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A validation of the 10-meter incremental shuttle walk test as a measure of aerobic power in cardiac and rheumatoid arthritis patients.

OBJECTIVE: To validate a simple, clinically relevant, and inexpensive test of aerobic power-the 10-meter incremental shuttle walk test (SWT)--in 2 separate patient populations. DESIGN: Two-sample validity study. SETTING: Physiotherapy department of major hospital in the United Kingdom. PATIENTS: Convenience samples of rheumatoid arthritis (RA) patients (n = 10) and cardiac patients (n = 10). INTERVENTION: Subjects were attached to a portable respiratory gas analyzer to measure oxygen uptake. They walked around an oval 10-meter course, starting at 0.5m/s, with velocity gradually increased by .17m/s increments for as long as they could, for up to 12 minutes. MAIN OUTCOME MEASURES: A subject's maximal rate of oxygen uptake during exercise (V(O)(2)max) established with linear extrapolation was regressed against the number of shuttles completed (distance walked). An earlier study (n = 28) showed high levels of reliability and validity with linear extrapolation. RESULTS: No significant linear relationship was found between V(O)(2)max and the number of shuttles completed (R(2); RA subjects = 9.7%, cardiac subjects = .03%, p > .05). CONCLUSION: These results do not support use of the SWT as a representative measure of aerobic power. Despite this finding, the advantages of developing a clinically viable alternative to costly laboratory testing warrants further study of the SWT in patient groups.

Adult↗

Reference values for the 6-min walk test in healthy subjects 20-50 years old.

In 102 healthy Caucasians, 20-50 years old, we investigated the effect of anthropometrics on the 6-min walk test (6MWT), in order to provide reference values for walk distance (6MWD), oxygen saturation (SpO2), pulse rate (PR), respiratory rate (RR), breathlessness perception (VAS) and for the walking distance and body weight product (DW). The mean 6MWD and DW values were 593 +/- 57 and 638+/-44 m (P < 0.01) and 35,030 +/- 5306 and 48,882 +/- 6555 kg m (P < 0.01), respectively for women and for men. While walking, SpO2 remained unaltered and subjects reached 67 +/- 10% of their maximal predicted heart rate and a RR mean value of 19 +/- 4 bpm. VAS ratings were significantly higher in females as compared to males (24 +/- 15 vs. 18 +/- 5 mm, P < 0.05), however, when corrected for PR change while walking, they were not different. The equation by stepwise multiple regression analysis included height, age and gender for the 6MWD and accounted for 42% of the total variance. This study confirms the relevant effect of anthropometrics on walking capacity and suggests that when rating dyspnea, the change in heart rate during walking should be considered.

Adult↗

Incremental shuttle walk test in the assessment of patients for heart transplantation.

OBJECTIVE: To compare the incremental shuttle walk test (ISWT) with treadmill exercise testing (TT) derived measurement of peak oxygen consumption (peak VO(2)) in patients undergoing assessment for cardiac transplantation. DESIGN: Prospective comparison. All investigations occurred during a single period of admission for transplant assessment. SETTING: Single UK cardiothoracic transplantation unit. PATIENTS: 25 patients recruited (21 men). Mean age was 53 years. INTERVENTIONS: Patients underwent two TT of peak VO(2) using the modified Naughton protocol and three (one practice) ISWT. Investigations were performed on consecutive days. MAIN OUTCOME MEASURES: Main outcome measures were repeatability of TT and ISWT assessments; relation between peak VO(2) and distance walked in the ISWT; and receiver operating characteristic (ROC) analysis to establish a distance walked in the ISWT that predicted which patients would have a peak VO(2) greater than 14 ml/min/kg. RESULTS: Both the ISWT and the TT were highly reproducible. Following the first practice walk, mean (SD) ISWT distances were 400.0 (146) m (ISWT2) and 401.3 (129) m (ISWT3), r = 0.90, p < 0.0001. Mean peak VO(2) by TT was 15.2 (4.4) ml/kg/min (TT1) and 15.0 (4.4) ml/kg/min (TT2), r = 0.83, p < 0.0001. The results revealed a strong correlation between distance covered in the ISWT and peak VO(2) obtained during TT (r = 0.73, p = 0.0001). ROC analysis showed that a distance walked of 450 m allowed the selection of patients with a peak VO(2) of over 14 ml/min/kg. CONCLUSIONS: This work confirms the utility of the ISWT in the assessment of exercise capacity in patients with severe heart failure undergoing assessment for cardiac transplantation. ISWT may provide a widely applicable surrogate measure for peak VO(2) estimation in this population. Shuttle distance walked may therefore allow the convenient, serial assessment of patients with heart failure before referral for transplantation.

