Six-minute Walk Test In Children Research Articles

Response to the six-minute walk test in children with cardiovascular risk

Cardiovascular risk (CVR) is defined as the possibility of a subject suffering from car diovascular disease within a certain period. Although the pathology appears in adult life, the physiopathological changes start to develop at an early age. To establish the relationship bet ween cardiorespiratory capacity (CRC)and CVR in children with metabolic syndrome. We analyzed data corresponding to 42 children aged from 5 to 15 years who were seen at the Children's Cardiology Unit of the Carlos Van Buren Hospital between 2015 and 2017. Each parti cipant was categorized according to the Alustiza's CVR score, which defines 3 levels of risk: low (0 to 6 points), medium (7 to 8 points) and high (9 or more points), which representing a greater probability of developing cardiovascular disease, and performed 6MWT. The mean age of the children was 10.9 ± 2.7 years, body mass index (BMI) = 31.0 ± 4.6 kg/m2 (z-score 3.2 ± 0.7), percentage of theoretical distance walked = 75.2 ± 8.9, and percentage of heart rate reserve (HRR) = 31.0 ± 9.4. There was no statistical association between 6MWT and CVR. There is no relationship between the cardiorespiratory capacity and the CVR. The use of the 6MWT is questioned as an ins trument to assess CVR in the population under study.

Six-minute Walk Test in Children with Cerebral Palsy: Comparing the Walking Distance between Different Level of Communication Function

Introduction: Children with cerebral palsy (CP), six-minute walk test (6MWT) is more difficult to perform because some children have communication impairment. The objective to study the distance of 6MWT among different level of communication in children with CP.Methods: This study was cross-sectional study , in a Rehabilitation Clinic, on Juli to December 2018. The subjects were children aged 7-18 years old with cerebral palsy with Gross Motor Function Classification System (GMFCS) I-III, Communication Function Classification System (CFCS) I-III, able to walkindependently with or without aid, and understand the instruction of 6MWT. All the subjects performed 6MWT. Level of communication function was evaluated by CFCS. The 6MWD between CFCS groups were compared.Results: There were 23 subjects mean aged 9 years old, consisted of 17(73.9%) male and 6(26.1%) female, with GMFCS level I-III in sequence were 3(13%), 11(47.8%), and 9(39.1%), also with CFCS level I-III in sequence were 5(21.7%), 7(30.4%), and 11(47.8%). Subjects with verbal communicationwere 14(60.9%) and nonverbal communication were 9(39.1%). The median of 6MWD in group with CFCS level I, II, and III respectively were 115 (60-282), 161 (17.5-281), and 135 (23-280) m. There was no significant difference in 6MWD between different groups of CFCS (p=0.960).Conclusion: There were no difference in walking distance on 6MWT among different level of communication function in children with CP.Keywords: Cerebral palsy, Six-minute walk-test, Six-minute walking-distance, Communication Function Classification System (CFCS)

Minimal detectable change in six-minute walk test in children and adolescents with cystic fibrosis

Purpose To provide test-retest reliability for the 6-min walk test and the physiological variables obtained during the test, and to establish the minimal detectable change for the distance walked in children and adolescents with cystic fibrosis. Methods 40 patients performed two 6-min walk tests on the same day (separated by 30-min of rest). The perceived breathlessness and fatigue in the legs were assessed with the modified Borg scale. The peripheral muscle strength was assessed using a hand dynamometer device, the medicine ball throw test and the horizontal jump test. Results The test-retest reliability of the distance walked, dyspnea and fatigue in the legs were good for children (minimal detectable change90–95: 59.39–70.55 m) and for adolescents (minimal detectable change90–95: 47.81–56.8 m) with cystic fibrosis. Exercise tolerance is more related to 6-min walk work (distance walked x body weight) than to the distance walked alone and showed a positive association with peripheral muscle strength and forced vital capacity. Conclusions The 6-min walk test is a reproducible and reliable tool to measure exercise tolerance for children and adolescents with cystic fibrosis. The minimal detectable changes reported for the distances achieved by these patients will be useful to identify the effectiveness of therapies aimed at alleviating or improving impaired physical capacity. IMPLICATIONS FOR REHABILITATION The 6-min walk test could be used to measure exercise tolerance for children and adolescents with cystic fibrosis, as it is a reliable test over time. An increase in the distance covered in the 6-min walk test that exceeds the minimum detectable change is recommended to determine improved exercise tolerance for children and adolescents with cystic fibrosis. The use of the 6-min walk work (distance walked x body weight) is recommended because it correlates better with exercise tolerance than the distance alone in children and adolescents with cystic fibrosis.

