT is predictive of mortality in patients with primary pulmonary hypertension. Our objectives were to evaluate the walk distance and resting oxygen saturation - oxygen saturation after the 6-min period (DeltaSat) during the 6MWT in patients with SSc, and to establish correlations between the 6MWT results and other clinical variables. METHODS: We analyzed 110 SSc patients. DeltaSat was defined as a fall of end-of-test saturation >or= 4%. Clinical and demographic data were collected. All the patients were submitted to chest radiographs and high-resolution CT (HRCT) and underwent pulmonary function testing and echocardiography, and the presence of autoantibodies was determined. RESULTS: The variables associated with a walk distance < 400 m (p < 0.05) were age, dyspnea index, fibrosis on radiography, pulmonary arterial systolic pressure (PASP) >or= 30 mm Hg, and desaturation. The variables associated with DeltaSat (p < 0.05) were age, positive anti-Scl-70 autoantibody, dyspnea index, fibrosis on radiography, FVC < 80% of predicted, PASP >or= 30 mm Hg, and ground-glass or reticular opacities on HRCT. In the multivariate logistic regression analysis, three variables were significant when tested with walk distance: age, race, and dyspnea index; four variables were significant when tested with DeltaSat: age, dyspnea index, positive anti-Scl-70 autoantibody, and FVC < 80% of predicted. CONCLUSIONS: Desaturation during a 6MWT provides additional information regarding severity of disease in scleroderma patients with pulmonary manifestations.

Adult↗

PubMed2005

Predicting peak oxygen uptake from 6-min walk test performance in male patients with left ventricular systolic dysfunction.

BACKGROUND: In patients with left ventricular systolic dysfunction (LVSD), peak oxygen uptake (pVO2) has strong predictive power for mortality, and can be used to guide management. However, many patients cannot tolerate standard test protocols. The 6-min walk test (6-MWT) is often used to estimate functional capacity due to its simplicity, cost effectiveness and familiarity to patients with LVSD. The relationship between 6-MWT performance and pVO2 is not certain, but if closely related could allow substitution of an expensive and cumbersome test for a cheaper and more familiar one. METHODS AND RESULTS: 120 male patients with LVSD (LVEF <40%; (mean+/-S.D.) age 68+/-13 years; BMI 28+/-5) performed, in random order, a maximal incremental treadmill exercise test with metabolic gas exchange measurements to derive peak oxygen consumption (pVO2 = 19.8+/-5.8 mL.kg(-1).min(-1)), and a standardised 6-MWT (308+/-142 m; r = 0.44; P = 0.00001). In multivariate models including demographic data, resting blood pressure and heart rate, spirometry, routine blood samples, and walk distance, five variables were independently predictive of peak oxygen consumption. pVO2 = 11.92 + (1.48 x FEV1 (L)) + (1.12 x haemoglobin (g dl(-1))) + (0.016 x distance walked (m)) - (0.33 x BMI) - (0.11 x age (years)). This equation accounted for 48% of the variation in pVO2. CONCLUSIONS: Using these five simple variables, peak oxygen consumption can be estimated with moderate accuracy. In clinical practice, however, when an estimate of peak oxygen consumption is required, incremental exercise testing with metabolic gas exchange measurements cannot be avoided in male patients with LVSD. Further work is needed to assess the relation between estimated pVO2 and outcome.

Adult↗

PubMed1999

Quantitative assessment of cervical spondylotic myelopathy by a simple walking test.

BACKGROUND: We developed a 30 m walking test as a quantifiable measure of severity of cervical spondylotic myelopathy (CSM), which will be of use in determining the effects of decompressive surgical treatment. METHODS: Preoperative measurements were made in 41 patients with CSM of 30 m walking times, number of steps taken over this distance, myelopathy disability index (MDI), and Nurick scores. The walking factors were compared with a similar number of age-matched and sex-matched controls. The individuals in the study were patients with CSM and no other relevant pathology consecutively referred for decompressive surgery to the National Hospital for Neurology and Neurosurgery. FINDINGS: Both walking time and the number of steps taken were significantly worse in pre-operative patients than in controls. The walking data were highly reproducible over three trials. Postoperatively, there was a significant improvement in walking time (p=0.0018) and number of steps taken (p=5.87 x 10(-6)). Only two of 41 patients were worse postoperatively. There was also a significant improvement in MDI (two-tailed Wilcoxon, related samples; p<0.0001) and Nurick scores (two-tailed Wilcoxon p<0.0001) postoperatively. The preoperative and postoperative walking scores were significantly and equally correlated with the MDI and Nurick scores. INTERPRETATION: Timed walks are an easily performed, quantitative, and valid means of assessing CSM and the effects of surgery.