Exercise Test↗

Validation of the Rockport Fitness Walking Test for adults with mental retardation.

This study determined if the generalized equations created for the Rockport Fitness Walking Test were a valid estimation of cardiorespiratory fitness for adults with mental retardation (MR). Subjects included 25 males and females (mean age = 33.3 +/- 7.4 yr) with MR. A maximal treadmill test was administered (mean VO2peak = 29.5 +/- 7.2 ml.kg-1 x min-1; 2.2 +/- 0.62 l.min-1). Subjects' age, weight, sex, walk time, and immediate post-HR were used in the generalized equations for predicting VO2peak (mean VO2peak = 36.5 +/- 7.6 ml.kg-1 x min-1 and 2.7 +/- 0.66 l.min-1). Significant correlations (P < 0.01) were obtained between the measured and predicted peak VO2 levels. However, significant and consistent differences were also observed between the measured and predicted VO2peak values (P < 0.02). Only 28% (l.min-1) and 36% (ml.kg-1 x min-1) of the subjects' measured VO2peak fell within the prespecified value of the predicted VO2peak, thus indicating that the prediction equations overestimated the VO2peak and cardiovascular fitness levels of adults with MR.

Adult↗

The relationship of the 6-min walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease.

STUDY OBJECTIVE: To assess the relationship of distance ambulated during the 6-min walk test (6'WT) to maximal oxygen consumption (VO2 max). DESIGN: Multivariate analysis of patient characteristics to VO2 max. SETTING: Pre-lung transplant evaluation. PATIENTS: 60 patients (22 men, 38 women; mean age, 44 years) with end-stage lung disease (mean FEV1 and forced vital capacity of 0.97 and 1.93, respectively). MEASUREMENTS AND RESULTS: The 6'WT was performed on a level hallway surface, and VO2 max was obtained during maximal cycle ergometry exercise testing with respiratory gas analysis. Multivariate analysis of patient characteristics (age, sex, weight, FEV1, FVC, diffusing capacity for carbon monoxide (DCO), 6'WT distance ambulated, number of rests per 6'WT, and the maximal heart rate, blood pressure, rate-pressure product, respiratory rate, oxygen saturation, rating of perceived exertion, and amount of supplemental oxygen used during the 6'WT) was performed on two groups of 30 patients each (group A or B) who were randomly assigned to either group by a process of random selection using a computer-generated random numbers program. Distance ambulated was the strongest independent predictor of VO2 max (r = 0.73; p < 0.0001) in both groups, and adding age, weight, and pulmonary function test results (FVC, FEV1, and DCO) to the regression equation increased the correlation coefficient to 0.83. Because of the significant correlation of distance ambulated during the 6'WT to VO2 max, the prediction equation obtained from the multivariate analysis of group A, VO2 max = 0.006 x distance (feet) +3.38, was used to estimate the VO2 max of the group B patients. No significant difference was observed between the estimated (x +/- SD = 8.9 +/- 2.4 mL/kg/min) and observed (x +/- SD = 9.4 +/- 3.8 mL/kg/min) VO2 max (mean difference, 0.5 mL/kg/min; SD of the difference = 2.88). CONCLUSIONS: The distance ambulated during a 6'WT can predict VO2 max in patients with end-stage lung disease. The addition of several patient characteristics can increase the ability to predict VO2 max and account for more of the variability. Such information is valuable when assessing patient response to therapeutic intervention if respiratory gas analysis is unavailable or impractical.

Blood Gas Analysis↗

The Standardized Three-metre Walking Test for elderly people (WALK3m): repeatability and real change.

