Distance Corridor Walk Research Articles

Usual-paced 400 m long distance corridor walk estimates cardiorespiratory fitness among older adults: The Study of Muscle, Mobility and Aging.

Cardiopulmonary exercise testing (CPET), the gold-standard method to quantify cardiorespiratory fitness (CRF), is not always feasible due to cost, access, and burden. The usual-paced 400 m long distance corridor walk (LDCW), a measure of mobility among older adults, may provide an alternate method to assess CRF. The purpose of this study was to develop and validate an estimating equation to estimate VO2 peak from average 400 m walking speed (WS) among participants in the Study of Muscle, Mobility and Aging (SOMMA). At baseline, women (58%) and men age 70 years and older enrolled in SOMMA (N = 820, 76.2 ± 4.9 years, 86% Non-Hispanic White) completed a 400 m LDCW (400 m WS = 400 m/completion time in seconds) and symptom-limited maximal CPET (Modified Balke Protocol). VO2 peak (mL/kg/min) was considered the highest 30-second average oxygen consumption during CPET. Other covariates included: age, sex, race, physical activity (7-day wrist-worn accelerometer), physical function (Short Physical Performance Battery, range 0-12), perceived physical fatigability (Pittsburgh Fatigability Scale, range 0-50), and Borg Rating of Perceived Exertion (RPE, range 6-20) at completion of the 400 m LDCW. Stepwise linear regression was used. Internal validation was completed using data-splitting method (70%; 30%). Mean VO2 peak was 20.2 ± 4.8 mL/kg/min and mean 400 m WS was 1.06 ± 0.2 m/s. Each 0.05 m/s increment in 400 m WS was associated with a 0.40 mL/kg/min higher VO2 peak after covariate adjustment. An estimating equation including 400 m WS, age, sex, race, and RPE was developed. Internal validation showed low overall bias (-0.26) and strong correlation (r = 0.71) between predicted and measured VO2 peak values. Bland-Altman plot and regression analyses indicated predicted VO2 peak was an acceptable alternative, despite mean underestimation of 4.53 mL/kg/min among the highly fit. Usual-paced 400 m LDCW strongly correlates with direct measures of CRF during CPET in older adults with lower fitness and can be used to test both fitness and function.

ESTIMATING CARDIORESPIRATORY FITNESS USING A USUAL-PACED 400 M–LONG DISTANCE CORRIDOR WALK IN OLDER ADULTS

Abstract Cardiopulmonary exercise testing (CPET) is the gold standard to measure cardiorespiratory fitness (CRF), assessed as peak oxygen consumption (VO2peak), yet is not always feasible in older adults due to cost, safety, and participant burden. Usual-paced 400-m Long Distance Corridor Walk (LDCW), a measure of mobility, may be an alternative to traditional CPET. We examined whether usual-paced 400-m LDCW was associated with VO2peak among older adults using cross-sectional data in SOMMA. Participants (N=820, age = 76.2±4.9, 58% women, 86% White) completed a usual-paced 400-m LDCW (seconds) and a treadmill CPET using a modified symptom-limited protocol at baseline. VO2peak (mL/kg/min) was defined as the highest 20-second average O2 consumption achieved during CPET. Mean VO2peak was 20.2±4.8 mL/kg/min and mean usual-paced 400-m LDCW time was 388.8±69.7 seconds. Usual-paced 400-m LDCW time was moderately inversely correlated with VO2peak (r=-0.52, p<0.0001). Potential covariates considered for the step-wise linear regression included age, sex, body mass index (BMI), Borg Rating of Perceived Exertion (RPE, range 6-20) at end of usual-paced 400-m LDCW, min/week moderate-vigorous physical activity (MVPA, CHAMPS questionnaire), 4-m gait speed, and Short Physical Performance Battery (range 0-12). The final parsimonious model included usual-paced 400-m LDCW time, age, sex, BMI, RPE, and MVPA. Every 30-second higher usual-paced 400-m LDCW time was associated with a 1.98 mL/kg/min lower VO2peak (p < 0.001), explaining 30.5% of the 55.7% total variance in VO2peak. Usual-paced 400-m LDCW was a strong estimator of CRF (VO2peak) after adjustment, providing an inexpensive and safer alternative among older adults across ranges of physical function and fitness.

