Prognostic value of the 6 min walk test in bronchiolitis obliterans syndrome

Nathan, Steven D.; Shlobin, Oksana A.; Reese, Erika; Ahmad, Shahzad; Fregoso, M.; Athale, Chanda; Barnett, Scott D.

doi:10.1016/j.rmed.2009.07.011

Cited by 13 publications

(6 citation statements)

References 24 publications

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“…One assessed the association with hospitalisation and found a statistically significant association [134]. Finally, all four studies (100%) that included patients with other respiratory disease or on the list for transplantation found statistically significant associations of 6MWD with mortality (table S26) [138][139][140][141].…”

Section: Relationship Of 6mwd To Clinical Outcomesmentioning

confidence: 96%

“…14 studies included patients with COPD [109][110][111][112][113][114][115][116][117][118][119][120][121][122], eight studies included patients with ILD [69,[123][124][125][126][127][128][129], nine studies included patients with PAH [43,[130][131][132][133][134][135][136][137] and four included studies patients with other chronic respiratory disease or on the list for transplantation [138][139][140][141]. Average 6MWD at baseline was between 300 and 450 m ( fig.…”

Section: Relationship Of 6mwd To Clinical Outcomesmentioning

confidence: 99%

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An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Singh¹,

Puhan²,

et al. 2014

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This systematic review examined the measurement properties of the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease.Studies that report the evaluation or use of the 6MWT, ISWT or ESWT were included. We searched electronic databases for studies published between January 2000 and September 2013.The 6-min walking distance (6MWD) is a reliable measure (intra-class correlation coefficients ranged from 0.82 to 0.99 in seven studies). There is a learning effect, with greater distance walked on the second test (pooled mean improvement of 26 m in 13 studies). Reliability was similar for ISWT and ESWT, with a learning effect also evident for ISWT (pooled mean improvement of 20 m in six studies). The 6MWD correlates more strongly with peak work capacity (r50.59-0.93) and physical activity (r50.40-0.85) than with respiratory function (r50.10-0.59). Methodological factors affecting 6MWD include track length, encouragement, supplemental oxygen and walking aids. Supplemental oxygen also affects ISWT and ESWT performance. Responsiveness was moderate to high for all tests, with greater responsiveness to interventions that included exercise training.The findings of this review demonstrate that the 6MWT, ISWT and ESWT are robust tests of functional exercise capacity in adults with chronic respiratory disease. OverviewThe aim of this systematic review was to examine the measurement properties for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. A companion paper describes the standard operating procedures for the tests [1]. The key findings of this systematic review are as follows.1) The 6-min walking distance (6MWD) is a valid and reliable measure of exercise capacity for people with chronic lung disease. The 6MWD correlates more strongly with measures of peak work capacity and physical activity than with respiratory function or quality of life, which supports its conceptualisation as a test of functional exercise performance.2) The ISWT offers a different protocol to the 6MWT as it is incremental and externally paced. The ISWT is a valid and reliable measure of cardiopulmonary exercise capacity in chronic obstructive pulmonary disease (COPD), where there is a strong relationship between ISWT distance and peak oxygen uptake (V9O 2 peak) or work rate on a cardiopulmonary exercise test (CPET).3) A learning effect is observed for the 6MWT and the ISWT. The second test usually is the better compared with the first, but this is inconsistent.4) The ESWT is a test of endurance capacity. It is externally paced and is performed along the same course as the ISWT. Two tests do not appear to be necessary if the second test is conducted on the same day.5) Reference equations have been proposed for the 6MWD and the ISWT. Age, height and weight are included in most equations. The influence of race and ethnicity is unclear.6) The safety profile of ...

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Section: Relationship Of 6mwd To Clinical Outcomesmentioning

confidence: 96%

Section: Relationship Of 6mwd To Clinical Outcomesmentioning

confidence: 99%

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Singh¹,

Puhan²,

et al. 2014

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“…However, survival analysis of time from study inclusion to re-transplantation or death failed to be significantly different between the two groups [17] . In a study by Nathan et al, physical fitness among 42 lung transplant recipients with BOS using the 6 minute walk test as parameter predicted survival and was thought to perform better than spirometry [18] .…”

Section: Discussionmentioning

confidence: 99%

Cardiac Mass and Function Decrease in Bronchiolitis Obliterans Syndrome after Lung Transplantation: Relationship to Physical Activity?

