Could peak oxygen uptake be estimated from proposed equations based on the six-minute walk test in chronic heart failure subjects?
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ABSTRACT:
SUBMITTER: Ribeiro-Samora GA
PROVIDER: S-EPMC5537474 | biostudies-other | 2017 Mar - Apr
REPOSITORIES: biostudies-other
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Project description:Background: To date, there is no reference for a 6-min walk test distance (6-MWD) immediately after cardiac surgery. Therefore, this study aimed to identify the determinants and to generate equations for prediction reference for 6-MWD in patients immediately after cardiac surgery. Methods: This is a cross-sectional study of the 6-min walk test (6-MWT) prior to participation in the cardiac rehabilitation (CR) program of patients after coronary artery bypass surgery (CABG) or valve surgery. The 6-MWT were carried out in a gymnasium prior to the CR program immediately after the cardiac surgery. Available demographic and clinical data of patients were analyzed to identify the clinical determinants of 6-MWD. Results: This study obtained and analyzed the data of 1,509 patients after CABG and 632 patients after valve surgery. The 6-MWD of all patients was 321.5 ± 73.2 m (60-577). The distance was longer in the valve surgery group than that of patients in the CABG group (327.75 ± 70.5 vs. 313.59 ± 75.8 m, p < 0.001). The determinants which significantly influence the 6-MWD in the CABG group were age, gender, diabetes, atrial fibrillation, and body height, whereas in the valve surgery group these were age, gender, and atrial fibrillation. The multivariable regression models generated two formulas using the identified clinical determinants for patients after CABG: 6-MWD (meter) = 212.57 + 30.47 (if male gender) - 1.62 (age in year) + 1.09 (body height in cm) - 12.68 (if with diabetes) - 28.36 (if with atrial fibrillation), and for patients after valve surgery with the formula: 6-MWD (meter) = 371.05 + 37.98 (if male gender) - 1.36 (age in years) - 10.61 (if atrial with fibrillation). Conclusion: This study identified several determinants for the 6-MWD and successively generated two reference equations for predicting 6-MWD in patients after CABG and valve surgery.
| S-EPMC8416754 | biostudies-literature
Project description:BackgroundCurrent statistics indicate that the overall cost of heart disease exceeds IDR 6.67 trillion per year. This growing concern has led researches on heart failure patient readmission in developing countries, and opened discussions on tactics to suppress hospital readmission rates. This study assesses the potential of VO2max and METs obtained from the 6-min walk test in predicting heart failure patient readmission.MethodsThis seven-month prospective cohort study recruited patients with heart failure which then underwent the 6-min walk test before discharged. Walking distance, estimated VO2 max, and METs were calculated and recorded. Patients were then followed-up for 3 months to track readmissions under the same diagnosis during the research period. The correlation between VO2max and METs with patient readmission was assessed.ResultsA total of 93 samples were included in this study. The results demonstrated that VO2max and METs correlate with incidence of heart failure readmission ≤30 days post discharge, with VO2max showing a moderate ability to predict patient readmissions with a cut-off of 14.5 mL/kgBW/minute (C = 0.750, p < 0.001), while METs showed a weak ability to predict readmissions with a cut-off of 3.8 (C = 0.743, p < 0.001).ConclusionsVO2 max and METs values acquired from 6MWT examination correlates with heart failure patient readmission ≤30 days. This knowledge can be used to prevent increased readmission rates, therefore hoping that it will be able to reduce the burden of treatment costs on heart failure patients.
| S-EPMC9142551 | biostudies-literature
Project description:Background and objectiveAlthough the six-minute walk test (6MWT) is widely used as a measure of exercise capacity, it may not be applicable in some settings and populations. This issue has led to increased use of the two-minute walk test (2MWT) to assess exercise capacity. The main objective of this study is to establish reference equations for the two-minute walk distance (2MWD) in healthy Chinese adults aged 18-85 years.MethodsA total of 973 volunteers took part in the study. We obtained verbal consent from all participants before the test, and the study design was approved by the ethics committees of Wenzhou People's Hospital. The participants performed two 2MWTs using a standardized protocol, and the longer distance was used for further analysis. Stepwise multiple regression analysis was performed using age, height and weight as independent variables and was used to establish the reference equations for the 2MWD in the male and female groups.ResultsThe mean walking distance for all participants was 199.1±25.81 m. Age and height were identified as independent factors that influenced the 2MWD, and they explained 35% and 34% of the variance in distance for the male and female groups, respectively.ConclusionThis study resulted in determination of reference equations for predicting the 2MWD in healthy Chinese adults. These 2MWD standards will provide useful references for medical care in some settings and populations.
