Protocol Variations and Six-Minute Walk Test Performance in Stroke Survivors: A Systematic Review with Meta-Analysis

Abstract

Objective. To investigate the use of the six-minute walk test (6MWT) for stroke survivors, including adherence to 6MWT protocol guidelines and distances achieved. Methods. A systematic search was conducted from inception to March 2014. Included studies reported a baseline (intervention studies) or first instance (observational studies) measure for the 6MWT performed by stroke survivors regardless of time after stroke. Results. Of 127 studies (participants n = 6,012) that met the inclusion criteria, 64 were also suitable for meta-analysis. Only 25 studies made reference to the American Thoracic Society (ATS) standards for the 6MWT, and 28 reported using the protocol standard 30 m walkway. Thirty-nine studies modified the protocol walkway, while 60 studies did not specify the walkway used. On average, stroke survivors walked 284 ± 107 m during the 6MWT, which is substantially less than healthy age-matched individuals. The meta-analysis identified that changes to the ATS protocol walkway are associated with reductions in walking distances achieved. Conclusion. The 6MWT is now widely used in stroke studies. The distances achieved by stroke patients indicate substantially compromised walking ability. Variations to the standard 30 m walkway for the 6MWT are common and caution should be used when comparing the values achieved from studies using different walkway lengths.

New targets for monitoring and therapy in Barth syndrome

“…The 6MWT distance is potentially susceptible to differences in testing conditions (in this case a 15-m walk track was used as opposed to a 30-m walk track). 44 Therefore, when using 6MWT to monitor clinical status, practitioners should be careful to maintain consistent test conditions. Additionally, we found that muscle weakness may become more pronounced with age in BTHS, and sensitive quantification of this feature is probably an important measure of disease progression.…”

Stroke rehabilitation

“…Testing must be completed in a formal settingIn patients with serious disabilities or close typical function, the scale may not be sufficiently delicate to identify changes in executionMotor Assessment Scale (MAS)60698The MAS was created to obtain a substantial and solid method for evaluating regular motor function following strokeThe MAS consists of 8 items relating to 8 regions of motor function (recumbent to side lying, prostrate to sitting over the edge of a bed, adjusted sitting, sitting to standing, walking, upper-arm function, hand developments and propelled hand exercises).Each parameter, except for general tonus, is evaluated utilizing a 7-point pecking order of useful criteria. Score extending from 0 (most basic) to 6 (generally complex) Interpretability: Scores mirror a task-oriented approach to assessment. Acceptability: The test is generally straightforward and brief to manage. Feasibility: The MAS is freely accessible in Carr et al66 A time of direction and practice evaluation is prescribed preceding formal use in a clinical or exploration settingThe item “general tonus” is difficult to survey in a dependable manner.The scoring pecking order connected with the propelled hand exercises itemSix-Minute Walk Test (6MWT)6148The 6MWT is a sub maximal test of functional activity limitThe 6MWT led utilizing a lobby or tracks 100 feet long.Patients select their own power of activity and are permitted to stop and rest during the test, at their own particular pace.Performance on the 6MWT is measured by aggregate separation strolled in feet or meters within the 6 minutes. Interpretability: The 6MWT is a broadly utilized apparatus that gives a quantitative measure of sub-maximal activity limit. It is concurred that age, stature, weight, and gender all freely affect the 6MWT in healthy adults. Acceptability: The 6MWT is moderately concise and heavily endured by patients; however, its utilization may be complicated by issues of continuance. Feasibility: The test is brief, modest and easy to assessIt is highly recommended that 6MWT combined with other measures for a better estimateStroke Impact Scale (SIS)62760Surveys health status after strokeA 59 item measure, 8 domains are assessed: strength (4 items), hand function (5 items), ADL/IADL (10 items), mobility (9 items), communication (7 items), participation/role function (8 items).Each item is rated on a 5-point Likert scale in terms of the difficulty the patient has experienced in completing each item.Cumulative scores are obtained for every space, scores range from 0-100.SIS assessment including ADL; cognition; communication; depression; functional mobility; gait; general health; life participation; quality of life; social relationships; socia...…”

Treadmill gait training combined with functional electrical stimulation on hip abductor and ankle dorsiflexor muscles for chronic hemiparesis

“…It is a method of measuring the maximum distance the patient can walk for 6 min, and exhibit high reliability for persons with stroke (ICC = .96) [7]. The Berg Balance Scale (BBS), developed by Katherine Berg, is a widely used clinical instrument used to measure static and dynamic balance.…”