The effect of walking path configuration on six-minute walk test performance and gait variability: A pilot study

Abstract

E-mail address: cleveland.barnett@ntu.ac.uk (C.T. Barnett). Introduction and aim: Gait variability reflects the inherent stability of gait resulting frompathologyor ageing [1],while assessments such as the six-minute walk test (6MWT) provide an overall indicator of functional capacity [2]. Accuratemeasurement of these gait characteristics is important for clinical decision making and the reporting of valid research data. However, variation in the configuration of gait trials, such as walkway lengths, number of trials/strides recorded and familiarisation protocols, are proposed to impact upon the key outcome measures associated with these gait characteristics [3,4]. Therefore, the current study investigated the effect ofwalkway configuration on 6MWTperformance and the variability of temporal–spatial gait measures. Patients, materials andmethods: Sixteen healthy participants (age 22.1±1.0 years, height 1.78±0.07m, mass 76.8±9.4 kg), completed two familiarisation 6MWT trials according to the American Thoracic Society guidelines [2]. Participants then completed five randomly ordered experimental 6MWT trials over two days with walkway configurations of 5m (5M), 10m (10M) and 15m (15M) straight sections, a rectangular box (6×3m) (BOX) and figure of eight incorporating two 10m straight sections (FIG8). During these trials, reflectivemarkerswere attached to the sacrumand the posterior and anterior aspects of the feetwith kinematic data being recorded at 100Hz by a nine-cameramotion capture system (Qualisys, Gothenburg, SE). Data were processed in Visual 3D (C-Motion, Inc., Germantown, USA) with the variability of temporal–spatial measures calculated. Results: Preliminary analysis of the data indicated that a decreasing need to turn and change direction, increased the 6MWT distance achieved (F(4,60) =101.97, p<0.001, p = 0.87) (Table 1). Post-hoc tests revealed that the greatest 6MWT distance was achieved during 15M and FIG8 trials (p=0.01), with the 5M trial resulting in a lower 6MWTdistancewhen compared to all other trials (p<0.01).Walking speedwas also increased,with the decreased need to change direction (F(4,60) =102.89, p<0.001, p = 0.87) (Table 1). Similarly, post-hoc tests revealed that the greatest walking speed was observed during the 15M and FIG8 trials (p=0.01) and the lowest during the 5M trial (p≤0.02). Although the number of strides participants took also increased with a reduced need to change direction (F(4,60) =7.93, p<0.001, p = 0.35) (Table 1), this effectwas reduced across trials, with amaximumdifference of 10.5 strides between 15M and 5M trials. Discussion and conclusions: Results indicated that walkway configuration had a significant effect on 6MWT performance. Increased uninterrupted gait i.e. reduced turning, resulted in