Changes in Physical Function and Body Composition among Group Lifestyle Balance Program Participants with Arthritis

Weight loss through diet and physical activity (PA) is recommended for osteoarthritis (OA) management. The Group Lifestyle Balance Program (GLBP) is an evidence-based, behavior change program designed to promote weight loss in individuals with prediabetes or metabolic syndrome through PA and healthy eating. To date, the GLBP has not been evaluated on those with OA specifically. PURPOSE: To examine the effects of the GLBP on measures of body composition and physical function (PF) in overweight and obese (BMI > 27) individuals with OA (N=15). METHODS: This study used a single-group, quasi-experimental design with repeated measures. All participants received the GLBP and outcome variables were obtained at baseline, 3, 6, and 12 months. Lean mass (LM), fat mass (FM), and body fat percentage (BF%) were obtained via bioelectric impedance. Total weight (WT), Body Mass Index (BMI), and waist circumference (WC) were also obtained. Measures of PF included the Short Physical Performance Battery (SPPB), grip strength (GS), 30-second chair stand test (CS30), and the Long Distance Corridor Walk (LDCW). The SPPB includes the time to complete 5 repeated chair stands (5CS), balance testing (side-by-side stand, semi-tandem stand, and tandem stand), and an 8-foot walk. The Friedman test was used to examine differences in SPPB scores and one-way repeated measures analysis of variance was used to examine mean differences in scores for all other outcomes. RESULTS: Participants had a mean age of 70.20 ± 3.95 years and were primarily white (93%), female (80%) and college educated (67%). There was a significant effect of time for WT (F(1.448, 20.275) = 6.591, p = .011), BMI (F(1.529, 21.408) = 6.474, p = .010), and WC (F(2.898, 40.566) = 4.826, p = .006). Bonferroni post hoc analyses indicated WT (p = .001), BMI (p = .002), and WC (p = .022) significantly improved from baseline to 3 months. There was also a significant effect of time for 5CS (F(3, 42) = 3.190, p = .033) and CS30 (F(3, 42) = 6.956, p = .001). Post hoc analyses indicated CS30 scores significantly improved from baseline to 3 months and from baseline to 12 months (p = .007). There were no significant differences observed for any other outcome measure (p > 0.05). CONCLUSION: The GLBP may be effective at improving weight and physical function measures in people with OA, but more research is warranted.

Sensorimotor Peripheral Nerve Function and the Longitudinal Relationship With Endurance Walking in the Health, Aging and Body Composition Study

ObjectivesTo determine whether lower extremity sensorimotor peripheral nerve deficits are associated with reduced walking endurance in older adults. DesignProspective cohort study with 6 years of follow-up. SettingTwo university research clinics. ParticipantsCommunity-dwelling older adults enrolled in the Health, Aging and Body Composition Study from the 2000–2001 annual clinical examination (N=2393; mean age ± SD, 76.5±2.9y; 48.2% men; 38.2% black) and a subset with longitudinal data (n=1178). InterventionsNot applicable. Main Outcome MeasuresParticipants underwent peripheral nerve function examination in 2000–2001, including peroneal motor nerve conduction amplitude and velocity, vibration perception threshold, and monofilament testing. Symptoms of lower extremity peripheral neuropathy included numbness or tingling and sudden stabbing, burning, pain, or aches in the feet or legs. The Long Distance Corridor Walk (LDCW) (400m) was administered in 2000–2001 and every 2 years afterward for 6 years to assess endurance walking performance over time. ResultsIn separate, fully adjusted linear mixed models, poor vibration threshold (>130μm), 10-g and 1.4-g monofilament insensitivity were each associated with a slower 400-m walk completion time (16.0s, 14.4s, and 6.9s slower, respectively; P<.05 for each). Poor motor amplitude (<1mV), poor vibration perception threshold, and 10-g monofilament insensitivity were related to greater slowing per year (4.7, 4.2, and 3.8 additional seconds per year, respectively; P<.05), although poor motor amplitude was not associated with initial completion time. ConclusionsPoorer sensorimotor peripheral nerve function is related to slower endurance walking and greater slowing longitudinally. Interventions to reduce the burden of sensorimotor peripheral nerve function impairments should be considered to help older adults maintain walking endurance—a critical component for remaining independent in the community.

