The historical evolution of the six-minute walk test as a measure of functional exercise capacity: a narrative review

Ubuane, Peter Odion; Animasahun, Barakat Adeola; Ajiboye, Olufunke Adewumi; Kayode-Awe, Mogbafolu Olugbemiga; Ajayi, Omotola Aderiyike; Njokanma, Fidelis O

doi:10.21037/jxym.2018.11.01

Cited by 6 publications

(14 citation statements)

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“…It is recognised that maximal or peak values of oxygen uptake measured at high intensity work rates are considered the gold standard of cardiorespiratory fitness testing [ 34 ] but this requires compliance, skilled expertise and expensive equipment for the measurement of gas exchange. While the 6MWT is not a gold standard measure of fitness it has wide acceptance and utility, particularly for non-athletes and children [ 35 ] as a pragmatic measure of functional capacity. The measurement of recovery heart rates following the 6MWT is a novel measure of fitness.…”

Section: Discussionmentioning

confidence: 99%

Relationships between physical function, body composition and metabolic health in Pacific Island youth

et al. 2022

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The Pacific Islands Families (PIF) study is a birth cohort study designed to increase knowledge about the growth and development of Pacific children living in Auckland, New Zealand. Adolescence is a critical time of growth and development, yet the roles of physical function and body composition in metabolic health at this life stage are not clear. We aimed to investigate associations between measures of physical function (the 6-minute-walk-test (6MWT)), heart rate changes before and after the 6MWT, handgrip strength, body composition including appendicular skeletal muscle mass (ASMM) measured by dual-energy X-ray absorptiometry and biomarkers of metabolic health from a fasting blood sample.A total of 200 youth (98 girls, 102 boys) aged 14–15 years, from the birth-cohort of children in the Pacific Islands families study were measured. In girls, the proportion of ASMM was lower and fat higher than in boys. Controlling for age, a 1% increase in ASMM predicted a longer walk distance (+6.3, 95%CI 2.2, 10.4 m in girls; +7.1, 95%CI 4.4, 9.1 m in boys) and lower heart rate following the 6MWT. ASMM and fat mass were independently predictive of maximal handgrip strength which was increased by 1.4 (1.0,1.8) kg in girls and 1.7 (1.3, 2.0) kg in boys for each kg increase in ASMM and reduced by 0.23 (0.08, 0.38) kg in girls and 0.26 (0.14, 0.37) kg in boys for each kg increase in fat mass. Lower total cholesterol and LDL were associated with an increase in distance walked in boys only. For each year of age, distance walked was reduced by 34 (15, 53) m in girls and 59 (36,84) m in boys. These findings should be explored further in the context of other influences such as food security, opportunities for physical activity and cultural expectations.

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Section: Discussionmentioning

confidence: 99%

Relationships between physical function, body composition and metabolic health in Pacific Island youth

et al. 2022

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“…Our data adds to existing published ones for Nigerian adolescents (21) and adults, (8,22) thus completing Nigerian references spanning school-age to adulthood, while also filling an acknowledged paucity of 6MWT data from sub-Saharan Africa. (9,15) The 6MWT is a valid and reliable measure of functional exercise capacity widely used in adults and children with disorders like asthma, congenital heart diseases, sickle cell disorders and others. (4,5,7,13).…”

Section: Discussionmentioning

confidence: 99%

Development of reference equations for the six-minute walk distance of school-aged Nigerian children