Improvement of the Six-Minute Walk Test in Children with Sickle Cell Disease over Time

The six-minute walk test (6MWT) was introduced in adults and children suffering from pulmonary or cardio-vascular conditions to assess their sub-maximal functional exercise capacity. In sickle cell disease (SCD), a reduced 6-minute walk distance was observed in adults with chronic pain, hip avascular necrosis and osteopenia ; and in children with low hemoglobin level, low fetal hemoglobin, a baseline elevated TRV. In a previous study (Dedeken et al., PLoS One 2014), we also showed that abnormal 6MWT was significantly associated with the presence of silent infarct.The aim of our study is to explore the evaluation of the 6MWT over time and to confirm the correlation with the cerebral vasculopathy in a larger cohort.This study was conducted at Hôpital Universitaire des Enfants Reine Fabiola (Brussels, Belgium) and included SCD children older than 6 years, regularly followed between 2011 and 2017 and who had at least two 6MWT. The age-standardized predicted value of the 6-minute walk distance (6MWD) was established as reported by Geiger. The 6MWT was considered as normal if the 6MWD was more than 80% of the age-standardized predicted value. Baseline hematological values, clinical events, cerebro-vascular disease, cardio-pulmonary parameters and disease-modifying treatment (DMT) were compared between those with normal and abnormal 6MWT and according to the 6MWD and between the 1st and the 2nd 6MWT overtime.118 patients have been assessed twice and had at first evaluation a 6MWD of 90.6% (Range 49-119%), with an abnormal test found in 5.1%. The characteristics of the patients are detailed in the Table 1. The changes of the 6MWD and the biological data over time are detailed in Table 2. After 4 years of follow-up, 77.1% of patients were treated with Hydroxyurea (HU) and 16.6% patients were chronically transfused. In parallel with the increased HU prescribing rate, we have observed a significant increase of the Hb and the MCV and a decrease of reticulocytes and hemolysis parameters. The first 6WMT was performed at the median age of 10.3 years and the last one at the median age of 14.1 years. The median 6MWD increased over time including for non-chronically transfused patients. Girls performed less well in the 6MWT (93% for girls vs. 95.7% for boys; P = 0.03). Acute chest syndrome was significantly more frequent in boys (62%) compare to girls (38.7%). Nevertheless, no other differences were founded between boys and girls regarding biological values, clinical events or DMT. 26.5% of our patients have silent infarcts at a median age of 14.6 years. The 6MWD was the same in patients with and without silent infarcts (92.5% vs. 95% ; P=0.17) even when chronically transfused patients were excluded (94% vs. 95% ; P= 0.20). Patients with silent infarcts have a significant lower hemoglobin level and higher reticulocytes count, neutrophils count, LDH and MCV.In conclusion, the 6MWD observed in our cohort characterized by a very high rate of HU treatment is much higher than published in others series and improved over time. With only 5% of SCD patients having a 6MWD < 80% of the normal predicted value at last evaluation, we were not able anymore to confirm a correlation between the presence of silent infracts and abnormal 6MWT. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Six-minute walk test in children and adolescents with renal diseases: tolerance, reproducibility and comparison with healthy subjects