Physical Activity and Change in Long Distance Corridor Walk Performance in the Health, Aging, and Body Composition Study.

To examine the prospective relationship between self-reported physical activity and aerobic fitness in the Health, Aging, and Body Composition Study (Health ABC) using the Long Distance Corridor Walk (LDCW). Cohort study with 7 years of follow-up. Two U.S. clinical sites. Community-dwelling older adults enrolled in Health ABC (N = 3,075, aged 70-79, 52% female, 42% black) with no self-reported difficulty walking one-quarter of a mile or climbing 10 steps. Participants were classified based on a physical activity questionnaire as being inactive (≤1,000 kcal/wk exercise activity, ≤2,719 kcal/wk total physical activity), lifestyle active (≤1,000 kcal/wk exercise activity, >2,719 kcal/wk total physical activity), or exercisers (≥1,000 kcal/wk exercise activity). The LDCW, an endurance walking test (400 m), was administered at Years 1 (baseline), 2, 4, 6, and 8 to assess aerobic fitness. At baseline, LDCW completion times (adjusted for age and sex) were 351.8 seconds (95% confidence interval (CI) = 346.9-356.8 seconds) for the inactive group, 335.9 seconds (95% CI = 332.7-339.1 seconds) for the lifestyle active group, and 307.7 seconds (95% CI = 303.2-312.3 seconds) for the exerciser group (P < .001). From baseline to Year 8, the inactive group slowed 36.1 seconds (95% CI = 28.4-43.8 seconds), the lifestyle active group slowed 38.1 seconds (95% CI = 33.6-42.4 seconds), and the exerciser group slowed 40.8 seconds (95% CI = 35.2-46.5 seconds), and did not differ significantly between groups. In linear mixed-effects models, the rate of change in LDCW time did not differ between the groups, although exercisers consistently had the fastest completion times (P < .001 for all pairwise comparisons). Decline in LDCW time occurred regardless of baseline activity, although exercisers maintained higher aerobic fitness, which may delay reaching a critically low threshold of aerobic fitness at which independence is impaired.

Ambulatory Function in Men with and without HIV Infection: Association with Cardiorespiratory Fitness

Objective: The study purpose was to compare ambulatory function in men with and without HIV infection, and test the association with aerobic exercise capacity. Methods: We conducted a cross-sectional study of 45 HIV-infected men and 37 age and race-matched HIVuninfected men at the Baltimore VA Medical Center. Participants performed cardiorespiratory exercise testing, sixminute walk (6-MW) and the 400-meter long distance corridor walk (LDCW) as part of a study of veterans without history of CVD. Results: The mean (SD) age was 55 (6) years. Among the 82 male participants, 98% were African American race. The 6-MW distance correlated with aerobic exercise capacity (VO2peak) in both HIV-infected subjects (r=0.50, p 0.1). Between HIV groups, there was a significant difference in LDCW (p=0.01) but not in 6-MW (p=0.3). Conclusions: In HIV-infected men without known CVD the 6-MW and LDCW, provide similar estimates of aerobic exercise capacity. The findings are comparable to uninfected men with similar demographic and clinical characteristics, and support endurance walk tests to estimate aerobic exercise capacity in HIV-infected patients.