Ubuane

Ajiboye

Adekunle

et al. 2021

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BACKGROUND: The six-minute walk test (6MWT), a simple, reliable and valid test that uses the distance walked in six minutes (six-minute walk distance, 6MWD) to quantify functional exercise capacity, is widely used in chronic cardiopulmonary and non-cardiopulmonary disorders. However, th absence of reference standards for Nigerian school-aged children limits its utility in this age group OBJECTIVES: To develop normative values and equations for the 6MWT of school-aged Nigerian children METHODS: In a cross-sectional study, healthy Nigerian children aged 6-11 years in Lagos completed 6MWT on 20-meter straight outdoor courses in their schools following standardized guidelines. Potential predictors: demographic (age, sex), anthropometric (height, weight, chest circumference, leg length) and physiological data [pre-walk, immediate post-walk and 5th-minute post-walk heart rate (HR), oxygen saturation (SpO2), systolic blood pressure (SBP), diastolic blood pressure (DBP) and rating of perceived exertion (RPE)] and the difference between pre-walk and post-walk HR (HR change), SpO2 (SpO2 change), SBP (SBP change), DBP (DBP change) and RPE (RPE change). Primary outcomes:six-minute walk distance (6MWD) in meters. RESULTS: Overall, 627 pupils (52.1% girls) walked 504.6 (66.6) m (95% CI: 499.4, 509.8), ranging from 326.6 to 673.0 m; boys walking 16 m longer (p=0.002). Stepwise linear regression yielded 6MWD=347.9+14(Age in years)+1.6(HR change)+17.6(sex; male=1, female=0)+1.2(SBP change);R square=0.25.Previously published reference equations mostly over-estimated Nigerian children's 6MWD. CONCLUSION: The reference values and equations, after validation in other Nigerian geographic populations, may be useful for the functional evaluation of Nigerian children aged 6-11 years with chronic childhood disorders.

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“…In 2002, the American Thoracic Society (ATS) developed and published guidelines on how to implement the test in a standardised manner (Crapo, Enright & Zeballos 2002). These guidelines aim to promote consistent clinical application of the test, thereby allowing comparisons, globally, across studies (Ubuane et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Whilst the gold standard for the objective measurement of maximal functional capacity is cardiopulmonary exercise testing (CPET), (Ubuane et al 2018), one can argue that this resource-heavy (i.e. equipment, training) test is often not feasible or necessary.…”

Section: Introductionmentioning

confidence: 99%

“…Reasons for this include its applicability in various populations, physiological systems and settings. Additionally, the test is easy to perform, not time-consuming, does not require additional equipment or special skills and is also more representative of the exertion of everyday activities (Bellet et al 2011;Chetta et al 2006;Ubuane et al 2018).…”

Section: Introductionmentioning

confidence: 99%

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Six-minute walk test protocol variations in low-resource settings – A scoping review

Fell

Hanekom

Heine

2021

South African Journal of Physiotherapy

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Background: The 6-min walk test (6MWT) is a validated tool, of submaximal intensity, used to objectively measure functional exercise capacity. In 2002, the American Thoracic Society (ATS) developed guidelines on standardising the implementation of the 6MWT. Despite the relative ease of conducting the 6MWT as per these guidelines, adaptations are implemented.Objectives: Identify (1) what 6MWT adaptations to the ATS guidelines have been described in low-resource settings (LRS), (2) the purpose of the adapted 6MWT and (3) the reported argumentation for making these adaptations in relation to the specific context.Methods: Five databases were searched from inception until February 2021. Studies that adapted and conducted the 6MWT in LRS were included. Data concerning the study source, participants, 6MWT: purpose, variations, outcome and rationale were extracted.Results: A total of 24 studies were included. The majority of studies (n = 18; 75%) were conducted in lower-middle income countries. The most common adaptation implemented was variation to course length. Eight studies provided a rationale for adapting the 6MWT. Space constraint was the most common reason for adaptation.Conclusion: The most common reason (space constraints) for adapting the 6MWT in LRS was addressed through adaptations in course length and/or configuration. The results of this review suggest that the value of the ATS-guided 6MWT in LRS may need to be re-evaluated.Clinical implications: Using adapted forms of the 6MWT may lead to an underestimation of a patient’s abilities, misinformed discharge and developing inappropriate exercise programmes. Additionally, diverting from ATS guidelines may affect the continuity of care.

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The historical evolution of the six-minute walk test as a measure of functional exercise capacity: a narrative review

Cited by 6 publications

References 0 publications

Relationships between physical function, body composition and metabolic health in Pacific Island youth

Relationships between physical function, body composition and metabolic health in Pacific Island youth

Development of reference equations for the six-minute walk distance of school-aged Nigerian children

Six-minute walk test protocol variations in low-resource settings – A scoping review

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