OBJECTIVES: (i) To examine the relative and absolute retest within-session reliability of the Standardized Three-metre Walking Test for elderly people (WALK3m), using walking time and number of steps as measures. (ii) To give clinicians details of how they can use the minimal detectable change in order to decide whether a patient's WALK3m performance has really changed. (iii) To give rules to decide whether one trial rather than three is sufficient. DESIGN AND ANALYSIS: Subjects made three trials of WALK3m in the same session. Variability and level of performance were related so the data were log (ln) transformed. Relative reliability was measured by the intraclass correlation coefficient (ICC) then absolute reliability by the repeatability factor (RF) and minimal detectable change (MDC) (one-tailed and two-tailed) was derived from the within-subjects standard deviation. SETTING: Rehabilitation areas in the acute geriatric medical units at three south-west London hospitals. SUBJECTS: The standardizing sample consisted of 81 inpatients approaching discharge to their own homes. RESULTS: The ICC for walking time was 0.97 and for step counts 0.96. The MDC for walking is a 36% decrease between first and second measurements. The corresponding value for step counts is 21%. CONCLUSION: WALK3m, whether measured by time or by step counts has excellent repeatability. Knowing the minimal detectable change can be of great value to clinicians who can calculate whether their patient is really making progress.

Age Factors↗

Reliability and validity of a twelve-minute walking test for coronary heart disease patients.

This study examined the reliability and validity of a 12-min. walking test for coronary heart disease patients. CHD patients (28 men, 18 women) were recruited out of 86 CHD patients of the Martini Hospital Groningen, The Netherlands. 46 CHD patients (age M=66.0 yr., SD=6.8) participated in the reliability study and 24 (age M=62.0 yr., SD=9.2) in the validity study. A test-retest analysis showed a satisfactory Bland-Altman plot and an intraclass coefficient of .98. The Pearson correlation between the score on the test and the VO2 peak was .77. This test gives a reliable and valid assessment of cardiorespiratory fitness of CHD patients.

Activities of Daily Living↗

Development and validation of a one-mile treadmill walk test to predict peak oxygen uptake in healthy adults ages 40 to 79 years.

The purpose of this investigation was to determine whether the Rockport one-mile walk test equation to predict maximal oxygen uptake was valid for application to treadmill walking. When the Rockport model was found to be inappropriate, a new regression model was developed for predicting peak oxygen uptake (VO2peak) from a one-mile treadmill walk. 304 healthy volunteers ages 40 to 79 years (mean age = 57.6 years, 154 men and 150 women) completed a VO2peak test and a one-mile treadmill walk. Stepwise regression was used to build a model for the relationship between VO2peak and a variety of predictor variables in a sub-sample development group (n = 154). This new model was then applied to a sub-sample validation group (n = 150). The new equation produced a correlation of 0.87, SEE = 4.7 ml x kg (-1) x min (-1) with a mean residual of 0.96 ml x kg (-1) x min (-1). The equation for predicting VO2peak developed in this investigation provides a means of assessing VO2peak that is easy to administer, allows for careful supervision of subjects, and can be completed at a low financial and temporal cost.

Adult↗

Validity and responsiveness of the 6 minute walk test for people with fibromyalgia.

OBJECTIVE: To determine the concurrent validity and responsiveness of the 6 minute walk test (6-MWT) as a measure of cardiorespiratory fitness in people with fibromyalgia. METHODS: Subjects completed the 6-MWT, a Fibromyalgia Impact Questionnaire (FIQ), and a peak oxygen consumption (pVO2) exercise test before (n = 28) and after (n = 20) a 12 week exercise program. RESULTS: The correlations between 6-MWT distance and pVO2 before (r = 0.328) and after (r = 0.420) the exercise program were not significant. Significant correlations were obtained between 6-MWT distance and FIQ total (r = -0.494, p < 0.01) and physical impairment (r = -0.403, p < 0.05) scores. Fifteen of 28 subjects completed the exercise program, with significant (p < 0.05) changes in 6-MWT distance (+78 m), pVO2 (+1.8 ml/kg/min), and FIQ total score (-9.9). The change in 6-MWT distance was correlated significantly (p < 0.05) with change in FIQ total score but no change in pVO2. CONCLUSION: The 6-MWT was not a valid predictor of cardiorespiratory fitness. However, it was sensitive to change and was also significantly related to FIQ total score.

Adult↗

The weighted walking test as an alternative method of assessing aerobic power.