Walking capacity of bariatric surgery candidates

Background This study characterizes the walking limitations of bariatric surgery candidates by age and body mass index (BMI) and determines factors independently associated with walking capacity. The setting was multi-institutional at research university hospitals in the United States. Methods Participants of the Longitudinal Assessment of Bariatric Surgery study (n=2458; age 18–78 yr, BMI 33–94 kg/m 2) attended a preoperative research visit. Their walking capacity was measured by self-report and the 400 m Long Distance Corridor Walk (LDCW). Results Almost two thirds (64%) of subjects reported limitations with walking several blocks, 48% had an objectively defined mobility deficit, and 16% reported at least some walking aid use. In multivariate analysis, BMI, older age, lower income, and greater bodily pain were independently associated ( P < .05) with walking aid use, physical discomfort during the LDCW, an inability to complete the LDCW, and a slower time to complete the LDCW. Female gender, Hispanic ethnicity (but not race), greater heart rate at rest, a history of smoking, several co-morbidities (history of stroke, ischemic heart disease, diabetes, asthma, sleep apnea, venous edema with ulcerations), and depressive symptoms were also independently related ( P < .05) to at least one measure of reduced walking capacity. Conclusions Walking limitations are common in bariatric surgery candidates, even among the least severely obese and youngest patients. Physical activity counseling must be tailored to individuals' abilities. Although several factors identified in the present study (eg, BMI, age, pain, co-morbidities) should be considered, directly assessing the patient's walking capacity will facilitate appropriate goal setting.

Use of Self-paced Walking Tests to Estimate Aerobic Fitness in Older HIV-infected Patients

PURPOSE: HIV-infected patients treated with highly active antiretroviral therapy (HAART) have increased risk for impaired aerobic capacity. Effects of aging could have an additional impact as HAART now prolongs survival for an estimated 30-50 years. Measuring aerobic capacity is cumbersome and requires resources that are not readily available to many clinicians. It is possible that field tests conducted in the office or clinic could provide adequate information regarding patients' aerobic capacity. This research aimed to determine the feasibility of using self-paced walking tests for estimating aerobic capacity in older HIV-infected patients. METHODS: 15 HIV-infected men, aged 50+ years (58 ± 5 yrs) on HAART, performed a modified Bruce graded exercise test (GXT) to exhaustion, a 6-minute walk (6-MW), and a Long Distance Corridor Walk (LDCW) on separate visits. CD4 cell count was high in these asymptomatic patients (441± 215 cells/uL). Associations between VO2peak and 6-MW distance and the 400-meter time of the LDCW were tested by Pearson correlation coefficients. Paired t-tests were used to compare ending heart rate for each test. Data are mean ± standard deviation. RESULTS: Tests were well tolerated by all subjects. Performance in the 6-MW (535 ± 92 meters) and the LDCW (400-m, 266 ± 41 seconds) walking tests were strongly correlated (r = -0.84, p<0.001). There was a linear association between VO2peak (19.4 ± 4.3 mL/kg/min) and both 6-MW distance (r = 0.55, p = 0.03) and 400-meter time (r = -0.65, p <0.01). Ending heart rate was the same for 6-MW (117 ± 15 bpm) and 400-m (118 ± 18 bpm) and was lower than the GXT (141 ± 14 bpm)(p<0.01). CD4 count was not associated with performance in any of the tests (p>0.2). CONCLUSIONS: These preliminary results suggest that self-paced walking tests may provide a safe and reasonable estimate of aerobic capacity in older HIV-infected patients on HAART. Additional subjects will help to determine the optimal protocol and covariates to derive an equation for estimating VO2peak.

Mobility Limitation in Self-Described Well-Functioning Older Adults: Importance of Endurance Walk Testing

Mobility limitations are prevalent, potentially reversible precursors to mobility loss that may go undetected in older adults. This study evaluates standardized administration of an endurance walk test for identifying unrecognized and impending mobility limitation in community elders. Men and women (1480 and 1576, respectively) aged 70-79 years with no reported mobility limitation participating in the Health, Aging and Body Composition study were administered the Long Distance Corridor Walk. Walk performance was examined to determine unrecognized mobility deficits at baseline and predict new self-recognition of mobility limitation within 2 years. On testing, 23% and 36% of men and women evidenced mobility deficits defined as a contraindication to exertion, meeting stopping criteria or exceeding 7 minutes to walk 400 m. Unrecognized deficits increased with age and were more prevalent in blacks, smokers, obese individuals, and infrequent walkers. Within 2 years, 21% and 34% of men and women developed newly recognized mobility limitation; those with baseline unrecognized deficits had higher rates, 40% and 54% (p <.001), respectively. For each additional 30 seconds over 5 minutes needed to walk 400 m, likelihood of newly recognized mobility limitation increased by 65% and 37% in men and women independent of age, race, obesity, smoking status, habitual walking, reported walking ease, and usual gait speed. A sizable proportion of elders who report no walking difficulty have observable deficits in walking performance that precede and predict their recognition of mobility limitation. Endurance walk testing can help identify these deficits and provide the basis for treatment to delay progression of mobility loss.

