Can the six-minute walk distance predict the occurrence of acute exacerbations of COPD in patients in Brazil?

Morakami, Fernanda Kazmierski; Morita, Andrea Akemi; Bisca, Gianna Waldrich; Felcar, Josiane Marques; Ribeiro, Marcelo Leite; Furlanetto, Karina Couto; Hernandes, Nídia A.; Pitta, Fábio

doi:10.1590/s1806-37562016000000197

Cited by 11 publications

(13 citation statements)

References 27 publications

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“…Garrod et al 8 reported that patients participating in an 8-week exercise training program and receiving supplemental oxygen showed significant improvement in the 6MWD (169 ± 112 m vs. 269 ± 124 m; p = 0.001) and in Chronic Respiratory Disease Questionnaire scores (24.0 vs. 17.4; p < 0.001) when compared with those who participated in the program but did not receive supplemental oxygen 8 . The finding of a higher mean 6MWD is consistent with those of Morakami et al, 31 who compared COPD patients in Brazil and Austria and found that mean walking time and movement intensity were greater in the former than in the latter.…”

Section: Discussionsupporting

confidence: 86%

Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

et al. 2018

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Objective: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. Methods: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen. The Saint George’s Respiratory Questionnaire (SGRQ) was used in order to assess quality of life, and the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index was calculated. The frequency of exacerbations and the mortality rate were noted. Treatment nonadherence was defined as LTOT use for < 12 h per day or no LTOT use during exercise. Results: A total of 60 patients with COPD and exertional hypoxemia were included in the study. Of those, 10 died and 11 experienced severe hypoxemia during follow-up, 39 patients therefore being included in the final analysis. Of those, only 18 (46.1%) were adherent to LTOT, showing better SGRQ scores, higher SpO2 values, and lower PaCO2 values than did nonadherent patients. In all patients, SaO2, the six-minute walk distance, and the BODE index worsened after one year. There were no differences between the proportions of adherence to LTOT at 3 and 12 months of follow-up. Conclusions: Quality of life appears to be lower in patients with COPD and exertional hypoxemia who do not adhere to LTOT than in those who do. In addition, LTOT appears to have a beneficial effect on COPD symptoms (as assessed by SGRQ scores). (Brazilian Registry of Clinical Trials - ReBEC; identification number RBR-9b4v63 [http://www.ensaiosclinicos.gov.br])

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Section: Discussionsupporting

confidence: 86%

Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

et al. 2018

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“…Although fat distribution and the decline in lean mass occurred differently in patients with COPD when compared to healthy individuals, it was not global. The decrease in lower limb muscle strength, primarily in the femoral quadriceps, is more marked in patients with COPD than in healthy individuals [14,26]. In the present study, despite the worse muscle performance of individuals with severe or very severe disease, the difference was not statistically significant, as reported by Costa et al [27].…”

Section: Discussionsupporting

confidence: 49%

Handgrip strength and its relation to isokinetic dynamometry in COPD

et al. 2020

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Introduction: Muscle dysfunction is one of the major changes found in chronic obstructive pulmonary disease (COPD) and associated with loss of functionality, morbidity and mortality. Objective: correlate two strength assessment methods: manual dynamometry for handgrip strength and isokinetic dynamometry for quadriceps strength in patients with COPD, and assess the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE), quality of life and muscle strength. Method: twenty-five patients with moderate to very severe COPD were evaluated by pulmonary function parameters, anthropometric variables, functional capacity, via the six-minute walk test, dyspnea, applying the modified Medical Research Council (mMRC) scale, BODE, quality of life, using the Saint George's Respiratory Questionnaire (SGRQ), handgrip strength with manual dynamometer and quadriceps force using an isokinetic dynamometer. Muscle strength was assessed with a manual portable dynamometer and isokinetic dynamometer. For statistical analysis, ANOVA with Bonferroni’s post-test, the chi-squared test and Pearson's correlation coefficient were used. Results: There was a strong correlation between the strength measurements and the two instruments (torque and quadriceps extension power with right handgrip strength: r = 0.74; p <0.001). The patients classified as very severe exhibited worse performance in the strength tests when compared to the moderate group, albeit with no statistically significant difference. Conclusion: In muscle strength measurements, a strong correlation was detected between the isokinetic dynamometer for quadriceps and the manual dynamometer for handgrip strength. These findings indicate that, in clinical practice, the manual dynamometer for handgrip strength could be used to assess peripheral muscle strength in patients with COPD.

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“…[9][10][11][12] The six-minute-walk test (6MWT) has been widely used to assess exercise capacity and predict COPD exacerbations. 10,[13][14][15] A recent systematic review suggested that, in the 6MWT, shorter walking distances indicated a high risk of severe and moderate COPD exacerbations, in which a severe exacerbation resulted in hospital admission. 10 Some studies found that a walking distance <350 m (or proxy) was an effective cut-off point for predicting exacerbations.…”

Section: Introductionmentioning

confidence: 99%

The five-repetition sit-to-stand test is a predictive factor of severe exacerbations in COPD

Medina-Mirapeix

Bernabeu-Mora

Valera-Novella

et al. 2021

Therapeutic Advances in Chronic Disease

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Background: Although the six-minute-walk test (6MWT) has been used to predict chronic obstructive pulmonary disease (COPD) exacerbations, additional research is necessary to identify more rapid, simpler tests that are directly associated with exacerbations, such as the five-repetition sit-to-stand (5STS) test and 4-m gait speed (4MGS) test. Aims: To determine the ability of the 5STS and 4MGS tests in predicting severe exacerbations in stable COPD over the following year, and to assess the ability of the best prognostic test to identify patients at high risk of hospital admission correctly. Methods: This prospective study included 137 patients with stable COPD. Multiple logistic regression models were constructed to assess whether the 6MWT, 5STS, and 4MGS tests were associated with severe exacerbations in the year following the test. Receiver-operating characteristic curves and the area under the curve (AUC) were evaluated to determine the accuracy of each test for identifying patients with severe exacerbations. Results: Scores of <350 m for the 6WMT and ⩽2 for the 5STS test were associated with severe exacerbations in the model adjusted for age and the number of exacerbations in the previous year. The 5STS test and the 6MWT had very similar predictive and discriminative abilities. Odds ratios were 3.20 (95% confidence interval [CI] 1.14–8.96) and 3.84 (95% CI 1.14–12.94) and AUCs were 0.793 (95% CI 0.704–0.882) and 0.783 (95% CI 0.686–0.879), respectively. Conclusions: The 5STS test predicted the risk of severe exacerbation within the following year among patients with COPD. The 5STS test could replace the 6MWT for identifying patients at high risk of hospital admission.

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Can the six-minute walk distance predict the occurrence of acute exacerbations of COPD in patients in Brazil?

Cited by 11 publications

References 27 publications

Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

Handgrip strength and its relation to isokinetic dynamometry in COPD

The five-repetition sit-to-stand test is a predictive factor of severe exacerbations in COPD

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