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Abstract The heterogeneity of Parkinson’s disease (PD) presents considerable challenges for accurate diagnosis, particularly during early-stage disease, when the symptoms may be extremely subtle. This study aimed to assess the accuracy of a convolutional neural network (CNN) technique based on the 6-min walk test (6MWT) measured using wearable sensors to distinguish patients with early-stage PD (n = 78) from healthy controls (n = 50). The participants wore six sensors, and performed the 6MWT. The time-series data were converted into new images. The results revealed that the gyroscopic vertical component of the lumbar spine displayed the highest classification accuracy of 83.5%, followed by those of the thoracic spine (83.1%) and right thigh (79.5%) segment. These findings suggest that the 6MWT and CNN models may facilitate earlier diagnosis and monitoring of PD symptoms, enabling clinicians to provide timely treatment during the critical transition from normal to pathologic gait patterns.

Background The 6-minute walk test (6MWT) is extensively used to assess the exercise capacity of obese populations and offers a reference for devising intervention measures. While reference equations for the 6MWT distance for various populations have been proposed internationally, there is a scarcity of studies on reference equations for the 6MWT distance among Chinese obese subjects aged 17 to 45 years with a BMI ≥ 30 kg/m2. Objective To develop reference equations for the 6MWT distance for outpatient obese subjects aged 17 to 45 years and to assess its influencing factors. Methods Following the American Thoracic Society guidelines, from June 2022 to September 2023, 143 adults aged 17 to 45 years with a BMI ≥30 kg/m2 (71 males and 72 females) who visitied the Department of Endocrinology, Northern Jiangsu People's Hospital, were prospectively selected for anthropometric measurements and the 6MWT. A stepwise multiple regression model was employed to establish reference equations for the 6MWT distance, and the newly developed equations were compared with existing prediction equations. Results The average 6MWT distance for the 143 subjects was (506.1±49.8) m, with males averaging (515.7±50.14) m, which was greater than the females' average of (496.6±47.9) m (P

Silicosis is associated with preventable but irreversible lung damage. Early quantifiable assessment of silicosis workers would promote early interventional steps to reduce health deterioration. The objectives of this study were to correlate spirometry findings and post-six-minute walk test oxygen desaturation (post-6MWT OD) in chronic simple silicosis with age, duration of silica exposure (DSE), smoking pack years (SPY), occupation, and mean pulmonary artery pressure. Based on occupational exposure to silica and radiologic confirmation of chronic simple silicosis, 104 patients (all males) were enrolled and grouped based on SPY (nil, 1-10, 11-20, and >20) and occupation (drillers and dressers). They were further investigated with spirometry, post-6MWT OD, and transthoracic echocardiography (TTE), and findings were statistically analyzed. Abnormal spirometry findings were seen in 62.5% of total cases (65/104), with the highest percentage in the >20 SPY group (84%; 21/25) and drillers (68.3%; 28/41). The post-6MWT OD was seen in 50.96% of cases (53/104) with the highest percentage in the >20 SPY group (56%; 14/25) and drillers (63.4%; 26/41). Normal and restrictive patterns were predominant among 20 SPY group. Normal, obstructive, and restrictive patterns were predominant among dressers, while mixed patterns were in drillers. Mean age and mean DSE were higher for >20 SPY group and dressers; obstructive and mixed patterns; and patients with post-6MWT OD. Pulmonary hypertension was significantly associated with the presence of abnormal spirometry patterns (69.3%; 45/65) and post-6MWT OD (79.3%; 42/53). Mean forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was significantly lower for the >20 SPY group. Mean FEV1 had an inverse relation with SPY, and mean FVC was lower for drillers than dressers. Spirometry, post-6MWT OD, and TTE assessment give a complete overview of the cardiopulmonary exercise capacity of chronic silicosis patients and facilitate early interventions with special consideration for workers involved in machine-based mining activity.

Abstract Patients with chronic diabetes may have a physical performance decline, which significantly increases the risk of falling. The study aimed to assess the validity of the Circular Tandem Walk Test (CTWT) in determining fall risk among older community-dwelling Thais with type 2 diabetes mellitus (T2DM). This is a cross-sectional diagnostic study of 71 older participants with T2DM from various communities. The participants were divided into “faller” (who had experienced one or more fall events) and “non-faller” groups based on 6-month fall history data. They were then interviewed about their fear of falling (FOF) using a single question and the Falls Efficacy Scale International (FES-I), followed by the CTWT. Thirty-five participants reported having fallen in the past six months. Significant differences were in the fallers and non-fallers CTWT, FOF, and FES-I scores (p

Background: Thalassemia major is a common type of genetic disorder found in improvement in the medical field, the life expectancy of these children was also increased so there arises a need to promote the quality of life of such patients. A lot of studies concentrate on various aspects of the life of thalassemia major, but no study was done to assess the physical fitness of such children which is quite important to regularize their exercise sessions. Objectives: The objective of this study was to find out the physical fitness of children with thalassemia patients. Materials and Methods: Nonexperimental study designed with 20 individuals diagnosed with thalassemia in major age groups between 7 and 18 both boys and girls. The outcome measure used in this study was 6-min walk test (6 MWT). Results: The mean distance covered in 6 min was 351.3 m on average. There was increase in heart rate and blood pressure after completion of the test, whereas oxygen saturation was found to drop post-6 MWT among these patients. Conclusion: Thalassemia major patients are found with this physical fitness when assessed with 6 MWT.