Use of physical performance measures to predict future disability and mortality in older cancer patients: The Health Aging and Body Composition Study (Health ABC)

9553 Background: Optimal treatment for older cancer patients remains unclear due to a poor understanding of which clinical characteristics predict toxicity and survival. Our objective was to examine baseline physical performance measures as predictors of future disability or death in older adults with incident cancer diagnoses. Methods: Among 3,075 individuals aged ≥70 years participating in the Health ABC observational study, 431 had a confirmed cancer diagnosis in the first 6 years of follow-up. Measures of physical performance included usual gait speed over 20 meters, 400 meter long distance corridor walk, and grip strength. We assessed the relationship between measures of physical performance most closely preceding cancer diagnosis and progression to major disability or death at 2 years after diagnosis. Major disability is defined by any of the following: requiring cane or walker for ambulation, inability to walk a quarter mile and/or climb 10 steps, or requiring assistance with activities of daily living. 404 subjects had complete data for analysis. Logistic regression models were fit for each performance measure, adjusting for demographics, health habits, comorbidity, metastatic disease, and cancer type. Results: The mean age was 77.1±3.3 years; 35.6% were female; and 44.7% were black. Progression to disability or death at 2 years after diagnosis occurred in 45.7%. Mean gait speed was 1.2±0.2 meters/second (m/s) and mean grip strength was 33.7±11.9 kilograms. A 0.1 m/s faster usual gait speed on the 20 meter course was associated with a 15% decrease in risk of subsequent disability or death (OR=0.85, 0.74- 0.96). Individuals who completed the long distance corridor walk had a 66% decrease in risk of subsequent disability or death compared to those who were unable to complete the test (OR=0.34, 0.19–0.60). There was no association between grip strength and progression to disability or death (OR=0.98, 0.96–1.02). Conclusions: In our study of cancer patients aged ≥70years, pre-diagnosis physical performance is independently associated with progression to disability or death. These results suggest that simple performance tests may provide useful information in pre-treatment evaluations of older adults with cancer. No significant financial relationships to disclose.

Associations Among Walking Performance, Physical Activity, and Subclinical Cardiovascular Disease

An objective measure of walking performance could have several potential applications in clinical settings. The cross-sectional relationships among long distance corridor walk (LDCW) time, physical activity, and subclinical cardiovascular disease (CVD) measures were examined before group randomization in 492 participants (mean age, 57.0+/-2.9 years) from the Women On the Move Through Activity and Nutrition (WOMAN) study, a randomized clinical trial involving postmenopausal women. Longer walk times were significantly associated with higher body mass index (P<0001), average waist circumference (P<0001), and lower levels of physical activity (P<002). The proportion of detectable coronary artery calcification and median aortic pulse wave velocity levels were significantly higher among those with slower walk times (P<002 and P<.001, respectively). Findings from the current report support the utility of the LDCW to identify women at higher risk for CVD who may be candidates for further cardiovascular testing or intensive lifestyle intervention.

Estimating Cardiorespiratory Fitness in Well‐Functioning Older Adults: Treadmill Validation of the Long Distance Corridor Walk