Adult↗

PubMedDate not supplied

Using a 6-minute walk test to predict outcomes in patients with left ventricular dysfunction.

Maximal oxygen consumption (VO2MAX) is an independent variable that predicts outcomes in patients suffering from left ventricular dysfunction (LVD). Determining VO2MAX in a rehabilitation setting is not only costly and time-consuming but it would also be beyond many patients' physical abilities. This study's goal was to show that a simpler and less costly 6-minute walk test can predict mortality in patients with LVD. Sixty-six Phase 1 cardiac rehabilitation patients with LVD performed the 6-minute walk test upon admission and at discharge from a rehabilitation hospital. Upon discharge, the group that was able to walk significantly longer distances upon discharge had a higher survival rate 3 months after discharge. The 6-minute walk test can predict longer survival in patients with LVD and can provide valuable information for determining treatment plans, future prognosis, and home disposition of deconditioned LVD patients in a rehabilitation setting.

Aged↗

PubMed2005

Physiological response to the six-minute walk test in pulmonary arterial hypertension.

The 6-min walk test (6MWT) is commonly used to evaluate exercise capacity in patients with pulmonary arterial hypertension (PAH). However, little is known about the corresponding metabolic stress as measured by cardiopulmonary exercise testing. The present study, therefore, measured ventilatory variables and heart rate during the 6MWT and symptom-limited incremental maximal exercise testing in 20 patients with PAH. The distance walked in 6 min was 450+/-22 m (mean+/-se). During the 6MWT, ventilation, O2 consumption, CO2 production and heart rate increased during the first 3-4 min, and then remained stable. As compared with the maximum values measured during the cardiopulmonary exercise test, O2 consumption tended to be higher (14.2+/-0.6 versus 12.9+/-0.7 mL.kg-1.min-1), while maximum ventilation (46+/-3 versus 57+/-4 L.min-1), respiratory quotient (0.90+/-0.02 versus 1.15+/-0.02) and heart rate (119+/-4 versus 135+/-4 beats.min-1) remained lower. In conclusion, patients with pulmonary arterial hypertension exercise at higher aerobic capacity and lower metabolic stress during the 6MWT than during a cardiopulmonary exercise test.

Exercise Test↗

PubMed1997

The six-minute walk test: a guide to assessment for lung transplantation.

BACKGROUND: A window of opportunity exists with regard to optimal timing for lung transplantation. Performance of a transplantation too early may rob the patient of months to years of survival, whereas waiting too long increases the risk of death before transplantation. Several studies have examined specific lung function tests as predictors of death, but none have been shown to be useful across the various disorders leading to end-stage lung disease. We therefore sought to examine the usefulness of the 6-minute walk test as a guide to assessment for transplantation. METHODS: We conducted a retrospective chart review of patients who were assessed and either were accepted or died waiting acceptance by the Toronto Lung Transplant Program between January 1991 and June 1995. One hundred forty-five patients with the following lung diseases were included: emphysema (n = 38), alpha-1-antitrypsin deficiency (n = 20), idiopathic pulmonary fibrosis (n = 26), primary pulmonary hypertension (n = 10), Eisenmenger's syndrome (n = 9), and cystic fibrosis (n = 41). The sensitivity, specificity, and positive and negative predicted values for a 6-minute walk distance of 300 and 400 m as a predictor of death were calculated. RESULTS: Mortality rates were as follows: emphysema (7.9%), alpha-1-antitrypsin deficiency (15%), idiopathic pulmonary fibrosis (42.3%), primary pulmonary hypertension (50%), Eisenmenger's syndrome (11%), and cystic fibrosis (24.4%). A 6-minute walk distance of less than 400 m had the following characteristics for prediction of death: sensitivity 0.80, specificity 0.27, positive predictive value 0.27, and negative predictive value 0.91. Similar findings for a 6-minute walk distance of less than 300 m were as follows: 0.52, 0.80, 0.38, and 0.88, respectively. CONCLUSION: The 6-minute walk test is a useful tool in the assessment of when to list patients for transplantation. A 6-minute walk test result of less than 400 meters appears to be a reasonable marker with regard to when a patient should be listed for transplantation.