Abstract Background The six-minute walk test (6MWT) is an established exercise test for patients with pulmonary arterial hypertension (PAH), affording insight into both exercise intolerance and overall prognosis. Despite the widespread application of the 6MWT, the prognostic implications of exercise-induced desaturation (EID) during this test has been inadequately studied in PAH patients. Thus, we evaluated the occurrence of EID and its prognostic significance in PAH patients. Methods We analyzed PAH patients in a single-center cohort from April 2016 to March 2021. EID was defined as a reduction in oxygen saturation exceeding 4% from the baseline or to below 90% at any point during the test. Results We analyzed 20 PAH patients in this cohort, primarily consisting of 16 females with an average age of 48.4 ± 13.3 years. Among them, ten exhibited EID. Baseline characteristics, echocardiographic data and right heart catheterization data were similar between the two groups. However, total distance (354.3 ± 124.4 m vs. 485.4 ± 41.4 m, P = 0.019) and peak oxygen uptake (12.9 ± 3.2 mL/kg⋅min vs. 16.4 ± 3.6 mL/kg⋅min, P = 0.019) were significantly lower in the EID group. During the total follow-up duration of 51.9 ± 25.7 months, 17 patients had at least one adverse clinical event (2 deaths, 1 lung transplantation, and 13 hospital admissions). The presence of EID was associated with poor clinical outcome (hazard ratio = 6.099, 95% confidence interval = 1.783–20.869, P = 0.004). Conclusions During the 6MWT, EID was observed in a half of PAH patients and emerged as a significant prognostic marker for adverse clinical events. Graphical Abstract

Objective: The study was aimed to assess the sex-linked differences in the Blood Pressure Indices (BPI) i.e., Mean Arterial Pressure (MAP) and Pulse Pressure (PP) of COVID patients after 6 Minute Walk Test (6MWT). Study type,settings& duration: This observational study was conducted in the Institute of Basic Medical Sciences,Khyber Medical University, Peshawar from December 2021 to April 2022. Methodology: There were 54 participants (21 Females and 33 Males). Participants with previous COVID-19 infection with a cut off of 3 months post COVID, were included in the study. The participant’s Heart Rate and Blood Pressure were recorded both before and after performing 6MWT. Results: Both pre and post stress comparison of mean difference between post COVID males and females, was significant for MAP (Post-Stress p=0.002 and Pre-Stress p=0.01) only. PP and HR did not show any significant differences between the males vs females in both pre and post stress phase. While, post COVID females had a higher HR than males in both pre and post phase. General Linear regression model was developed while controlling for age and to check the relation between MAP, PP and HR.R squared came out to be 0.648 while MAP was significant with a pvalue = 0.012. Conclusion: This study found a significant difference in Mean Arterial Pressure (MAP) between male and female COVID-19 patients after a 6-minute walk test, suggesting sex-based variations in blood pressure response post-infection. Further research with larger samples is needed to explore the clinical implications of this finding.

Objective: This study aimed to examine the influence of wearing different types of face masks on the results of the 6-Minute Walk Test (6MWT) in a cohort of healthy volunteers. Materials and Methods: Volunteers were partitioned into three groups (each comprising 36 individuals) with different mask-wearing conditions: NIOSH-approved N95 mask, and double-mask scenarios featuring two layers of surgical mask, and a combination of a surgical mask covered by a cloth face mask. Each participant performed two rounds of the 6MWT, one while wearing a mask and another without. Various metrics, such as the six-minute walk distance (6MWD), oxygen saturation (SpO2), and dyspnea and fatigue scores, were measured. Results: No significant differences were found in the 6MWD results between the mask-wearing and non-mask-wearing scenarios across all the mask types.Strong positive correlations were also established between the 6MWD results in the mask-wearing and non-mask-wearing conditions. However, a small cohort experienced dyspnea significantly more when wearing double surgical masks compared to not wearing a mask. Additionally, there were no major deviations in SpO2 levels or fatigue scores regardless of the type of mask used. Conclusion: The study indicated that wearing an N95 mask, or double surgical masks, or cloth-over-surgical face masks did not significantly influence the outcomes of the 6MWT in healthy individuals. However, caution is advised in the case of wearing double surgical masks, as this may induce a greater sense of dyspnea. This suggests that face masks can be worn safely during physical fitness and pulmonary function assessments, aligning with their essential role in viral spread prevention in daily life.

