Screening for physical inactivity among adults: the value of distance walked in the six-minute walk test. A cross-sectional diagnostic study

Abstract

CONTEXT AND OBJECTIVES: Accelerometry provides objective measurement of physical activity levels, but is unfeasible in clinical practice. Thus, we aimed to identify physical fitness tests capable of predicting physical inactivity among adults. DESIGN AND SETTING: Diagnostic test study developed at a university laboratory and a diagnostic clinic. METHODS: 188 asymptomatic subjects underwent assessment of physical activity levels through accelerometry, ergospirometry on treadmill, body composition from bioelectrical impedance, isokinetic muscle function, postural balance on a force platform and six-minute walk test. We conducted descriptive analysis and multiple logistic regression including age, sex, oxygen uptake, body fat, center of pressure, quadriceps peak torque, distance covered in six-minute walk test and steps/day in the model, as predictors of physical inactivity. We also determined sensitivity (S), specificity (Sp) and area under the curve of the main predictors by means of receiver operating characteristic curves. RESULTS:The prevalence of physical inactivity was 14%. The mean number of steps/day (≤ 5357) was the best predictor of physical inactivity (S = 99%; Sp = 82%). The best physical fitness test was a distance in the six-minute walk test and ≤ 96% of predicted values (S = 70%; Sp = 80%). Body fat > 25% was also significant (S = 83%; Sp = 51%). After logistic regression, steps/day and distance in the six-minute walk test remained predictors of physical inactivity. CONCLUSION:The six-minute walk test should be included in epidemiological studies as a simple and cheap tool for screening for physical inactivity. RESUMO CONTEXTO E OBJETIVOS:A acelerometria fornece medida objetiva do nível de atividade física, porém não é viável na prática clínica. Assim, foram investigados testes de aptidão física capazes de predizer inatividade física em adultos. DESENHO E LOCAL: Estudo de teste diagnóstico, desenvolvido em laboratório universitário e uma clínica de diagnósticos. MÉTODOS: 188 participantes assintomáticos tiveram o nível de atividade física avaliado por acelerometria, ergoespirometria em esteira, composição corporal por bioimpedância, função muscular isocinética, equilíbrio postural em plataforma de força e teste de caminhada de seis minutos. Foram realizadas análise descritiva e regressão logística múltipla, incluindo idade, sexo, consumo de oxigênio, gordura corporal, centro de pressão, pico de torque de quadríceps, distância percorrida no teste de caminhada de seis minutos e passos/dia no modelo como preditores da inatividade física. Adicionalmente, foram determinadas a sensibilidade (S), especificidade (Sp) e área abaixo da curva dos principais preditores por meio de curvas de característica de operação do receptor. RESULTADOS: A prevalência da inatividade física foi 14%. O número médio de passos/dia (≤ 5357) foi o melhor preditor da inatividade física (S = 99%, Sp = 82%). O melhor teste de aptidão física foi a distância no teste de caminhada de seis minutos e ≤ 96% dos valores preditos (S...

Self-Administered Six-Minute Walk Test Using a Free Smartphone App in Asymptomatic Adults: Reliability and Reproducibility

“…The six-minute walk test may be helpful in healthy asymptomatic subjects for cardiovascular risk screening in the clinical practice [4], due to its low cost, easy application, and performed in international standardization [6]. Furthermore, a walking distance below 96% of the predicted values can identify asymptomatic adults with low physical activity levels [11] and cardiorespiratory fitness [12]. Thus, it can be an excellent strategy to reduce the risk of cardiovascular disease.…”

Is the six-minute walk test still reliable compared to cardiopulmonary exercise test for exercise capacity in children with congenital heart disease?

“…Nevertheless, the criteria for the descending level of the 6MWT distance to evaluate the degree of exercise capacity was controversial and unclear. Dourado ( 24 ) and Sperandio ( 25 ) et al verified that a 6MWT distance below 96% is a critical point for identifying physically inactive adults with cardiorespiratory fitness levels below the normal range. Although there are differences in the subjects and statistical methods, it also indicates that the aerobic capacity of children with CHD is distinct from that of the general adult population.…”

Content validity and test–retest reliability with principal component analysis of the translated Malay four-item version of Paffenbarger physical activity questionnaire

“…These questions assessed the subject's lifestyle by identifying how many stairs they climbed up each day and the distances they walked on average. Sperandio's study showed that walking less than 500 meters per week was the best predictor of physical inactivity [9] as it provided a better research metric for epidemiologic research and better public health targets than walking duration [10].…”