OBJECTIVES:To evaluate exercise tolerance and the reproducibility of the six-minute walk test in Brazilian children and adolescents with chronic kidney disease and to compare their functional exercise capacities with reference values for healthy children.METHODS:This cross-sectional study assessed the use of the six-minute walk test in children and adolescents aged 6-16 with stage V chronic kidney disease. For statistical analysis of exercise tolerance, including examinations of correlations and comparisons with reference values, the longest walked distances were considered. The reproducibility of the six-minute walk test was assessed using intraclass correlation coefficients.RESULTS:A total of 38 patients (14 females and 24 males) were evaluated, including 5 on peritoneal dialysis, 12 on hemodialysis and 21 who had undergone renal transplantation, with a median age of 11.2 years (6.5-16). The median walked distance was 538.5 meters (413-685) and the six-minute walk test was found to be reproducible. The walked distance was significantly correlated with age (r=0.66), weight (r=0.76), height (r=0.82), the height Z score (r=0.41), hemoglobin (r=0.46), hematocrit (r=0.47) and post-test systolic blood pressure (r=0.39). The chronic kidney disease patients predicted walked distance was 84.1% of the reference value according to age, 90.6% according to age-corrected height and 87.4% according to a predictive equation.CONCLUSIONS:The stage V chronic kidney disease patients had a significantly decreased functional exercise capacity, as measured by the six-minute walk test, compared with the healthy pediatric reference values. In addition, the six-minute walk test was shown to be well tolerated, reliable and applicable as a low-cost tool to monitor functional exercise capacity in patients with renal disease.

Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review.

ObjectiveThe aim of the study is to compare the available reference values and the six-minute walk test equations in healthy children/adolescents. Our systematic review was planned and performed in accordance with the PRISMA guidelines. We included all studies that established reference values for the six-minute walk test in healthy children/adolescents.MethodsTo perform this review, a research was performed in PubMed, EMBASE (via SCOPUS) and Cochrane (LILACS), Bibliographic Index Spanish in Health Sciences, Organization Collection Pan-American Health Organization, Publications of the World Health Organization and Scientific Electronic Library Online (SciELO) via Virtual Health Library until June 2015 without language restriction.ResultsThe initial research identified 276 abstracts. Twelve studies met the inclusion criteria and were fully reviewed and approved by both reviewers. None of the selected studies presented sample size calculation. Most of the studies recruited children and adolescents from school. Six studies reported the use of random samples. Most studies used a corridor of 30 meters. All studies followed the American Thoracic Society guidelines to perform the six-minute walk test. The walked distance ranged 159 meters among the studies. Of the 12 included studies, 7 (58%) reported descriptive data and 6 (50%) established reference equation for the walked distance in the six-minute walk test.ConclusionThe reference value for the six-minute walk test in children and adolescents ranged substantially from studies in different countries. A reference equation was not provided in all studies, but the ones available took into account well established variables in the context of exercise performance, such as height, heart rate, age and weight. Countries that did not established reference values for the six-minute walk test should be encouraged to do because it would help their clinicians and researchers have a more precise interpretation of the test.

Six-Minute Walk Test in Children With Spastic Cerebral Palsy and Children Developing Typically

To quantify the 6-minute walk test (6MWT) in children with spastic cerebral palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels I to III and to compare with a sample of children with typical development (TD). A total of 145 children with CP and 137 children with TD completed the 6MWT. Mean 6MWT scores were 439.57 ± 49.81 m for children functioning at GMFCS level I (n = 74), 386.74 ± 66.47 m for GMFCS level II (n = 53), 305.28 ± 66.95 m for GMFCS level III (n = 18), and 528.42 ± 67.77 m for children with TD (n = 137). Results of a pair-wise comparison showed significant differences (P < .001) between 6MWT scores of children with CP across GMFCS levels I to III and children with TD. A range of 6-minute walk distance reference values for children with spastic CP and children with TD were established.

Commentary on "Six-Minute Walk Test in Children With Spastic Cerebral Palsy and Children Developing Typically".

