6-Minute Walk Test For Children Research Articles

Commentary on “Validity of the Early Activity Scale for Endurance and the 6-Minute Walk Test for Children With Cerebral Palsy”

“How should I apply this information?” This study provides descriptive and validity data for the Early Activity Scale for Endurance (EASE) in a cohort of children with cerebral palsy (CP) and highlights the importance of endurance for overall physical activity and participation in meaningful daily activities. The EASE is a useful tool for discussion with parents regarding their children's endurance during daily activities. This offers a clinical advantage over a capacity measure such as the 6-minute walk test (6MWT) or other complicated laboratory-based tools. The EASE is designed to capture endurance information for young children and those with limited or no walking, which may increase its clinical utility. Younger participants had lower EASE scores (lower endurance capacity) as well as shorter 6MWT distances, which could be meaningful to better understand endurance trends in CP. “What should I be mindful about when applying this information?” Therapists should consider the study age range (<12 years) and clinical population (only CP). The EASE is designed for use with children at all Gross Motor Function Classification System (GMFCS) levels; however, this study did not provide a comparison endurance measure for those in GMFCS levels IV and V to establish convergent validity. EASE scores were significantly lower for children in GMFCS levels IV and V; however, study results were unable to discriminate actual endurance deficits versus perceived endurance deficits due to limitations in self-initiated movement and mobility in these specific children. Therefore, therapists should interpret EASE outcomes cautiously for children in GMFCS levels IV and V. Continued psychometric evaluation of the EASE is warranted to establish responsiveness to measure endurance changes over time. The authors state that the EASE likely measures a different construct of endurance capacity from walking; however, further research is needed to determine how EASE results correlate with specific motor functions (other than walking) and participation in daily activities at home, school, and community settings. Helen Carey, PT, DHSc, PCS Kettering College Kettering, Ohio Jessica Lewis, PT, DPT, PCS Nationwide Children's Hospital Columbus, Ohio

Validity of the Early Activity Scale for Endurance and the 6-Minute Walk Test for Children With Cerebral Palsy.

This study aimed to describe Early Activity Scale for Endurance (EASE) scores and 6-minute walk test (6MWT) distances of children with cerebral palsy (CP) by functional ability level, sex, and age and to examine the convergent validity of the 2 tests. A total of 708 participants with CP, Gross Motor Function Classification System (GMFCS) levels I to V, completed the EASE, and 376 of the study participants (3-12years), GMFCS levels I to III, completed the 6MWT. Children with CP vary in EASE scores and 6MWT distances based on GMFCS level and, to a lesser extent, age. The EASE and the 6MWT demonstrate a statistically significant but low, positive correlation. Understanding the relationship between these outcomes and GMFCS levels and age assists clinicians in establishing plans of care targeted at improving endurance for activity and functional walking capacity for children with CP.

Developmental Trajectories and Reference Percentiles for the 6-Minute Walk Test for Children With Cerebral Palsy.

The purposes of this study were to document longitudinal developmental trajectories in 6-minute walk test (6MWT) distances and to develop age-specific reference percentiles for children across different Gross Motor Function Classification System (GMFCS) levels. A TOTAL OF: 456 children with cerebral palsy ages 3 to 12 years of, GMFCS levels I to III participated. Children's motor function was classified on the GMFCS, and children completed the 6MWT 2 to 5 times in 2 years. Longitudinal developmental trajectories support that 6MWT distances increase with age followed by a tapering, as children approach their functional limit relative to their GMFCS level. Reference percentile graphs were created to monitor change over time. The 6MWT longitudinal developmental trajectories, reference percentiles, and interpretation of percentile change should assist collaborative and proactive intervention planning relative to functional walking capacity for children with cerebral palsy.

Commentary on "Developmental Trajectories and Reference Percentiles for the 6-Minute Walk Test for Children With Cerebral Palsy".

“How should I apply this information?” This study is a secondary analysis of 2 large, high-quality longitudinal datasets tracking the developmental trajectories of children with cerebral palsy (CP). The study's results suggest that individual children's 6-minute walk test (6MWT) performance can vary vastly at different time points, and still be interpreted as “progressing as expected.” Thus, it is not clear how the test provides meaningful information for children, their families, or clinicians. The high degree of intrachild variability over time is surprising, and it is unclear what is contributing to this. It is possible that the study's 6MWT administration procedure (which differed from conventional 6MWT protocols in the lack of a practice walk, lack of standardized verbal praise, and use of creativity to achieve compliance) and child factors (eg, pain, fitness, fatigue, or motivation) may be contributing. “What should I be mindful about when applying this information?” Giving children and parents messages-relating performance to percentiles has the potential to be a negative experience, particularly if children's performance places them below average. Children with CP have motor delays in comparison to their peers, and being told they are also behind their comparable CP peers may be demoralizing. Based on the information presented, incorporating the 6MWT into clinical practice is of limited benefit, and does not justify the time/effort and possible harms. The study focuses on using the 6MWT to predict future 6MWT performance. The 6MWT may be a more useful prognostic tool if its performance can be shown to reliably predict other more clinically useful outcomes. Carol Maher, BPT (Hons), PhD University of South Australia Adelaide, Australia Kerrie Kuszczakowski, BPT Novita Children's Services Adelaide, Australia