AbstractIntroduction: The six-minute walk test (6MWT) is a well-established tool for assessing submaximal functional capacity for cardiac patients, but space limitations challenge its implementation. Treadmill-based (TR) 6MWT is a promising alternative, but it requires patients to complete a familiarization test to adapt treadmill speed regulation. With the advancement of sensors, it is possible to automatically control speed for individual patients and thus overcome the space limitation or the speed control difficulty on the treadmill for each patient.Methods: This study investigated the validity and interchangeability of automated speed TR6MWT and standard hallway (HL) 6MWT. Eighteen patients were assessed at baseline of the 12-week cardiac rehabilitation program. Fourteen of them were assessed after rehabilitation. All patients performed three TR6MWTs and three HL6MWTs at baseline and one of each test after the program.Results: Patients well tolerated the TR6MWT. There was a strong correlation between both test methods (r = 0.79). However, patients performed significantly better in HL6MWT (514.8m ± 59.7m) than in TR6MWT (447.2 ± 79.1m) with 95% CI, 40.4-94.6m, p < 0.05. Both tests showed high test-retest reliability (intraclass correlation coefficient of 0.86). The TR6MWT showed a valuable comparison of the effect of the cardiac rehabilitation program (20% increase, effect size 1.1) even though it is not interchangeable with the HL6MWT.Conclusion: The automated speed TR6MWT appears to be an acceptable tool with adequate validity, reliability, and responsiveness for assessing functional capacity in patients utilizing cardiac rehabilitation programs.

Abstract Objective To investigated the dynamic ventilatory responses and their influence on functional exercise capacity in patients with long-COVID-19 syndrome (LCS). Results Sixteen LCS patients were subjected to resting lung function (spirometry and respiratory oscillometry-RO) and cardiopulmonary performance to exercise (Spiropalm®-equipped six-minute walk test-6MWT and cardiopulmonary exercise test-CPX). At rest, spirometry showed a normal, restrictive and obstructive pattern in 87.5%, 6.25% and 6.25% of participants, respectively. At rest, RO showed increased resonance frequency, increased integrated low-frequency reactance and increased difference between resistance at 4–20 Hz (R4-R20) in 43.7%, 50%, and 31.2% of participants, respectively. The median of six-minute walking distance (DTC6) was 434 (386–478) m, which corresponds to a value of 83% (78–97%) of predicted. Dynamic hyperinflation (DH) and reduced breathing reserve (BR) were detected in 62.5% and 12.5% of participants, respectively. At CPX, the median peak oxygen uptake (VO2peak) was 19 (14–37) ml/kg/min. There was a significant correlation of 6MWD with both R4-R20 (rs=-0.499, P = 0.039) and VO2peak (rs=0.628, P = 0.009). Our results indicate that DH and low BR are contributors to poor exercise performance, which is associated with peripheral airway disease. These are promising results considering that they were achieved with simple, portable ventilatory and metabolic systems.

Abstract Most established clinical walking tests assess specific aspects of movement function (velocity, endurance, etc.) but are generally unable to determine specific biomechanical or neurological deficits that limit an individual’s ability to walk. Recently, inertial measurement units (IMU) have been used to collect objective kinematic data for gait analysis and could be a valuable extension for clinical assessments (e.g., functional walking measures). This study assesses the reliability of an IMU-based overground gait analysis during the 2-min walk test (2mWT) in individuals with spinal cord injury (SCI). Furthermore, the study elaborates on the capability of IMUs to distinguish between different gait characteristics in individuals with SCI. Twenty-six individuals (aged 22–79) with acute or chronic SCI (AIS: C and D) completed the 2mWT with IMUs attached above each ankle on 2 test days, separated by 1 to 7 days. The IMU-based gait analysis showed good to excellent test–retest reliability (ICC: 0.77–0.99) for all gait parameters. Gait profiles remained stable between two measurements. Sensor-based gait profiling was able to reveal patient-specific gait impairments even in individuals with the same walking performance in the 2mWT. IMUs are a valuable add-on to clinical gait assessments and deliver reliable information on detailed gait pathologies in individuals with SCI. Trial registration: NCT04555759.

