The six-minute walk test as a fall risk screening tool in community programs for persons with stroke: a cross-sectional analysis

Regan, Elizabeth; Middleton, Addie; Stewart, Jill Campbell; Wilcox, Sara; Pearson, Joseph L.; Fritz, Stacy L.

doi:10.1080/10749357.2019.1667657

Cited by 23 publications

(11 citation statements)

References 51 publications

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“…The 6MWT includes straight and turn walking, measures functional capacity, and is widely used to measure the response of therapeutic interventions [ 11 ]. Recently, a study with stroke survivors reported a moderate relationship with 6MWT and fall risk [ 12 ]. Research reports differences in turning strategies between fall-risk and no fall-risk populations, and that viable elderly fall-risk classification can be achieved with turn data [ 5 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Fall risk classification for people with lower extremity amputations using random forests and smartphone sensor features from a 6-minute walk test

et al. 2021

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Fall-risk classification is a challenging but necessary task to enable the recommendation of preventative programs for individuals identified at risk for falling. Existing research has primarily focused on older adults, with no predictive fall-risk models for lower limb amputees, despite their greater likelihood of fall-risk than older adults. In this study, 89 amputees with varying degrees of lower limb amputation were asked if they had fallen in the past 6 months. Those who reported at least one fall were considered a fall risk. Each participant performed a 6 minute walk test (6MWT) with an Android smartphone placed in a holder located on the back of the pelvis. A fall-risk classification method was developed using data from sensors within the smartphone. The Ottawa Hospital Rehabilitation Center Walk Test app captured accelerometer and gyroscope data during the 6MWT. From this data, foot strikes were identified, and 248 features were extracted from the collection of steps. Steps were segmented into turn and straight walking, and four different data sets were created: turn steps, straightaway steps, straightaway and turn steps, and all steps. From these, three feature selection techniques (correlation-based feature selection, relief F, and extra trees classifier ensemble) were used to eliminate redundant or ineffective features. Each feature subset was tested with a random forest classifier and optimized for the best number of trees. The best model used turn data, with three features selected by Correlation-based feature selection (CFS), and used 500 trees in a random forest classifier. The resulting metrics were 81.3% accuracy, 57.2% sensitivity, 94.9% specificity, a Matthews correlation coefficient of 0.587, and an F1 score of 0.83. Since the outcomes are comparable to metrics achieved by existing clinical tests, the classifier may be viable for use in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Fall risk classification for people with lower extremity amputations using random forests and smartphone sensor features from a 6-minute walk test

et al. 2021

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“…This is because walking capacity is an important determinant of FC to independently perform activities of daily living (6, 7), which inevitably is expected to translate to better QOL (9). In addition, this test has also been demonstrated to serve as screening tool to detect falls risk in this population (10). However, the impact of a holistic individualized evidence-based multimodal exercise program on this important outcome measure in people with ND has yet to be investigated.…”

Section: Introductionmentioning

confidence: 99%

A retrospective evaluation of the Brain and Body Fitness Studio service on functional capacity and quality of life in people with neurological disorders

Ramos

Chakraborty²,

Dalleck³

et al. 2023

Front. Neurol.

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BackgroundPeople with neurological disorders (ND) are less physically active than the general population due to physical, sensory, and/or cognitive impairments. These individuals often feel intimidated to join mainstream health and wellness centers due to lack of specialized support for people with ND. The Brain and Body Fitness Studio (BBFS) is one of the first Accredited Exercise Physiologist-led interprofessional services in Adelaide South Australia to provide individualized evidence-based multimodal exercise prescription and social support for this population. This comprehensive retrospective study evaluated the impact of BBFS on functional capacity (FC) determined as the 6-min walk distance (6 MWD) achieved during a 6-min walk test (6 MWT), of its members with ND.MethodsSixty-two BBFS members (age, 66 ± 10 years; 60% male) with ND (85% Parkinson's Disease; average time since diagnosis, 4 years [IQR, 2 to 12 years]) and complete pre- and post-6-month clinical assessment of the primary outcome of the study, the 6 MWD, were included in this retrospective analysis. A series of sub-analyses were also performed to investigate the effects of adherence to the recommended prescription of at least twice a week in the program (≥80 vs. < 80% adherence), and disease stage (time since diagnosis; ≥6 vs. < 6 years) on FC.ResultsAlthough there was no statistically significant change in 6 MWD from pre- to post-6-month BBFS program (+15 ± 90 m, p = 0.19), a clinically meaningful improvement of >14 m was evident. Improvement in 6 MWD was significantly greater in members who attended at least 80% of the recommended visits (≥80% visits, +37 ± 58 m; ≤ 80% visits,−1 ± 105 m, p = 0.046). We also found a 6 MWD improvement from pre- to post-6 months in those in the early years of their ND (< 6 years since diagnosis, +39 ± 76 m), but not in those in the later years of their ND (≥6 years since diagnosis, −36 ± 123 m, between group difference, p = 0.029).ConclusionA clinically meaningful 6 MWD improvement may be elicited by services provided by BBFS in people with ND. Overall, the benefits appear to be more evident in members who attended the BBFS for at least 80% of the recommended visits and those who were in the early stage of their ND diagnosis.

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“…All these tests show great potential as optimal balance screening tools with high acceptability by clinicians and a short running time [ 22 ]. Moreover, in addition to assessing functional capacity, the 6-min walk test (6MWT) also provides relevant information regarding the fall risk and balance confidence [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical assessment of balance and functional impairments in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis

et al. 2022

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The objective of this study is to compare the balance and functional capacity between stable Chronic Obstructive Pulmonary Disease (COPD) patients versus healthy controls using clinical tests. A comprehensive search of PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Web of Science was conducted from inception to 21 January 2022. Studies reporting the association between COPD status and balance or functional capacity using clinical tests were included. Two independent reviewers examined the titles and abstracts, extracted the data using a standardised form, and assessed the risk of bias of the included articles. A total of 27 studies with 2420 individuals with stable COPD were included. Overall, the risk of bias in the included studies was low to moderate. The meta-analysis showed a higher history of falls in individuals with COPD (Odds Ratio: 1.59 [95%CI: 1.25–2.02]). Furthermore, an overall effect in favour of the healthy controls was observed in the Timed Up and Go (mean difference: 2.61 s [95%CI: 1.79–3.43]), Berg Balance Scale (mean difference: −6.57 points [95%CI: −8.31 to −4.83]), static balance tests (standardised mean difference: −1.36 [95%CI: −2.10 to −0.62]), and the 6-minute walk test (mean difference: −148.21 meters [95%CI: −219.37 to −77.39]). In conclusion, individuals with stable COPD have worse balance and functional capacity compared to healthy controls. These results may guide clinicians to elaborate on therapeutic strategies focused on screening of balance and functional impairments. This is in addition to generating rehabilitation guidelines aimed at reducing the risk of falling in people with COPD.

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The six-minute walk test as a fall risk screening tool in community programs for persons with stroke: a cross-sectional analysis

Cited by 23 publications

References 51 publications

Fall risk classification for people with lower extremity amputations using random forests and smartphone sensor features from a 6-minute walk test

Fall risk classification for people with lower extremity amputations using random forests and smartphone sensor features from a 6-minute walk test

A retrospective evaluation of the Brain and Body Fitness Studio service on functional capacity and quality of life in people with neurological disorders

Clinical assessment of balance and functional impairments in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis

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