The aim of the present study was to determine maximal oxygen uptake (VO2max) directly during uphill walking exercise and to compare these values with those achieved during running and cycling exercise. Forty untrained students (20 males and 20 females) took part in three exercise tests. The running test was performed on a horizontal treadmill and the speed was gradually increased by 0.3 m . s(-1) every 3 min. The walking test was conducted on a treadmill inclined at 12% (speed of 1.8 m . s(-1)). The load was further increased every 3 min by the addition of a mass of one-twentieth of the body mass of the participant (plastic containers filled with water and added to a backpack carried by the participant). During the bicycle ergometry test, the workload was increased by 20 W every 2 min. All tests were performed until volitional exhaustion. During all tests, oxygen uptake, minute ventilation, tidal volume, respiratory frequency, heart rate, hydrogen ion concentration, base excess, and blood lactate concentration were analysed. The Pearson correlation coefficients between the weighted walking test and the commonly applied running and bicycle ergometry tests indicate a strong association with the new test in evaluating maximal oxygen uptake. The negligible differences in VO2max between the three tests for the male participants (running: 61.0 ml . kg(-1) . min(-1); walking: 60.4 ml . kg(-1) . min(-1); cycling: 60.2 ml . kg(-1) . min(-1)), and the fact that the females achieved better results on the walking test than the cycle ergometer test (running: 45.0 ml . kg(-1) . min(-1); walking: 42.6 ml . kg(-1) . min(-1); cycling: 40.1 ml . kg(-1) . min(-1)), confirm the suitability of the new method for evaluating aerobic power. The weighted walking test could be useful in the assessment of aerobic power in individuals for whom running is not advised or is difficult. In addition, the new test allows for determination of VO2max on small treadmills with a limited speed regulator, such as those found in specialist physiotherapy and fitness centres.

Acid-Base Equilibrium↗

Multivariable assessment of the 6-min walking test in patients with chronic obstructive pulmonary disease.

Functional exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) is often assessed by the 6-min walking test (6MWT). To assess if the use of multiple factors adds to walking distance in describing performance in the 6MWT, an exploratory factor analysis was performed on physiological measurements and dyspnea ratings recorded during testing. Eighty-three patients with mild to severe COPD performed repeated 6MWTs before inpatient pulmonary rehabilitation. Factor analysis on 15 variables yielded a stable four-factor structure explaining 78.4% of the total variance. Recorded heart rate variables contributed to factor 1 (heart rate pattern), walking distance, heart rate increase, and decrease contributed to factor 2 (endurance capacity), oxygen desaturation variables contributed to factor 3 (impairment of oxygen transport), and dyspnea and effort variables contributed to factor 4 (perceived symptoms). Walking distance decreased in half of the 53 patients measured posttreatment, but self-perceived change in exercise tolerance improved in 84% and was explained by change in walking distance, by less desaturation, and by less dyspnea (R(2) = 0.55, p = 0.005). Qualitative analysis showed that 29 of 53 patients improved in three or four factors. Performance in the 6MWT can be described with four statistically independent and clinically interpretable factors. Because clinically relevant changes consist of more than only walking distance, assessment of functional exercise tolerance in patients with COPD improves by reporting multiple variables.

Adult↗

Intensity and daily reliability of the six-minute walk test in moderate chronic heart failure patients.

OBJECTIVE: To assess the intensity and daily reliability of the six-minute walk test (6MWT) in patients with moderate chronic heart failure (CHF). DESIGN: Evaluation of testing protocol. SETTING: Hospitalized care. PARTICIPANTS: CHF patients under optimal drug treatment (CHF-D, n=12) or optimal drug treatment plus multisite cardiac pacing (CHF-P, n=12). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak values of oxygen uptake (VO2) and heart rate during a symptom-limited, treadmill exercise test and VO2, heart rate, and distance during 2 6MWT sessions (morning and afternoon). The 6MWT intensity was estimated by the ratio (%) of VO2 and heart rate values measured at the end of this test in relation to the respective peak values obtained during the treadmill exercise test. RESULTS: Subjects' VO2 and heart rate during the 6MWT were lower (P<.001) and were about 90% of the peak values (VO2: CHF-D, 90.5%+/-11.1%; CHF-P, 93.0%+/-13.2%; heart rate: CHF-D, 90.6%+/-6.6%; CHF-P, 91.4%+/-9.6%). The distance walked during both 6MWT sessions did not differ significantly, with low coefficients of variation (< or =2.0%) and high intraclass correlation coefficients (> or =.98). In CHF-D only, the patients' VO2 and heart rate were significantly (P<.01, P<.05, respectively) higher during the afternoon session. CONCLUSIONS: Despite an intensity significantly lower but close to that of the symptom-limited exercise test, the 6MWT was well tolerated in both CHF groups. In these populations, the 6MWT is reliable on a daily basis, for the distance walked. However, for assessing VO2 and heart rate values in CHF-D patients, the 6MWT must always be performed at the same time of day.