Abstract We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiotherapist-supervised inpatient rehabilitation programme during 2007–2017. The percentage of the predicted 6mWT distance, and the lower limit of normal distance was calculated based on individual patients’ age, sex, and body mass index. We used Cox regression with adjustment for confounders to determine multivariable-adjusted hazard ratios (HRs) for mortality. Over a median follow-up period of 6.4 (IQR: 3.5–9.2) years, 15% (n = 169) patients died. We observed a strong and independent inverse association between 6mWT distance and mortality, with every 10 m increase in distance associated to a 4% reduction in mortality (HR: 0.96, 95% CI 0.94–0.98, P

Introduction: Chronic Kidney Disease (CKD) is a condition that affects multiple organs, including the respiratory system. Haemodialysis is a commonly used treatment for End-stage Renal Disease (ESRD), but it can lead to respiratory issues, reduced muscle strength, decreased functional capacity, and lower quality of life. The Six-minute Walk Test (6MWT) is widely accepted for assessing functional capacity in CKD patients. Aim: To evaluate the impact of haemodialysis on the functional capacity and Rate of Perceived Exertion (RPE) in patients with CKD by employing the 6MWT as a comprehensive measure. Materials and Methods: A prospective cohort study was conducted in the Department of Nephrology and Dialysis ward at MGM Hospital, Aurangabad, Maharashtra, India, from April 2020 to December 2021. A total of 73 patients were included in the present study. The primary outcome measure was the walked distance assessed using the 6MWT, and secondary outcomes are the RPE were evaluated using the Modified Borg Scale (MBS). Gait speed was also measured. Baseline demographic data, laboratory investigations, and associated co-morbidities were collected. The tests were performed before and immediately after the haemodialysis session. Data were analysed using the Student’s t-test and one-way Analysis of Variance (ANOVA), and the statistical significance level was setup at p

Background: The combination of chronic obstructive pulmonary disease (COPD) and overweight/obesity is a common clinical situation in modern healthcare. The objective of this study was to conduct a comparative analysis of exercise tolerance in normal body weight (NBW) and overweight patients with COPD in the 6MWT using the original device for cardiorespiratory analysis and a method for assessing the cardiorespiratory condition. Methods and Results: The study included 194 patients with COPD. The patients were divided into two groups. Group 1 consisted of 96 COPD patients with NBW: 77(80.21%) men and 19(19.79%) women aged 41 to 73 years (mean age of 63.33 ± 8.44 years). Group 2 consisted of 98 overweight COPD patients: 74(75.51%) men and 24(24.49%) women aged 55 to 71 (mean age of 64.84 ± 5.46 years). To assess tolerance to physical activity and to objectify the functional status of patients, the 6MWT was used and carried out according to generally accepted principles. The distance covered in 6 minutes (6MWD) was measured in meters and compared with the proper 6MWD(i). The developed device for cardiorespiratory analysis was used to obtain the most accurate 6MWT result. All patients in the study groups underwent an analysis of the composition of the body by the bioelectrical impedance method using a fat mass analyzer BC-555 (Tanita Corporation, Tokyo, Japan). The percentages of fat, water, muscle mass (MM), and bone mass were evaluated. The average value of the 6MWD/6MWD(i) ratio in COPD patients with NBW was significantly lower than in COPD patients with overweight (P=0.0121). Before the test, the study groups did not differ in the level of SpO2. However, according to the results of comparative analysis, this parameter was significantly lower in patients with NBW immediately after the 6MWT (P=0.0000), which, along with a lower value of the distance traveled as a percentage of the proper value in Group 1 patients, may indicate a lower tolerance to physical activity in COPD patients with NBW than in patients with overweight. In COPD patients with NBW, the percentage of fat and MM were significantly lower than in COPD patients with overweight (P=0.0000 in both cases). There was a direct correlation between 6MWD and body mass index (r=0.56, P=0.003) and between 6MWD and MM percentage (r=0.59, P=0.016). Conclusion: Higher exercise tolerance is found in overweight COPD patients than in COPD patients with NBW. This phenomenon can be explained to some extent by the compositional components of the body, in particular, by a significantly lower percentage of lean MM in patients with NBW.