Adult↗

PubMed2001

Relationship between muscle strength and the time taken to complete a standardized walk-turn-walk test.

We examined the effects of age and gender on the relationship between knee strength and walking time during a walk-turn-walk test in 176 male and 168 female generally healthy participants of the Baltimore Longitudinal Study of Aging who were aged 21-89 years. Subjects were timed as they walked 50 ft (15.24 m), turned around, and walked back to the starting point, both at a comfortable pace and as fast as possible. Isokinetic concentric knee extensor strength was measured at 30 degrees /s by using a Kin-Com dynamometer. Both comfortable and fast gait times increased with increasing age for both women and men, starting in middle age. An interaction was found between gender and age showing that older women are slower than older men at both paces. Gait time decreased linearly with increasing knee extensor strength, plateauing at higher strength levels (>130 N m for comfortable gait, and 190 N m for fast gait). Most women occupied the linear part of the curve below the plateau. Adjustment for body size, age, physical activity, and particularly number of steps to complete the task removed the relationship between strength and gait time for the comfortable gait. Women took longer to complete the walk-turn-walk test than men at older ages, were on the linear part of the strength-gait time relationship, and used more steps to complete the task, all of which may contribute to their greater likelihood of frailty in later years.

Adult↗

PubMed1997

Six-minute walk test and heart rate variability: lack of association in advanced stages of heart failure.

BACKGROUND: The 6-minute walk and heart rate variability have been used to assess mortality risk in patients with heart failure, but their relationship to each other and their usefulness for predicting mortality at 1 year are unknown. OBJECTIVE: To assess the relationships between the 6-minute walk test, heart rate variability, and 1-year mortality. METHOD: A sample of 113 patients in advanced stages of heart failure (New York Heart Association Functional Class III-IV, left ventricular ejection < 0.25) were studied. All 6-minute walks took place in an enclosed, level, measured corridor and were supervised by the same nurse. Heart rate variability was measured by using (1) a standard-deviation method and (2) Poincaré plots. Data on RR intervals obtained by using 24-hour Holter monitoring were analyzed. Survival was determined at 1 year after the Holter recording. RESULTS: The results showed no significant associations between the results of the 6-minute walk and the two measures of heart rate variability. The results of the walk were related to 1-year mortality but not to the risk of sudden death. Both measures of heart rate variability had significant associations with 1-year mortality and with sudden death. However, only heart rate variability measured by using Poincaré plots was a predictor of total mortality and risk of sudden death, independent of left ventricular ejection fraction, serum levels of sodium, results of the 6-minute walk test, and the standard-deviation measure of heart rate variability. CONCLUSIONS: Results of the 6-minute walk have poor association with mortality and the two measures of heart rate variability in patients with advanced-stage heart failure and a low ejection fraction. Further studies are needed to determine the optimal clinical usefulness of the 6-minute walk and heart rate variability in patients with advanced-stage heart failure.

Death, Sudden↗

PubMed2006

Reliability, validity, and responsiveness of a 2-min walk test to assess exercise capacity of COPD patients.

PURPOSES: To investigate the reliability, validity, and responsiveness of a 2-min walk test (2MWT) in Chinese COPD patients with moderate-to-severe disease. METHODS: This study consisted of two parts. Forty-seven stable COPD patients with moderate-to-severe disease participated in the first part of study for the investigation of reliability and validity. The demographic and anthropomorphic data collected included age, gender, body weight, height, and body mass index. Each subject performed a pulmonary function test, a cardiopulmonary exercise test, three trials of a 2MWT, and two trials of 6-min-walk test (6MWT) in random order within a 5-day period. Fifteen of these subjects participated in the second part of study for the evaluation of the responsiveness of the 2MWT following pulmonary rehabilitation. The 2MWT and 6MWT were conducted before and after the program for comparison. RESULTS: Forty-five subjects (mean [+/- SD] age, 71.8 +/- 8.3 years; mean FEV1, 0.88 +/- 0.27 L) completed the first part of study, and 9 subjects (mean age, 74 +/- 8.7 years; mean FEV1, 0.94 +/- 0.28 L) completed the second part of study. The intraclass correlation coefficient of the repeated 2MWTs was high (R = 0.9994; p < 0.05), mean differences across trials ranged from 0.3 to 0.8 m (95% confidence interval, -3.1 to 4.6 m) demonstrated its high test-retest reliability. Significant correlations were found between the 2MWT and the 6MWT, the maximum oxygen uptake (V(O2)max) in milliliters per minute, and the V(O2)max in milliliters per kilogram per minute (r = 0.937, 0.454, and 0.555 respectively; p < 0.0125). Following rehabilitation, there were significant improvements in the mean 2MWT and 6MWT walking distance of 17.2 +/- 13.8 m and 60.6 +/- 35.5 m, respectively, with moderate effect sizes (0.61 and 0.53, respectively) and large standardized mean responses (1.25 and 1.70, respectively). High correlation was found between changes in the 2MWT and the 6MWT (r = 0.70; p < 0.05). CONCLUSION: The 2MWT was shown to be a reliable and valid test for the assessment of exercise capacity and responsive following rehabilitation in patients with moderate-to-severe COPD. It is practical, simple, and well-tolerated by patients with severe COPD symptoms.