To determine criterion validity of the 400-m walk component of the Long Distance Corridor Walk (LDCW) and develop equations for estimating peak oxygen consumption (VO2) from 400-m time and factors intrinsic to test performance (e.g., heart rate (HR) and systolic blood pressure (SBP) response) in older adults. Cross-sectional validation study. Gerontology Research Center, National Institute on Aging, Baltimore, Maryland. Healthy volunteers (56 men and 46 women) aged 60 to 91 participating in the Baltimore Longitudinal Study of Aging between August 1999 and July 2000. The LDCW, consisting of a 2-minute walk followed immediately by a 400-m walk "done as quickly as possible" over a 20-m course was administered the day after maximal treadmill testing. HR and SBP were measured before testing and at the end of the 400-m walk. Weight, height, activity level, perceived effort, and stride length were also acquired. Peak VO2 ranged from 12.2 to 31.1 mL oxygen/kg per minute, and 400-m time ranged from 2 minutes 52 seconds to 6 minutes 18 seconds. Correlation between 400-m time and peak VO2 was -0.79. The estimating equation from linear regression included 400-m time (partial coefficient of determination (R2)=0.625), long versus short stride (partial R2=0.090), ending SBP (partial R2=0.019), and a correction factor for fast 400-m time (<240 seconds; partial R2=0.020) and explained 75.5% of the variance in peak VO2 (correlation coefficient=0.87). A 400-m walk performed as part of the LDCW provides a valid estimate of peak VO2 in older adults. Incorporating low-cost, safe assessments of fitness in clinical and research settings can identify early evidence of physical decline and individuals who may benefit from therapeutic interventions.

Measuring fitness in healthy older adults: the Health ABC Long Distance Corridor Walk.

The Health ABC Long Distance Corridor Walk (LDCW) was designed to extend the testing range of self-paced walking tests of fitness for older adults by including a warm-up and timing performance over 400 meters. This study compares performance on the LDCW and 6-minute walk to determine whether the LDCW encourages greater participant effort. Subjects were administered the LDCW and 6-minute walk during a single visit. Test order alternated between subjects, and a 15-minute rest was given between tests. The Baltimore Veterans Affairs Medical Center. Twenty volunteers age 70 to 78. The LDCW, consisting of a 2-minute warm-up walk followed by a 400-meter walk and a 6-minute walk test were administered using a 20-meter long course in an unobstructed hallway. Heart rate (HR) and blood pressure (BP) were recorded at rest and before and after all walks. All 20 subjects walked a faster pace over 400 meters than for 6 minutes, in which the mean distance covered was 402 meters. From paired t-tests, walking speed was faster (mean difference = 0.23 m/sec; P < .001), and ending HR (mean difference = 7.6 bpm; P < .001) and systolic BP (mean difference = 8.3 mmHg; P = .024) were greater for the 400-meter walk than for the 6-minute walk. Results were independent of test order and subject fitness level. Providing a warm-up walk and using a target distance instead of time encouraged subjects to work closer to their maximum capacity. This low-cost alternative to treadmill testing can be used in research and clinical settings to assess fitness and help identify early functional decline in older adults.

ESTIMATING FITNESS IN OLDER ADULTS

This study evaluated the validity of the Long Distance Corridor Walk (LDCW) as a low cost alternative to treadmill-based assessment of cardiorespiratory fitness in older adults. The LDCW consist of: 1) a 2-min warm-up walk (“covering as much ground as possible”) that also serves as a stepped-down test for those unable to walk for a longer period and 2) a 400m walk “done as quickly as possible”. The 400m component has been found to encourage greater effort than time-limited tests, such as the 6-min walk. Overall and sex-specific equations for estimating VO2max using time to walk 400m, age, race, HR and BP response, perceived effort, height, weight, stride length, and activity level were also developed. The study population consisted of 56 men and 46 women aged 60–91 participating in the Baltimore Longitudinal Study on Aging who had a maximal treadmill test with measured O2 consumption. Subjects did the LDCW the day after treadmill testing on a 20m course. VO2max ranged from 12.2 - 31.1 ml O2/kg/min and time on the 400m walk ranged from 2:52 to 6:18. The correlation between 400m walk time and VO2max was −0.79. The linear regression equation including all variables listed explained 76% of the variance in VO2max. Using a stepwise procedure, only 400m walk time (partial R2 = .625), stride length (partial R2 = 0.55), and ending SBP (partial R2 = 0.32) entered the model explaining 74% of the variance in VO2max. The LDCW provides a valid estimate of cardiorespiratory fitness in older adults. Time to walk 400m with adjustment for stride length and effort, as indicated by ending SBP, produces remarkably close estimates of VO2max, correlating 0.82 for men and 0.86 for women with that determined from a maximal treadmill test.

Longitudinal variations in maximal oxygen intake with age and activity.

Longitudinal variations in maximal oxygen intake with age and activity.