Hinrichs¹,

Renne²,

Schoenfeld³

et al. 2014

PLoS ONE

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RationaleThere is a need to expand knowledge on cardio-pulmonary pathophysiology of bronchiolitis obliterans syndrome (BOS) following lung transplantation (LTx).ObjectivesThe purpose of this study was to assess MRI-derived biventricular cardiac mass and function parameters as well as flow hemodynamics in patients with and without BOS after LTx.MethodsUsing 1.5T cardiac MRI, measurements of myocardial structure and function as well as measurements of flow in the main pulmonary artery and ascending aorta were performed in 56 lung transplant patients. The patients were dichotomized into two gender matched groups of comparable age range: one with BOS (BOS stages 1–3) and one without BOS (BOS 0/0p).Measurements and Main ResultsSignificantly lower biventricular cardiac mass, right and left ventricular end-diastolic volume, biventricular stroke volume, flow hemodynamics and significant higher heart rate but preserved cardiac output were observed in patients with BOS 1–3 compared to the BOS 0/0p group (p<0.05). In a stepwise logistic regression analysis global cardiac mass (p = 0.046) and days after LTx (p = 0.0001) remained independent parameters to predict BOS. In a second model an indicator for the physical fitness level - walking number of stairs - was added to the logistic regression model. In this second model, time after LTx (p = 0.005) and physical fitness (p = 0.01) remained independent predictors for BOS.ConclusionThe observed changes in biventricular cardiac mass and function as well as changes in hemodynamic flow parameters in the pulmonary trunk and ascending aorta are likely attributed to the physical fitness level of patients after lung transplantation, which in turn is strongly related to lung function.

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“…A few studies have evaluated 6MWT in BO patients; most deal with post bone marrow transplantation (BMT) BO, a different entity with a progressive nature. The 6MWT was found to have important prognostic value in BO, and to improve after pulmonary rehabilitation …”

Section: Introductionmentioning

confidence: 95%

Six‐minute walk, lung clearance index, and QOL in bronchiolitis obliterans and cystic fibrosis

Gur

Masarweh

Toukan

et al. 2018

Pediatric Pulmonology

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Introduction: The 6-min walk test (6MWT) predicts outcome in pulmonary hypertension. Recently, its use was reported in both cystic fibrosis (CF) and bronchiolitis obliterans (BO). While the 6MWT is a simple, non-invasive and inexpensive tool, lung clearance index (LCI) measurement requires expensive equipment and expertise. We aimed to evaluate 6MWT in BO and CF, and to compare to MBW (multiple breath washout), pulmonary function tests and quality of life (QOL).Methods: A prospective single center study assessing 6MWT, MBW, spirometry, whole-body plethysmography and QOL (SF-36 questionnaire) in BO and CF patients and correlations between them.Results: Thirty-three BO patients and 37 CF patients. LCI was significantly higher in BO (12.4 ± 4.2 vs 10.5 ± 3.4, P = 0.044) while FEF 25-75% was significantly lower in BO (43.9 ± 24.4 vs 60.8 ± 30.8, P = 0.014). 6MWD was 474.8 ± 76.3 in BO and 506.6 ± 70 in CF (P > 0.05). There was no correlation between 6MWD and LCI in these small study groups There were few correlation between spirometry prameters and 6MWD. In CF, SF-36 scores correlated with pulmonary functions. Conclusions:The 6MWT is an easy-to-perform test that may be helpful in chronic lung diseases in regions with limited resources. However,with the current limited data, 6MWT cannot replace LCI or spirometry as a marker of disease progression. Is is suggested that, together with QOL, the 6MWT may provide a global estimation of the physiological and general well-being of these patients. Further larger multi-center studies are warranted to evaluate the correlations of 6MWT with pulmonary physiology parameters in various chronic diseases. K E Y W O R D S bronchiolitis obliterans, cystic fibrosis, lung clearance index, quality of life, six-minute walk Michal Gur and Kamal Masarweh are equal contributers.

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Prognostic value of the 6 min walk test in bronchiolitis obliterans syndrome

Cited by 13 publications

References 24 publications

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Cardiac Mass and Function Decrease in Bronchiolitis Obliterans Syndrome after Lung Transplantation: Relationship to Physical Activity?

Six‐minute walk, lung clearance index, and QOL in bronchiolitis obliterans and cystic fibrosis

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