Learning and Encouragement Effects on Six-Minute Walking Test in Children

To evaluate learning and encouragement effects on the 6-minute walk test in children between 6 and 12 years of age. Two 6-minute walk tests separated by a 10-minute resting period were performed by healthy children between 6 and 12 years of age to evaluate the learning (part 1) and encouragement effects (part 2; randomization with and without encouragement). Distance and cardiorespiratory variables were used as outcomes. 148 children were recruited. The intraclass correlation coefficient estimates were 0.927 (95% CI, 0.893-0.951; part 1) and 0.844 (95% CI, 0.744-0.907; part 2). The test-retest agreement was verified for distance (P = .679) with a bias of 1.1 m (95% CI, -4 to 6), but the increase in distance with encouragement was significantly and clinically relevant (P < .001; +41 m; 95% CI, 33-50). No training is required for the 6-minute walk test in children, in contrast with adults, but there was an encouragement effect on the walked distance in these children. Guidelines should take these results into account. ClinicalTrials.gov: NCT03276299.

Physical activity level and performance in the six-minute walk test of children and adolescents with sickle cell anemia.

BackgroundTo establish determinants of maximum walking distance in the 6-minute walk test of children and adolescents with sickle cell anemia, and to compare the performance in this test with physical activity level between patients and healthy controls.MethodsA cross-sectional study was performed in which the participants answered the Physical Activity Questionnaire for Older Children and Adolescents, and completed the 6-minute walk test.Main resultsFifty-seven patients and 58 controls were studied. By univariate analysis of the patients, age (p < 0.0001) and indirect bilirubin (p = 0.008) were associated with maximum walking distance in the 6-minute walk test. In multivariate analysis, age was positively associated (p < 0.0001; beta: 0.75), while body mass index was inversely associated with distance walked (p = 0.047; beta: −0.32). This yields the following equation: maximum distance walked = 487.7 (age × 18.3) − (12 × body mass index) meters. Patients reported a lower physical activity level however there was no significant difference in the distance walked in six minutes between patients (500.6 ± 88.7 m) and controls (536.3 ± 94 m).ConclusionThe determinants for the 6-minute walk test in children and adolescents with sickle cell anemia were age and body mass index. There was no significant difference in the 6-minute walk test but patients with sickle cell anemia had a lower physical activity level compared to healthy controls.

Predictive Value of the 6-Minute Walk Test in Children with Cystic Fibrosis

In children with cystic fibrosis (CF), acute respiratory deterioration resulting in hospitalization is associated with significant morbidity and

Assessment of Physical Performance Using the 6-Minute Walk Test in Children Receiving Treatment for Cancer

The study of physical performance in children with cancer is emerging as an important variable in symptom research. Studies have shown that children with cancer experience deficits in physical performance during treatment that may be present years after therapy. The aim of this study was to determine if distance on the 6-minute walk test (6MWT) changed in children during the first 3 cycles of cancer treatment and to compare the distances walked with healthy norms. This is a secondary data analysis of 19 boys and 10 girls, aged 6 to 17 years, who were newly diagnosed with cancer and were part of a larger study that measured changes in fatigue and physical performance during the first 3 cycles of chemotherapy. Participants performed the 6MWT between days 15 and 29 of the first and third cycles of chemotherapy. Pediatric cancer patients did not have a significant change in the distance walked at cycle 3 of chemotherapy compared with cycle 1. When compared with 2 different normative data sets for healthy children, most children with cancer performed significantly below their peers. Children had poor strength and endurance after 3 cycles of chemotherapy even when their disease was responding to treatment. Interventions are needed to promote rehabilitation and maintenance of physical performance, as both are important to quality of life and ongoing child development. Children receiving cancer treatment who are ambulatory may appear to be functioning normally but are in fact severely deconditioned compared with their healthy peers.

Reference Values on the 6-Minute Walk Test for Children Living in the United States

: The purpose of this study was to investigate reference values for the 6-minute walk test (6MWT) and the relationship between 6-minute walk distance (6MWD) and age, sex, and anthropometric variables in children who are healthy, aged 7 to 11 years and living in the United States. : The sample included 100 children, 57 female, 43 male, mean age 9.66 ± 1.08 years. Measures included height, weight, body mass index, leg length, and 6MWD. : Mean 6MWD was 518.50 ± 73.56 m. Values were lower than those reported for children living in other countries with the exception of England. There were no significant associations between the 6MWD and other variables with the exception of body mass index in males. : Our findings suggest 6MWT values for children living in other countries may not be directly applicable to children living in the United States.

Commentary on Reference Values on the 6-Minute Walk Test for Children Living in the United States

Commentary on Reference Values on the 6-Minute Walk Test for Children Living in the United States