| S-EPMC6085060 | biostudies-literature
Project description:BackgroundIn spinal muscular atrophy (SMA), weakness, decreased endurance, and fatigue limit mobility. Scales have been developed to measure function across the wide spectrum of disease severity. However, these scales typically are observer dependent, and scores are based on sums across Likert-scaled items. The Six-Minute Walk Test (6MWT) is an objective, easily administered, and standardized evaluation of functional exercise capacity that has been proven reliable in other neurologic disorders and in children.MethodsTo study the performance of the 6MWT in SMA, 18 ambulatory participants were evaluated in a cross-sectional study. Clinical measures were 6MWT, 10-m walk/run, Hammersmith Functional Motor Scale-Expanded (HFMSE), forced vital capacity, and handheld dynamometry. Associations between the 6MWT total distance and other outcomes were analyzed using Spearman correlation coefficients. A paired t test was used to compare the mean distance walked in the first and sixth minutes.ResultsThe 6MWT was associated with the HFMSE score (r = 0.83, p < 0.0001), 10-m walk/run (r = -0.87, p < 0.0001), and knee flexor strength (r = 0.62, p = 0.01). Gait velocity decreased during successive minutes in nearly all participants. The average first minute distance (57.5 m) was significantly more than the sixth minute distance (48 m) (p = 0.0003).ConclusionThe Six-Minute Walk Test (6MWT) can be safely performed in ambulatory patients with spinal muscular atrophy (SMA), correlates with established outcome measures, and is sensitive to fatigue-related changes. The 6MWT is a promising candidate outcome measure for clinical trials in ambulatory subjects with SMA.
| S-EPMC2839195 | biostudies-literature
Project description:Functional tests such as Motor Function Measure-32 (MFM-32), supine to stand, ascend/descend stairs permit the assessment of task-specific motor function in neuromuscular disease (NMD). The 6-min walk test (6MWT), though functional, is primarily used to assess endurance and disease progression in children with neuromuscular disorders. Barriers to 6MWT administration, in this population, can include reduced attention span due to age and inability to tolerate test length due to weakness. We propose task-specific functional deficits are related to endurance. Additionally, the 2-min walk test (2MWT) could effectively replace the 6MWT in this population. Seventy-seven participants, ages 5-18, with a variety of neuromuscular disorders performed the 6MWT, timed functional tests (TFT), and the MFM-32. Correlation and paired t-test analyses were used to compare the distance walked in the first 2 min (2MWD) to the distance walked in the entire 6 min (6MWD) and to the functional outcome measures above. The 2MWD strongly correlated with 6MWD and the other outcome measures. Paired t-test analysis also showed that the 2MWD did not differ from the distance walked in the last 2 min of the 6MWT. Although equivalence testing could not reject the claim that this difference exceeded the upper practical limit of 9.5 m, it only showed a modest overestimation of the 4-6MWD compared with the 2MWD. Together, our results support the ability of the 2MWD to predict the 6MWD, specifically in the pediatric neuromuscular disease population.
| S-EPMC6423958 | biostudies-literature
Project description:IntroductionSix Minute Walk Test (6MWT) is a simple test used to measure exercise capacity in Chronic Pulmonary Diseases (CPDs). Decreased exercise capacity significantly affects the quality of life. The 6MWT is a known tool to measure exercise capacity and quality of life in CPD. However, the role of change in follow up Six Minute Walk Distance (6MWD) in assessing mortality and its correlation with known prognostic factors haven't been tested to the best of our knowledge.AimTo study the correlation of change in 6MWD with change in spirometry and to study the role of 6MWD in predicting mortality in CPD.Settings and designProspective cohort study.Materials and methodsA total of 139 CPD patients were grouped into obstructive, restrictive and post Tuberculosis (TB) sequelae. Optimized treatment was given and they were followed up regularly. Spirometry and 6MWT was done at the beginning and after one year. Mean decline in FEV1, FVC was correlated with mean decline in 6MWD.Statistical analysisWith STATA 13.1 correlation between 6MWT and spirometric values were done using Wilcoxon signed rank test. Predictors of mortality were studied using multivariate analysis.ResultsOverall mean decline in 6MWD was 16.07 m/year. There was no correlation between mean change in 6MWD and change in FEV1, FVC, and FEV1/FVC. On multivariate analysis, 6MWD was the better predictor of mortality than FEV1 (p<0.001), FVC (p<0.001). At cut off value of 240 meters, sensitivity and specificity of 6MWT in predicting mortality was 71.05% and 81.94% respectively.ConclusionThe 6MWD changes independently and has no correlation with change in spirometry, it is an independent predictor of mortality in CPD.
| S-EPMC5449834 | biostudies-literature
Project description:The six-minute walk test (6MWT) is a simple test that is widely used to assess functional exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Patients with IPF have reduced exercise capacity due to a number of factors, such as impaired respiratory mechanics and circulatory problems. As a self-paced and usually submaximal exercise test, the 6MWT reflects the exercise level of everyday activities. Variables measured during the 6MWT, such as six-minute walk distance (6MWD) and desaturation, are strong predictors of mortality in patients with IPF. However, the results of a 6MWT are affected by numerous factors, including age, body size, comorbidities and the use of supplemental oxygen during the test, and these need to be borne in mind when interpreting the results of individual and serial tests. Clinical studies, including trials of potential therapies for IPF, have differed in the methodology used to implement the 6MWT, hindering the comparison of results across studies. In this review, I describe the utility of the 6MWT in patients with IPF and provide recommendations for standardisation of the test for use both in clinical practice and research. A brief video on how to set up and administer the 6MWT is available at http://www.usscicomms.com/respiratory/lancaster/6mwt/.