BackgroundThe 6-minute walk test (6MWT) is a commonly used method to assess the exercise capacity of people with many health conditions, including persistent pain. However, it is conventionally performed with in-person supervision in a hospital or clinic, therefore requiring staff resources. It may also be difficult when in-person supervision is unavailable, such as during the COVID-19 pandemic, or when the person is geographically remote. A potential solution to these issues could be to use GPS to measure walking distance. ObjectiveThe primary aim of this study was to assess the validity of a GPS-based smartphone app to measure walking distance as an alternative to the conventional 6MWT in a population with persistent pain. The secondary aim of this study was to estimate the difference between the pain evoked by the 2 test methods. MethodsPeople with persistent pain (N=36) were recruited to complete a conventional 6MWT on a 30-m shuttle track and a 6MWT assessed by a smartphone app using GPS, performed on outdoor walking circuits. Tests were performed in random order, separated by a 15-minute rest. The 95% limits of agreement were calculated using the Bland-Altman method, with a specified maximum allowable difference of 100 m. Pain was assessed using an 11-point numerical rating scale before and after each walk test. ResultsThe mean 6-minute walk distance measured by the GPS-based smartphone app was 13.2 (SD 46; 95% CI −2.7 to 29.1) m higher than that assessed in the conventional manner. The 95% limits of agreement were 103.9 (95% CI 87.4-134.1) m and −77.6 (95% CI −107.7 to −61) m, which exceeded the maximum allowable difference. Pain increased in the conventional walk test by 1.1 (SD 1.0) points, whereas pain increased in the app test by 0.8 (SD 1.4) points. ConclusionsIn individuals with persistent pain, the 2 methods of assessing the 6MWT may not be interchangeable due to limited validity. Potential reasons for the differences between the 2 methods might be attributed to the variation in track layout (shuttle track vs continuous circuit); poor GPS accuracy; deviations from the 30-m shuttle track; human variability in walking speed; and the potential impact of a first test on the second test due to fatigue, pain provocation, or a learning effect. Future research is needed to improve the accuracy of the GPS-based approach. Despite its limitations, the GPS-based 6MWT may still have value as a tool for remote monitoring that could allow individuals with persistent pain to self-administer frequent assessments of their functional capacity in their home environment.

Aims The aim was to evaluate whether standardised exercise performance during the incremental shuttle walk test (ISWT) can be used to assess disease severity in children and young people (CYP) with chronic conditions, through (1) identifying the most appropriate paediatric normative reference equation for the ISWT, (2) assessing how well CYP with haemophilia and cystic fibrosis (CF) perform against the values predicted by the best fit reference equation and (3) evaluating the association between standardised ISWT performance and disease severity.Methods A cross-sectional analysis was carried out using existing data from two independent studies (2018–2019) at paediatric hospitals in London,UK. CYP with haemophilia (n=35) and CF (n=134) aged 5–18 years were included. Published reference equations for standardising ISWT were evaluated through a comparison of populations, and Bland-Altman analysis was used to assess the level of agreement between distances predicted by each equation. Associations between ISWT and disease severity were assessed with linear regression.Results Three relevant reference equations were identified for the ISWT that standardised performance based on age, sex and body mass index (Vardhan, Lanza, Pinho). A systematic proportional bias of standardised ISWT was observed in all equations, most pronounced with Vardhan and Lanza; the male Pinho equation was identified as most appropriate. On average, CYP with CF and haemophilia performed worse than predicted by the Pihno equation, although the range was wide. Standardised ISWT, and not ISWT distance alone, was significantly associated with forced expiratory volume in 1 s in CYP with CF. Standardised ISWT in CYP with haemophilia was slightly associated with haemophilia joint health score, but this was not significant.Conclusions ISWT performance may be useful in a clinic to identify those with worsening disease, but only when performance is standardised against a healthy reference population. The development of validated global reference equations is necessary for more robust assessment.

Background: Cigarette smokers have a lower level of pulmonary function and physical fitness than non-smokers. Very little information is available for the short-term effects of smoking to lungs of asymptomatic smokers. Aims and Objectives: The main focus of this study is to evaluate short duration toxic consequences of smoking to the lungs of asymptomatic smokers through spirometry and 6 min walk test (6MWT). Materials and Methods: The present study is an observational cross-sectional study conducted in a tertiary care hospital which includes 160 individuals, 80 smokers and 80 non-smokers. The spirometric variables and 6MWT were performed to quantify smoking exposure. The whole statistics was analyzed using SPSS 21 and the mean between two groups was compared after applying standard Chi-square test. The means across more than 2 groups were compared after applying the standard analysis of variance (ANOVA) test. Results: Most of lung function parameter such as forced expiratory volume in 1 s (FEV1), FEV1%, FEV1/forced vital capacity % (FVC%), maximum mid-expiratory flow 25–75%, peak expiratory flow rate (PEFR), PEFR%, and maximum voluntary ventilation % is decreased significantly in asymptomatic smokers than non-smokers except FVC and FVC%. The 6MWT distance is also reduced gradually and significantly in asymptomatic smokers from 1–5 pack-years to 15–20 pack-years. Conclusion: Lung function parameters and 6MWT decreased significantly in asymptomatic smoker with increased quantum of pack-years. Therefore, early screening of high-risk smokers would lead to reduction of the clinical disease.