Aged↗

PubMed2001

The 2-minute walk test as a measure of functional improvement in persons with lower limb amputation.

OBJECTIVE: To determine the construct validity and responsiveness of the 2-minute walk test as a measure of function in individuals with lower extremity amputation. DESIGN: The distances walked in 2 minutes were compared with the results on the physical functioning subscale of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Houghton Scale. SETTING: Regional amputee rehabilitation program. PATIENTS: Retrospective data from 290 patients (mean age, 66yr) with unilateral transtibial, unilateral transfemoral, or bilateral amputations. INTERVENTION: Repeated testing. MAIN OUTCOME MEASURES: Distance walked in 2 minutes, SF-36 (aggregated into physical and mental composite scores), and the Houghton score. We also examined the change in the distance before and after a rehabilitation program. RESULTS: The distance walked in 2 minutes showed a weak correlation with the physical functioning subscale of the SF-36 (r = .22, p = .008) and a moderate correlation with the total Houghton score at discharge from rehabilitation (r = .493, p <or= .001). The correlation between distance walked in 2 minutes and SF-36 physical functioning subscale at follow-up was moderate (r = .479, p < .001). There was a significant improvement in distance walked in 2 minutes at discharge and follow-up compared with baseline (mean change +/- standard deviation at discharge, 13.6 +/- 19.9m; at follow-up, 41.2 +/- 34m, p < .001). CONCLUSION: The 2-minute walk test was responsive to change with rehabilitation in persons with lower extremity amputation. In addition, the 2-minute walk test showed adequate correlation with measures of physical functioning and prosthetic use in this population.

Aged↗

PubMed1992

Treadmill validation of an over-ground walking test to predict peak oxygen consumption.

The purpose of this study was to determine whether a test developed to predict maximal oxygen consumption (VO2max) during over-ground walking, was similarly valid as a predictor of peak oxygen consumption (VO2) when administered during a 1-mile (1.61 km) treadmill walk. Treadmill walk time, mean heart rate over the last 2 full min of the walk test, age, and body mass were entered into both generalized (GEN Eq.) and gender-specific (GSP Eq.) prediction equations. Overall results indicated a highly significant linear relationship between observed peak VO2 and GEN Eq. predicted values (r = 0.91), a total error (TE) of 5.26 ml.kg-1.min-1 and no significant difference between observed and predicted peak VO2 mean values. The peak VO2 for women (n = 75) was predicted accurately by GSP Eq. (r = 0.85; TE = 4.5 ml.kg-1.min-1), but was slightly overpredicted by GEN Eq. (overall mean difference = 1.4 ml.kg-1.min-1; r = 0.86; TE = 4.56 ml.kg-1.min-1). No significant differences between observed peak VO2 and either GEN Eq. (r = 0.85; TE = 4.3 ml.kg-1.min-1) or GSP Eq. (r = 0.85; TE = 4.8 ml.kg-1.min-1) predicted values were noted for men (n = 48) with peak VO2 values less than or equal to 55 ml.kg-1.min-1. However, both equations significantly underpredicted peak VO2 for the remaining high peak VO2 men (n = 22). In conclusion, the over-ground walking test, when administered on a treadmill, is a valid method of predicting peak VO2 but underpredicts peak VO2 of subjects with observed high peak VO2 values.

Adult↗

PubMedDate not supplied

Validity and reliability of the 6-minute walk test in a cardiac rehabilitation population.

