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

Abstract

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.

Is Skeletal Muscle Dysfunction a Limiting Factor of Exercise Functional Capacity in Patients with Sickle Cell Disease?

“…The absolute distance performed during the 6-MWT was significantly reduced in SCD patients as previously described [ 9 , 10 , 11 , 12 , 13 , 14 ], and we hypothesized that the apparition of skeletal muscle fatigue during the test could have participated in the lower distance reached by SCD patients. However, the 6-MWT did not result in skeletal muscle fatigue as shown by the absence of significant reduction in Tmax and/or modification in the RMS value during and after the 6-MWT.…”

“…SCD patients display low functional capacity as demonstrated by the reduced distance performed by patients during a 6-min walk test (6-MWT) [ 9 , 10 , 11 , 12 , 13 , 14 ]. The 6-MWT is a submaximal exercise test used in a clinical setting to assess functional capacity in various chronic diseases [ 15 , 16 ].…”

Evaluation of the functional capacity and quality of life of children and adolescents during and after cancer treatment

“…As for the sample calculation, this was based on the study by Melo, 11 considering an alpha of 5% and power of 80%, with an estimate of 48 patients to detect the difference between the intervention and control groups. Data were presented as mean ± standard deviation and median, for scalar data and absolute frequency, and percentage for categorical data.…”

End points for sickle cell disease clinical trials: renal and cardiopulmonary, cure, and low-resource settings

“…77 The panel identified more literature on cardiopulmonary outcomes in adults associated with abnormal 6-minute walk test results. 70,74,81 Therefore, the panel recommends using the 6-minute walk test as an outcome in adult SCD trials but recognizes that in the future, this may be expanded to pediatric trials. 82 ACS ACS is a frequent complication in both children and adults living with SCD.…”