“How can I apply this information?” The 6-minute walk test (6MWT) may be useful to assess and quantify walking skills in children with spastic cerebral palsy functioning at Gross Motor Function Classification System (GMFCS) levels I through III. This study described a modified 6MWT protocol that may be necessary or helpful in a clinical setting. The mean distances for each GMFCS level and for children with typical development, as well as the differences between these groups, may assist therapists with comparing outcomes and setting appropriate goals for this population. “What should I be mindful of when applying this information?” Age and height correlated with 6MWT results, but the relationship strengths were low and inconsistent between groups. Therefore, further studies are needed to substantiate the variables that predict walking outcomes. The modified 6MWT protocol may have contributed to the results of this study differing from previous research. Therapists need to determine the most appropriate 6MWT course design and protocol for their setting and patients, while identifying how modifications may affect outcomes. In addition to the potential biases mentioned in the study, therapists may want to consider the time of day, joint range of motion, and frequency/intensity of therapy services when clinically administering and interpreting the 6MWT. Heather Hanson, PT, DPT, PCS Janet Rosenberg, PT Step by Step Developmental Services Rochester, New York

Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children

Objectiveto compare physical performance and cardiorespiratory responses in the six-minute walk test (6MWT) in asthmatic children with reference values for healthy children in the same age group, and to correlate them with intervening variables. Methodsthis was a cross-sectional, prospective study that evaluated children with moderate/severe asthma, aged between 6 and 16 years, in outpatient follow-up. Demographic and spirometric test data were collected. All patients answered the pediatric asthma quality of life (QoL) questionnaire (PAQLQ) and level of basal physical activity. The 6MWT was performed, following the American Thoracic Society recommendations. Comparison of means was performed using Student's t-test and Pearson's correlation to analyze the 6MWT with study variables. The significance level was set at 5%. Results40 children with moderate or severe asthma were included, 52.5% males, 70% with normal weight and sedentary. Mean age was 11.3 ± 2.1 years, mean height was 1.5± 0.1 m, and mean weight was 40.8 ± 12.6 Kg. The mean distance walked in the 6MWT was significantly lower, corresponding to 71.9% ± 19.7% of predicted values; sedentary children had the worst values. The difference between the distance walked on the test and the predicted values showed positive correlation with age (r = 0.373, p = 0.018) and negative correlation with cardiac rate at the end of the test (r = –0.518, p < 0.001). Regarding QoL assessment, the values in the question about physical activity limitations showed the worst scores, with a negative correlation with walked distance difference (r= –0.311, p = 0.051). Conclusionsasthmatic children's performance in the 6MWT evaluated through distance walked is significantly lower than the predicted values for healthy children of the same age, and is directly influenced by sedentary life style.

Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children

Objectiveto compare physical performance and cardiorespiratory responses in the six-minute walk test (6MWT) in asthmatic children with reference values for healthy children in the same age group, and to correlate them with intervening variables. Methodsthis was a cross-sectional, prospective study that evaluated children with moderate/severe asthma, aged between 6 and 16 years, in outpatient follow-up. Demographic and spirometric test data were collected. All patients answered the pediatric asthma quality of life (QoL) questionnaire (PAQLQ) and level of basal physical activity. The 6MWT was performed, following the American Thoracic Society recommendations. Comparison of means was performed using Student's t-test and Pearson's correlation to analyze the 6MWT with study variables. The significance level was set at 5%. Results40 children with moderate or severe asthma were included, 52.5% males, 70% with normal weight and sedentary. Mean age was 11.3±2.1 years, mean height was 1.5±0.1 m, and mean weight was 40.8±12.6 Kg. The mean distance walked in the 6MWT was significantly lower, corresponding to 71.9%±19.7% of predicted values; sedentary children had the worst values. The difference between the distance walked on the test and the predicted values showed positive correlation with age (r=0.373, p=0.018) and negative correlation with cardiac rate at the end of the test (r=-0.518, p<0.001). Regarding QoL assessment, the values in the question about physical activity limitations showed the worst scores, with a negative correlation with walked distance difference (r=-0.311, p=0.051). Conclusionsasthmatic children's performance in the 6MWT evaluated through distance walked is significantly lower than the predicted values for healthy children of the same age, and is directly influenced by sedentary life style.