PURPOSE: Although the 6-minute walk test is commonly used to assess the functional status of patients with severe cardiopulmonary disease, few studies have tested its value in a cardiac rehabilitation (CR) population with milder disease status. The purpose of this study was to examine the validity and reliability of the 6-minute walk in a Phase II/III CR program. METHODS: Ninety-four patients (61 men, 33 women) aged 63 +/- 10 years completed three 6-minute walks on nonconsecutive days. Patients also completed the Duke Activity Status Index (DASI) and the Short Form 36 Health Survey (SF-36). In addition, maximum metabolic equivalents (METs) from a symptom-limited graded exercise test were obtained from files. RESULTS: The 6-minute walk was linearly related to maximum METs (r = 0.687, P < 0.001), supporting the validity of the test. Patients walked significantly farther in each 6-minute walk (F = 19.83, P < 0.001), and strong test-retest reliability was demonstrated (intraclass correlation = 0.97). Distance walked decreased with older age (F = 19.49, P < 0.001), with men walking farther than women (F = 7.19, P < 0.01). The 6-minute walk was moderately correlated with scores from the DASI (r = 0.502, P < 0.001), and the Physical Function subscale of the SF-36 (r = 0.624, P < 0.001). CONCLUSIONS: The 6-minute walk is a valid and reliable method of assessing functional ability in a Phase II/III CR population. A learning effect of 6% was observed over the three walks; however, it is unknown if this learning effect will be retained over time. This test may be particularly valuable to smaller CR centers that want to document functional improvements but do not have access to conventional treadmill tests.

Adult↗

PubMed2004

Plasma levels of tumor necrosis factor-alpha correlate with the six-minute walk test results in patients with mild to moderate heart failure.

BACKGROUND: The plasma levels of brain natriuretic peptide, tumor necrosis factor-alpha, big endothelin-1 and cardiac troponins have been reported to correlate with the severity of heart failure. METHODS: In a single population of 80 outpatients with mild to moderate chronic heart failure the correlation between the patient's functional capacity, as evaluated at a 6-min walk test, the clinical parameters and plasma levels of brain natriuretic peptide, tumor necrosis factor-alpha, big endothelin-1 and cardiac troponins was evaluated. RESULTS: A significant inverse correlation was found with the patient's age (p < 0.0001), NYHA functional class (p < 0.0001), left ventricular dysfunction etiology (ischemic vs dilated cardiomyopathy, p < 0.0005), heart rate (p < 0.05), plasma levels of brain natriuretic peptide (p < 0.05) and of tumor necrosis factor-alpha (p < 0.0005). At multiple regression analysis a correlation was found between the 6-min walk test results and the patient's age (p < 0.05), NYHA functional class (p < 0.01), left ventricular dysfunction etiology (ischemic vs dilated cardiomyopathy, p < 0.05) and tumor necrosis factor-alpha plasma levels (p < 0.05). CONCLUSIONS: In our patients with mild to moderate heart failure, a significant correlation was found between the results of the 6-min walk test and only the plasma concentrations of tumor necrosis factor-alpha among the laboratory parameters analyzed in this study.

Adult↗

PubMed2003

[Reproducibility of the shuttle walk test in children with cystic fibrosis].

INTRODUCTION: Exercise testing is useful in the respiratory evaluation of patients with cystic fibrosis. The shuttle walk test (SWT) is a progressive, externally paced, exercise test requiring the subject to walk/run back and forth between two fixed points. The aim is to assess the reproductibility of the SWT in paediatric patients with cystic fibrosis. METHODS: This prospective study recruited 31 children with stable disease. The patients performed two SWT one day (SWT 1 and 2) and two others (SWT 3 and 4) within 15 days. Only SWT 2 and 4 were assessed for reproducibility. RESULTS: 61% were boys, median age (range): 12.9 (7-18.9) years, median Shwachman score (range): 80 (65-100), median values for FEV1 and FVC (range): 92 (55-154) and 92 (64-140)% predicted, respectively. Median distance for SWT 2-4 (range): 910 (580-1020) and 925 (540-1020) metres. Reproducibility for SWT distance and physical activity measured by an accelerometer is very good (intra-class correlation coefficient=0.90 and 0.92, respectively). SWT distance correlated with physical activity (p=3.10(-4)) and weight (p=0.03). SWT distance was independent of the following parameters: height, weight-for-age Z-score, FEV1, FVC, Shwachman score, colonisation with Pseudomonas aeruginosa. CONCLUSIONS: The SWT is reproducible in paediatric patients with cystic fibrosis and provides assessment of respiratory performance that complements spirometric measures of lung function.

Adolescent↗