Abstract Objective To evaluate the association between sympathovagal balance and exercise performance, as measured by the 6-min walk test (6MWT), in women with systemic sclerosis (SSc) without cardiac involvement. Results This was a cross-sectional study in which 69 women with SSc [median age 51 (40–63 years)] without cardiac involvement underwent the 6MWT. Throughout the 6MWT, heart rate variability (HRV) was assessed using dedicated software. Methods The median 6-min walking distance (6MWD) was 451 (392–498) meters, and 29 (42%) participants did not achieve 80% of the predicted value for healthy adults. Desaturation during the 6MWT (SpO2 ≤ 4%) was observed in 10.1% of participants. Significant correlations were observed between the 6MWD and the following HRV parameters: number of successive normal-to-normal RR interval differences > 50 ms (r s =-0.397, P = 0.013), low-frequency range (r s =0.374, P = 0.023), high-frequency range (r s =-0.372, P = 0.023), and parasympathetic nervous system index (r s =-0.342, P = 0.045). Conclusion In women with SSc, there is an interrelationship of the 6MWD with both vagal withdrawal and sympathetic hyperactivation. This relationship between autonomic imbalance and worse exercise performance might increase cardiovascular risk, even in patients without apparent cardiac involvement. Control of the heart by the autonomic nervous system may be a potential target for treating patients with SSc.

In facilities where a track required is not available for gait speed test, a simpler method using a shorter track and test duration is needed. One of such methods is the 4-meter gait speed. This study aimed to determine the cut off values for 4MGS and its correlation with the 6-minute walk test (6MWT), a more common functional performance test with shorter track and time. Data for this study were collected at the Department of Rehabilitation of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. The consecutive sampling approach was used to recruit healthy Indonesian adults (n=61) aged 18–50 years into this cross sectional study. The anthropometric and respiratory variables were measured as descriptive data and the cut-off values were determined by calculating the mean 4-meter gait speed (4MGS)-2SD for each gender. The 6MWT was performed afterwards to assess the correlation between 4MGS and 6-minute walk distance (6MWD). Results presented a mean 4MGS value of 2.114±0.309 m/s (male) and 1.908±0.227m/s (female) with the cut-off values for normal gait speed of 1.496 m/s and 1.454m/s for male and female, respectively. Factors affecting 4MGS were body height, body weight, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1). The 4MGS is only shown to be weakly correlated with 6MWD (r=0.314, p=0.014). The cut-off values for 4MGS can be used as a reference to assess the normality of gait speed as a parameter of functional mobility in healthy Indonesian adults and should be used in adjunct to 6MWT to represent a comprehensive functional capacity status.

BackgroundExercise-induced desaturation (EID) is highly prevalent, and associated with the prognosis in patients with chronic obstructive pulmonary disease (COPD) . Current predicators of EID mostly depend on pulmonary function, and the assessment for their values is different.ObjectiveTo explore simple, and accurate methods suitably used in primary care to predict EID by six-minute walk test (6MWT) in patients with stable COPD.MethodsA retrospective study was conducted. Participants were 67 stable COPD patients with respiratory clinic follow-ups selected from China-Japan Friendship Hospital from 2019 to 2020. Data were collected, including assessment results of pulmonary function test, 6MWT, modified Medical Research Council (mMRC) , and COPD Assessment Test (CAT) , as well as calculated BODE index. EID in 6MWT was defined as the difference between minimum oxygen saturation in 6MWT and resting oxygen saturation at the beginning of 6MWT (ΔSpO2) ≥4%. mMRC score, CAT score and BODE index were compared between patients with and without EID in 6MWT to estimate the association of ΔSpO2 in 6MWT with mMRC score, CAT score and BODE index. ROC analysis was used to estimate the predictive value of mMRC score, CAT score and BODE index for inducible hypoxia in 6MWT.ResultsThe ΔSpO2 in 6MWT was significantly negatively correlated with mMRC score (r=-0.492, P

Background and Aim: There has been a lack of uniformity on how to triage coronavirus disease 2019 (COVID-19) patients visiting the emergency units of hospitals. Triage tools are themselves spreading the pandemic in hospital areas. The present study compared a master two-step (M2ST) exercise stress test versus a 6-min walk test (6MWT) in COVID-19–positive patients visiting the emergency unit of a hospital. Materials and Methods: Thirty-nine patients underwent 6MWT followed by M2ST, while another set of 38 patients underwent M2ST followed by 6MWT in this randomized, crossover, open-label, and noninferiority study. The exercise tests assessed the change from baseline in SpO2, heart rate (HR), respiratory rate, blood pressure, exertion, and dyspnea on the modified-Borg scale. Results: Noninferiority was established for SpO2 (P < 0.05), systolic blood pressure (SBP; P < 0.001), and diastolic blood pressure (DBP; P < 0.05), but not for HR (P = 0.3) and respiratory rate (P = 0.6). The difference between the pretest and posttest (delta change) values for the parameters SpO2, respiratory rate, HR, SBP, and DBP correlated significantly (P < 0.001) with Pearson correlation coefficient (r = 0.764, 0.783, 0.473, 0.838, and 0.783, respectively). The delta change values of modified-Borg scale for dyspnea (P = 0.291) and exertion (P = 0.208) were statistically insignificant between the two exercise tests. However, the correlation between the tests was statistically significant (P < 0.001). Conclusion: M2ST, a timesaving, cost-effective, and easy to perform exercise stress test, has been identified as a reliable alternative for 6MWT.