Six-Minute Walk Test in Children With Cerebral Palsy Gross Motor Function Classification System Levels I and II: Reproducibility, Validity, and Training Effects

Nsenga Leunkeu A, Shephard RJ, Ahmaidi S. Six-minute walk test in children with cerebral palsy Gross Motor Function Classification System levels I and II: reproducibility, validity, and training effects. ObjectivesTo assess the reproducibility and validity of the 6-minute walk test (6MWT) with gas collection, and to evaluate effectiveness of a walking program in children with cerebral palsy (CP). DesignAssessment and controlled training study. SettingRehabilitation service. ParticipantsChildren/adolescents with CP (N=24; 12 boys, 12 girls; mean age, 14.2±2.0y, Gross Motor Function Classification System levels I and II). InterventionAfter a cycle-ergometer stress test and the 6MWT, subjects were assigned to training (n=12, 40min of moderate walking exercise 3 times per week for 8wk) or a matched control group (n=12). Main Outcome MeasuresPeak oxygen consumption (V̇o2peak), peak ventilation, peak heart rate, and 6MWT distance. ResultsTest-retest correlations for the 6MWT were good (V̇o2peak: r=.90, P<.001, intraclass correlation coefficient [ICC]=.85; peak ventilation: r=.88, P<.001, ICC=.83; peak heart rate: r=.86, P<.001, ICC=.82; distance walked: r=.87, P=.007, ICC=.80). Mean scores for the 6MWT also closely matched corresponding cycle-ergometer data. Significant improvements in 6MWT V̇o2peak, peak ventilation, and peak heart rate were found after 8 weeks of training (P<.05). ConclusionsThe 6MWT appears reproducible and valid relative to cycle-ergometer assessments of cardiorespiratory responses, and offers a simple method of clinical assessment. An 8-week moderate walking program improves the cardiopulmonary fitness of children with CP, as measured by 6MWT.

Six-minute walk test in children with chronic conditions

Six-minute walk test in children with chronic conditions

Six-Minute Walk Test in Children and Adolescents

Six-Minute Walk Test in Children and Adolescents

Six-minute walk test in children with chronic conditions

ObjectivesThe 6-minute walk test (6MWT) is a frequently used indicator of functional exercise capacity. The goals of this study were to compare the 6-minute walk performance of three paediatric patient...

Six-Minute Walk Test in Children and Adolescents

To evaluate the 6-minute walking distance (6MWD) for healthy Caucasian children and adolescents of a population-based sample from the age of 3 to 18 years. Two hundred and eighty boys and 248 girls completed a modified test, using a measuring wheel as incentive device. Median 6MWD increased from the age of 3 to 11 years in boys and girls alike and increased further with increasing age in boys (from 667.3 m to 727.6 m), whereas it essentially plateaued in girls (655.8 m to 660.9 m). After adjusting for age, height (P = .001 in boys and P < .001 in girls) remained independently correlated with the 6MWD. In the best fitting and most efficient linear and quadratic regression models, the variables age and height explained about 49% of the variability of the 6MWD in boys and 50% in girls. This modified 6-minute walk test (6MWT) proved to be safe, easy to perform, and highly acceptable to children. It provides a simple and inexpensive means to measure functional exercise capacity in children, even of young age, and might be of value when conducting comparable studies.

Physiologic response of the six-minute walk test in children with juvenile idiopathic arthritis

To determine the physiologic response of the 6-minute walk test (6-mwt) in children with juvenile idiopathic arthritis (JIA). Eighteen children with JIA (age 7-17 years; 6 boys, 12 girls) performed a 6-mwt and a maximal exercise test. The physiologic response of the 6-mwt was on average between 80% and 85% of the peak values of heart rate and oxygen uptake (VO2peak) during the maximal exercise test, except for the minute ventilation, which had a mean percentage of 68.5%. Backward regression analysis showed that height and distance walked were the best predictors of VO2peak during cycling (R2 = 0.883, P < 0.001). During the 6-mwt, the difference between the first and second minute was significant in every variable, except for heart rate. The range of walking distance of children with JIA was comparable with that of healthy elderly people. The physiologic response of the 6-mwt is at a submaximal, intense level of exercise. The course of the responses during the 6-mwt was normal. The 6-mwt can be regarded as a good test for measuring functional exercise capacity.