| S-EPMC6291931 | biostudies-literature
Project description:BackgroundMeasurement of oxygen saturation (SpO2) during the 6 minute walk test (6MWT) could be impacted by the measurement site.AimsTo compare SpO2 and heart rate (HR) between forehead and finger sensors during the 6MWT. Sensor readings were also to be compared for signal quality and with capillary blood gas (CBG) pre and post 6MWT.Method80 subjects with pulmonary vascular disease (PVD) and/or interstitial lung disease (ILD) performed the 6MWT. Pulse oximetry was recorded at 30 s intervals. CBG was taken pre and post 6MWT to determine capillary oxygen saturation (SCO2).ResultsThe forehead sensor recorded higher values for SpO2 (p < 0.001) and HR (p < 0.01) compared with the finger sensor during the 6MWT. For both sensors, the demonstrated bias compared to CBG post 6MWT was higher and more variable in subjects who desaturated. During the 6MWT there was a higher occurrence (p < 0.001) of poor signal quality in the finger sensor compared with the forehead sensor.ConclusionThis study suggests that the sensor site can impact pulse oximetry readings. The variance in bias suggests pulse oximetry may not accurately reflect SCO2 measurements particularly in subjects who desaturate during 6MWT.
| S-EPMC8796114 | biostudies-literature
Project description:The six-minute walk (6MW) is a common walking outcome in multiple sclerosis (MS) thought to measure fatigability in addition to overall walking disability. However, direct evidence of 6MW induced gait deterioration is limited by the difficulty of measuring qualitative changes in walking.This study aims to (1) define and validate a measure of fatigue-related gait deterioration based on data from body-worn sensors; and (2) use this measure to detect gait deterioration induced by the 6MW.Gait deterioration was assessed using the Warp Score, a measure of similarity between gait cycles based on dynamic time warping (DTW). Cycles from later minutes were compared to baseline cycles in 89 subjects with MS and 29 controls. Correlation, corrected (partial) correlation, and linear regression were used to quantify relationships to walking and fatigue outcomes.Warp Scores rose between minute 3 and minute 6 in subjects with mild and moderate disability (p<0.001). Statistically significant correlations (p<0.001) to the MS walking scale (MSWS-12), modified fatigue impact scale (MFIS) physical subscale, and cerebellar and pyramidal functional system scores (FSS) were observed even after controlling for walking speed. Regression of MSWS-12 scores on Warp Scores and walking speed explained 73.9% of response variance. Correlations to individual MSWS-12 and MFIS items strongly suggest a relationship to fatigability.The Warp Score has been validated in MS subjects as an objective measure of fatigue-related gait deterioration. Progressive changes to gait cycles induced by the 6MW often appeared in later minutes, supporting the importance of sustained walking in clinical assessment.
| S-EPMC5035201 | biostudies-literature
Project description:BackgroundThe six-minute walk test (6MWT) is a safe, simple, inexpensive tool for evaluating the functional exercise capacity of patients with chronic respiratory disease. However, there is a lack of standard reference equations for the six-minute walk distance (6MWD) in the healthy Chinese population aged 18-59 years.AimsThe purposes of the present study were as follows: 1) to measure the anthropometric data and walking distance of a sample of healthy Chinese Han people aged 18-59 years; 2) to construct reference equations for the 6MWD; 3) to compare the measured 6MWD with previously published equations.MethodThe anthropometric data, demographic information, lung function, and walking distance of Chinese adults aged 18-59 years were prospectively measured using a standardized protocol. We obtained verbal consent from all the subjects before the test, and the study design was approved by the ethics committee of Wenzhou People's Hospital. The 6MWT was performed twice, and the longer distance was used for further analysis.ResultsA total of 643 subjects (319 females and 324 males) completed the 6MWT, and average walking distance was 601.6±55.51 m. The walking distance was compared between females and males (578±49.85 m vs. 623±52.53 m; p < 0.0001) and between physically active subjects and sedentary subjects (609.3±56.17 m vs. 592±53.23 m; p < 0.0001). Pearson's correlation indicated that the 6MWD was significantly correlated with various demographic and the 6MWT variables, such as age, height, weight, body mass index (BMI), heart rate after the test and the difference in the heart rate before and after the test. Stepwise multiple regression analysis showed that age and height were independent predictors associated with the 6MWD. The reference equations from white, Canadian and Chilean populations tended to overestimate the walking distance in our subjects, while Brazilian and Arabian equations tended to underestimate the walking distance. There was no significant difference in the walking distance between Korean reference equations and the results of the current study.ConclusionIn summary, age and height were the most significant predictors of the 6MWD, and regression equations could explain approximately 34% and 28% of the distance variance in the female and male groups, respectively.
| S-EPMC5598997 | biostudies-literature