The endurance shuttle walk test (ESWT) is a simple, acceptable, field-based test first established in 1999 to measure endurance exercise capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of this systematic review was to examine the reliability and responsiveness of ESWT in COPD. Of the 791 articles identified through electronic databases, 17 were included in this review. Qualitative and quantitative analyses were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and as per Consensus-Based Standards for the Selection of Health Status Measurements Instruments, the quality of the studies was graded as low for reliability and moderate for responsiveness. Qualitative analysis indicated inadequate evidence for the reliability of the ESWT in patients with COPD. The meta-analysis found strong evidence that ESWT was responsive to change following pulmonary rehabilitation with an estimated mean difference (ESWT time, seconds) 303.19 s (95% CI: 175.63–430.75; p< 0.001), ambulatory oxygen with a mean difference (ESWT time, seconds) 129.04 s (95% CI: 47.98–210.09; p=0.002), and (ESWT mean distance, meters) 80.71 m (95% CI: 38.66–122.76; p< 0.001). The ESWT was also responsive to bronchodilation with a mean difference of 168.62 m (95% CI: 117.03–220.21; p< 0.001). Our findings suggest the strong potential of ESWT as a responsive test in COPD, but to draw a definitive conclusion regarding the reliability of the ESWT, further research is needed in this population.

Introduction: Exercise-induced desaturation is common in patients with moderate to severe chronic obstructive pulmonary disease (COPD). It provides additional information about physical capacity and disease evolution, and it is an important predictor of mortality. Aim: To compare the six-minute walk test (6MWT) and the cardio-pulmonary exercise test (CPET) as methods for detection of desaturation in COPD patients. To explore the relationship between exercise-related desaturation, symptom questionnaires (mMRC, CAT, and SGRQ), pulmonary function testing (PFT), and blood-gas analysis. Patients and methods: Forty adult male COPD patients, mean age 67.2±8.4 years (mean ± SD) underwent 6MWT, CPET, PFT, blood-gas analysis, and scored their symptoms (mMRC, CAT, and SGRQ). Oxygen desaturation was monitored during exercise. Desaturation was defined as a decrease in SpO2 of ≥4% and values ≤88% held for ≥3 minutes. Results: The studied patients had COPD stage 2A – 4D (GOLD 2011). The patients were categorized into two groups – with desaturation (A, n=19) and without desaturation (B, n=21). CPET elicited 21 individuals who experienced desaturation, 19 of them desaturated during 6MWT as well. In the whole group, the percentage of desaturation during CPET was 6.6±4.9% compared to 6.0±4.9% during 6MWT (p

Evaluating variability and stability using measures for nonlinear dynamics may provide additional insight into the structure of the locomotor system, reflecting the neuromuscular system's organization of gait. This is in particular of interest when this system is affected by a respiratory disease and it's extrapulmonary manifestations. This study assessed stride-to-stride fluctuations and gait stability in patients with chronic obstructive pulmonary disease (COPD) during a self-paced, treadmill 6-minute walk test (6MWT) and its association with clinical outcomes. In this cross-sectional study, eighty patients with COPD (age 62±7y; forced expiratory volume in first second 56±19%predicted) and 39 healthy older adults (62±7y) were analyzed. Gait parameters including stride-to-stride fluctuations (coefficient of variation (CoV), predictability (sample entropy) and stability (Local Divergence Exponent (LDE)) were calculated over spatiotemporal parameters and center of mass velocity. Independent t-test, Mann-Whitney U test and ANCOVA analyses were conducted. Correlations were calculated between gait parameters, functional mobility using Timed Up and Go Test, and quadriceps muscle strength using dynamometry. Patients walked slower than healthy older adults. After correction for Speed, patients demonstrated increased CoV in stride length (F(1,116) = 5.658, p = 0.019), and increased stride length predictability (F(1,116) = 3.959, p = 0.049). Moderate correlations were found between mediolateral center of mass velocity LDE and normalized maximum peak torque (ρ = -0.549). This study showed that patients with COPD demonstrate alterations in stride length fluctuations even when adjusted for walking speed, highlighting the potential of nonlinear measures to detect alterations in gait function in patients with COPD. Association with clinical outcomes were moderate to weak, indicating that these clinical test are less discriminative for gait alterations.

The clinical spectrum of COVID-19 infection patients extends from being asymptomatic to mild, moderate and severe disease. This classification is largely based on oxygen saturation and respiratory rate. Asymptomatic/mild disease patients are managed in home isolation or COVID care centers. A subgroup of these patients will deteriorate and develop moderate to severe disease. Six-minute walk test is useful in identifying this group of patients by inducing hypoxia in normoxemia patients. This stage of the disease is labelled as 'pre-hypoxemia' phase in asymptomatic/mild disease. Identifying this stage in the course of illness of patients will help in intercepting further deterioration at the earliest by timely intervention.