Aged↗

Six-minute walking test in cystic fibrosis adults with mild to moderate lung disease: comparison to healthy subjects.

The six-minute walking test (6MWT) has been widely utilized to evaluate global exercise capacity in patients with cystic fibrosis. The aim of this study was to assess the exercise capacity by 6MWT, measuring four outcome measures: walk distance, oxygensaturation and pulse rate during the walk, and breathlessness perception after the walk, in a group of cystic fibrosis adults with mild to moderate lung disease, and in healthy volunteers, as the control group. Moreover, the study examined the relationship between 6MWT outcome measures and pulmonary function in patients. Twenty-five adults (15 females, age range 18-39 years) with cystic fibrosis and 22 healthy volunteers (14 females, age range 20-45 years) performed a 6MWT following a standard protocol. Walk distance, oxygen saturation (SpO2) and pulse rate at rest and during walk, and breathlessness perception after walk assessed by visual analogue scale (VAS) were measured. Cystic fibrosis patients did notdiffer from healthy volunteers in walk distance (626 +/- 49 m vs. 652 +/- 46 m) and pulse rate. Patients significantly differed from healthy volunteers in SPO2 during the walk (mean SpO2) (P < 0.0001) and VAS (P < 0.0001). In patients, SPO2 during the walk significantly correlated with forced expiratory volume in 1 sec (FEV1) (P < 0.0001), residual volume (RV) (P < 0.001), resting SPO2 (base SpO2) (P < 0.001), and inspiratory capacity (IC) (P < 0.01). In addition, VAS significantly correlated with resting SPO2 (P < 0.01) and IC (P < 0.01). On the basis of regression equations by stepwise multiple regression analysis, SpO2 during walk was predicted by FEV1 (r2 = 0.60) and VAS by IC (r2 = 0.31), whereas walk distance was not reliably predicted by any assessed variables. This study showed that cystic fibrosis adults with mild to moderate lung disease covered a normal walk distance with unimpaired cardiac adaptation, but experienced a significant fall in oxygen saturation and an increased breathlessness perception during exercise. Resting pulmonary function was related to oxygen saturation and breathlessness perception during walk, but contributed significantly only tothe prediction of oxygen saturation. We suggest that 6MWT could be valuable for identifying patients who might experience oxygen desaturation and dyspnoea during demanding daily activities.

Adolescent↗

Validation of the Rockport Fitness Walking Test in college males and females.

The purposes of this study were (a) to validate the Rockport Fitness Walking Test (RFWT) in college students, and (b) to develop prediction equations on this college sample if the RFWT proved invalid. Subjects were administered a test to determine maximal oxygen uptake (VO2max) on a treadmill and the RFWT in a field testing environment. Comparisons were made between the measured VO2max and the VO2max predicted from the equations of Kline, Porcari, Hintermeister, et al. (1987). The Kline, Porcari, Hintermeister, et al. equations overpredicted VO2max by 16-18% in the males and by 22-23% in the females. The correlation coefficients between the measured and predicted VO2max values ranged from .39 to .59. Derivation of new prediction equations using the same variables as in the RFWT produced only one equation that had sufficient accuracy to recommend its use. It was concluded that the original RFWT overpredicts VO2max in college students and should not be used with this population.

Adult↗

Relationship between outcome measures of six-minute walk test and baseline lung function in patients with interstitial lung disease.

BACKGROUND AND AIM OF THE WORK: In patients with interstitial lung disease (ILD), the six-minute walk test (6MWT) has been rarely used, and up till now, the relationship between outcome measures of the test and baseline lung function has not yet been examined. Therefore, we assessed walk distance, oxygen desaturation, and breathlessness perception during 6MWT, and their relationships to baseline lung function in patients with ILD. METHODS: Forty ILD patients with history of breathlessness during physical exertion performed a 6MWT following a standard protocol. Breathlessness perception during walk was assessed by visual analogue scale (VAS, in mm). RESULTS: The mean walk distance was 487 meters (range 271-689). Mean baseline oxygen saturation (Base SpO2, %) was 94% and was reduced during walk, either as mean oxygen saturation (Mean SpO2, 89%, p < 0.001) or as mean fall in oxygen saturation during walk (Fall SpO2, 5%). Furthermore, VAS significantly increased after walk (5 mm to 44 mm, p < 0.001). A close relationship of TLco and TLC to walk distance and Fall SpO2 was found (r = 0.45 and 0.42 and r = -0.75 and -0.64, respectively; p < 0.001, each). On the basis of regression equations by stepwise multiple regression analysis, walk distance was predicted by age and FVC (r2 = 0.50), Mean SpO2 by TLco and Base SpO2 (r2 = 0.80), and Fall SpO2 only by TLco (r2 = 0.57). Breathlessness perception was not reliably predicted by any assessed variables. CONCLUSIONS: We confirmed that 6MWT provides a global evaluation of sub-maximal exercise capacity in ILD patients. We also found that walk distance and oxygen desaturation, but not breathlessness perception during walk, are strictly related to baseline lung function.

