Standard Reference for the Six-Minute-Walk Test in Healthy Children Aged 7 to 16 Years

Li, Albert Martin; Yin, Jun; Au, Jun T.; So, Hung‐Kwan; Tsang, Terence; Wong, Eric; Fok, Tai-fai; Ng, Pak Cheung

doi:10.1164/rccm.200607-883oc

Cited by 250 publications

(286 citation statements)

References 17 publications

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“…Mean baseline walking distance was 372 m, considerably more than the values of around 200 m seen in the phase 3 study [Hendriksz et al, [Link]]. The fact that walking distances were closer to normal in this patient group (i.e., 70–80% of that of an unaffected population [Lammers et al, 2008; Li et al, 2007]) may have made it more challenging to show improvement and could possibly account for the lack of change in 6MWT distance in this study. Also, these patients can probably not be expected to reach 6MWT distances comparable to healthy (unaffected) age/height‐matched controls due to the presence of skeletal and joint abnormalities.…”

Section: Discussionmentioning

confidence: 84%

Safety and physiological effects of two different doses of elosulfase alfa in patients with morquio a syndrome: A randomized, double‐blind, pilot study

Burton

Berger

Lewis

et al. 2015

American J of Med Genetics Pt A

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The primary treatment outcomes of a phase 2, randomized, double‐blind, pilot study evaluating safety, physiological, and pharmacological effects of elosulfase alfa in patients with Morquio A syndrome are herewith presented. Patients aged ≥7 years and able to walk ≥200 m in the 6‐min walk test (6MWT) were randomized to elosulfase alfa 2.0 or 4.0 mg/kg/week for 27 weeks. The primary objective was to evaluate the safety of both doses. Secondary objectives were to evaluate effects on endurance (6MWT and 3‐min stair climb test [3MSCT]), exercise capacity (cardio‐pulmonary exercise test [CPET]), respiratory function, muscle strength, cardiac function, pain, and urine keratan sulfate (uKS) levels, and to determine pharmacokinetic parameters. Twenty‐five patients were enrolled (15 randomized to 2.0 mg/kg/week and 10 to 4.0 mg/kg/week). No new or unexpected safety signals were observed. After 24 weeks, there were no improvements versus baseline in the 6MWT, yet numerical improvements were seen in the 3MSCT with 4.0 mg/kg/week. uKS and pharmacokinetic data suggested no linear relationship over the 2.0–4.0 mg/kg dose range. Overall, an abnormal exercise capacity (evaluated in 10 and 5 patients in the 2.0 and 4.0 mg/kg/week groups, respectively), impaired muscle strength, and considerable pain were observed at baseline, and there were trends towards improvements in all domains after treatment. In conclusion, preliminary data of this small study in a Morquio A population with relatively good endurance confirmed the acceptable safety profile of elosulfase alfa and showed a trend of increased exercise capacity and muscle strength and decreased pain. © 2015 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 84%

Safety and physiological effects of two different doses of elosulfase alfa in patients with morquio a syndrome: A randomized, double‐blind, pilot study

Burton

Berger

Lewis

et al. 2015

American J of Med Genetics Pt A

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“…4,25 Oxygen saturation using a finger sensor and a 3900P pulse oximeter (Datex-Ohmeda) and a rating of perceived exertion (RPE) using the Borg CR10 scale 26 were collected at baseline and postwalk.…”

Section: Mwtmentioning

confidence: 99%

Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension

Zapico

Fuentes

Rojo-Tirado

et al. 2016

Journal of Cardiopulmonary Rehabilitation and Prevention

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exercise testing oxygen uptake pulmonary hypertension ■ PURPOSE: To determine whether the 6-minute walk test (6MWT) is a predictor of peak oxygen uptake (Vo 2 ) in patients with idiopathic pulmonary arterial hypertension (IPAH).■ METHODS: A total of 157 patients treated for IPAH completed a 6MWT in accordance with American Thoracic Society standards. Heart rate, pulse oximetry, and Borg rating of perceived exertion were determined at baseline and posttest. A cardiopulmonary exercise test (CPET) was performed on a cycle ergometer using a ramp protocol. Participants were stratified post hoc by age into 3 groups: children (n = 26), adolescents (n = 49), and adults (n = 82). Multiple linear regression analysis was performed to predict peak Vo 2 from the 6MWT.■ RESULTS: The regression equation generated for the children was the only model to strongly predict peak Vo 2 (r = 0.87; P < .001). Similar models for adolescent (r = 0.59; P < .001) and adult groups (r = 0.68; P < .001) did not achieve the same level of correlation.■ CONCLUSION: Six-Minute Walk Test was able to accurately predict peak Vo 2 in children (6-12 years) with IPAH; however, the model was weaker for predicting peak Vo 2 in older populations. These findings suggest that 6MWT may be as valid a test for predicting peak Vo 2 in children with IPAH as CPET measured peak Vo 2 . In older IPAH populations, CPET is the only reliable method for the evaluation of peak Vo 2 . The cardiopulmonary response to exercise is an important clinical assessment tool, as it provides an integrated assessment of the respiratory, cardiac, and metabolic systems. The current gold standard method for assessing aerobic exercise response in humans is the maximum incremental cardiopulmonary exercise test (CPET). Peak V o 2 , measured by a CPET, has been widely used to assess functional capacity and predict survival in patients with advanced symptomatic heart failure and respiratory dysfunction. 1,2 However, CPET requires the use of expensive equipment and trained medical team supervision to conduct and evaluate each test. Submaximal tests, like the 6-minute walk test (6MWT), provide useful information on daily physical performance that are safe, simple, standardized, and inexpensive. The 6MWT offers a better estimation of daily living activities than other walk tests 3 and the American Thoracic Society has endorsed and published guidelines for performing the 6MWT in clinical settings. 4

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“…Therefore, it is recommended that heart rate should be consistently monitored both at rest and during the walk when using the 6-MWT, as has been done with typically developing children. 26,27 When measuring heart rate, distractions and other factors unrelated to energy expenditure should be kept to a minimum to help ensure that the heart rate values are related to energy expenditure and not to these other factors. At present there is no test to measure 'psychological' preparedness for tests such as the 6-MWT; that is to address the 'voluntary' component of the test.…”

Section: Submaximal Exercise Testsmentioning

confidence: 99%

Identification of a core set of exercise tests for children and adolescents with cerebral palsy: a Delphi survey of researchers and clinicians

Verschuren

Ketelaar

Keefer

et al. 2011

Developmental Medicine &Amp; Child Neurology

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Standard Reference for the Six-Minute-Walk Test in Healthy Children Aged 7 to 16 Years

Abstract: These 6MWD standards will provide useful references for the care of pediatric patients.

Cited by 250 publications

References 17 publications

Safety and physiological effects of two different doses of elosulfase alfa in patients with morquio a syndrome: A randomized, double‐blind, pilot study

Safety and physiological effects of two different doses of elosulfase alfa in patients with morquio a syndrome: A randomized, double‐blind, pilot study

Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension

Identification of a core set of exercise tests for children and adolescents with cerebral palsy: a Delphi survey of researchers and clinicians

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