Adult↗

Cardiorespiratory requirements and reproducibility of the six-minute walk test in elderly patients with coronary artery disease.

OBJECTIVES: To measure the cardiorespiratory requirements of the six-minute walk test (6MWT), to compare this demand with the symptom-limited exercise test (SLET) at ventilatory threshold and at maximal level in elderly patients with coronary artery disease (CAD), and to assess the reproducibility of the 6MWT in cardiorespiratory exchanges in those patients. DESIGN: Comparative and reproducibility sample. SETTING: Cardiac rehabilitation service. PARTICIPANTS: Twenty-five people with CAD. INTERVENTIONS: Subjects performed an SLET and a 6MWT. To test 6MWT reproducibility, 9 patients performed 2 repeated 6MWTs. MAIN OUTCOME MEASURES: The 6MWT cardiorespiratory values, measured with a portable gas analyzer, were compared with the SLET data and with the data from the 2 repeated 6MWTs. RESULTS: The 6MWT peak oxygen uptake (VO2peak, 14.27+/-2.94 mL.min(-1).kg(-1)) and heart rate (94+/-14 beats/min) did not differ from the SLET values at ventilatory threshold (VO2, 13.4+/-2.65 mL.min(-1).kg(-1); heart rate, 91+/-17 beats/min), whereas the 6MWT ventilation (VEpeak, 36.72+/-10.03 L/min) was higher than the SLET at ventilatory threshold (Ve, 31.54+/-8.93 L/min, P<.03). Maximal 6MWT cardiorespiratory data were lower than the SLET maximal values. Cardiorespiratory values did not differ between the 2 repeated 6MWT (VO2peak, 15.33+/-3.52 mL.min(-1).kg(-1) vs 15.11+/-2.65 mL.min(-1).kg(-1); VEpeak, 39.07+/-12.33 L/min vs 39.07+/-12.13 L/min; heart rate, 95+/-21 beats/min vs 89+/-15 beats/min). CONCLUSIONS: The 6MWT cardiorespiratory requirement values did not differ from SLET values at ventilatory threshold except for ventilation, and 6MWT values are reproducible in elderly patients with CAD.

Age Factors↗

The 6-min walk test: a quick measure of functional status in elderly adults.

OBJECTIVES: To determine the correlates of the total 6-min walk distance (6MWD) in a population sample of adults > or = 68 years old. METHODS: The standardized 6-min walk test (6MWT) was administered to the Cardiovascular Health Study cohort during their seventh annual examination. RESULTS: Of the 3,333 participants with a clinic visit, 2,281 subjects (68%) performed the 6MWT. There were no untoward events. The mean 6MWD was 344 m (SD, 88 m). Independent general correlates of a shorter 6MWD in linear regression models in women and men included the following: older age, higher weight, larger waist, weaker grip strength, symptoms of depression, and decreased mental status. Independent disease or risk factor correlates of a shorter 6MWD included the following: a low ankle BP, use of angiotensin-converting enzyme inhibitors, and arthritis in men and women; higher C-reactive protein, diastolic hypertension, and lower FEV(1) in women; and the use of digitalis in men. Approximately 30% of the variance in 6MWD was explained by the linear regression models. Newly described bivariate associations of a shorter 6MWD included impaired activities of daily living; self-reported poor health; less education; nonwhite race; a history of coronary heart disease, transient ischemic attacks, stroke, or diabetes; and higher levels of C-reactive protein, fibrinogen, or WBC count. CONCLUSIONS: Most community-dwelling elderly persons can quickly and safely perform this functional status test in the outpatient clinic setting. The test may be used clinically to measure the impact of multiple comorbidities, including cardiovascular disease, lung disease, arthritis, diabetes, and cognitive dysfunction and depression, on exercise capacity and endurance in older adults. Expected values should be adjusted for the patient's age, gender, height, and weight.

Activities of Daily Living↗