Introduction A recent clinical practice guideline set forth recommendations for the administration of the 6 Minute Walk Test, including course set-up and using mathematical calculation to obtain the distance walked. In clinical practice and research, however, deviations from these protocols exist. Purpose To assess for differences in total distance walked between use of mathematical calculation and a measuring wheel during three different course configurations of the 6 Minute Walk Test. Methods Fifty healthy adults (18 males, 32 females) completed this study. The mean age was 37.04 (13.76) years ranging from 23 to 61 years. Each participant completed three course configurations of the 6 Minute Walk Test: a 12-meter straight walkway representing the Academy of Neurologic Physical Therapy Core Set of Outcome Measures Clinical Practice Guideline protocol, a 30-meter straight walkway, representing the American Thoracic Society’s recommended protocol, and a 1.2-meter by 12-meter rectangular walkway, of which the Core Set of Outcome Measures Clinical Practice Guideline was derived. For mathematical calculation, the total number of laps counted, and this total number was multiplied by the distance of one lap with any partial lap added. Additionally, a research assistant followed behind each participant with a measuring wheel to capture distance walked. Results For all configurations, there were statistically significant differences between mathematical calculation and a measuring wheel, with mathematical calculation producing significantly less total distance. Additionally, there were statistically significant differences between all course configurations, despite the method of measurement. Conclusion Adhering to 6 Minute Walk Test protocols, including the method of measuring the distance, is imperative to accurately interpret results and compare to existing data.Key messages Despite recommendations for standardized administration of the 6 Minute Walk Test, deviations exist, including the method of which to obtain the total distance walked; either by use of mathematical calculation or a measuring wheel. In three different 6 minute walk test course configurations, including the American Thoracic Society’s recommended protocol and the Academy of Neurologic Physical Therapy recommended protocol, the measuring wheel resulted in significantly larger distances than use of the mathematical calculation. Despite the measuring wheel able to account for the turns during the 6 Minute Walk Test, it is imperative for clinicians to utilize standardized procedures such as using mathematical calculation, in order to accurately track progress and compare to existing data, of which mathematical calculation was used to derive.

Background Severe asthma limits exercise to avoid respiratory symptoms. The objective of the present study was to investigate the role of the 6-min walk test (6MWT) in severe asthma. Methods Consecutive patients with severe eosinophilic asthma were enrolled. A 6MWT was performed before and after 12 months. Inhaled therapy dose, oral corticosteroids dose, pulmonary function tests, eosinophil blood count, fractional exhaled nitric oxide (FeNO), Asthma Control Test (ACT) score and responses to the Asthma Quality of Life Questionnaire (AQLQ) were also recorded. Results Of the 22 patients enrolled, 13 were treated with mepolizumab 100 mg every 4 weeks in addition to conventional therapy and nine with conventional therapy only. The majority of the patients were treated with high-dose inhaled corticosteroids/long-acting β-agonists/long-acting muscarinic receptor antagonists, while approximately half were on continuous oral corticosteroids. After 12 months, the mepolizumab group only showed a significant improvement in pulmonary function tests (percentage forced expiratory volume in 1 s and percentage forced expiratory flow at 25–75% forced vital capacity (FEF25–75%), both p0.05). By paired comparisons, statistically significant improvements of the mean 6-min walk distance (6MWD) were observed in the mepolizumab (p

Background The 6-min walk test (6MWT) is widely used to assess exercise capacity across chronic health conditions, but is currently not useful to assess symptoms, as the scores do not account for the 6-min walk distance (6MWD). We aimed to 1) develop normative reference equations for breathlessness and leg discomfort intensity expressed as modified Borg (mBorg)/6MWD ratios; and 2) validate the equations in people with COPD. Methods Analysis of people aged ≥40 years who performed two 6MWTs (on a 20-m course) in the Canadian Cohort Obstructive Lung Disease (CanCOLD) study: a healthy cohort (n=291; mean±sd age 67.5±9.4 years; 54% male) with normal 6MWD and lung function, and a COPD cohort (n=156; age 66.2±9.0 years; 56% male; forced expiratory volume in 1 s (FEV1)/forced vital capacity 56.6±8.2%; FEV1 74.4±18.6% pred). The mBorg score was calculated as the Borg 0–10 category ratio intensity rating of breathlessness or leg discomfort recorded at the end of the 6MWT +1 (range 1–11), to avoid zeros and yield ratios proportional to the symptom score and 6MWD−1. Results Using data from the healthy cohort, sex-specific normative reference equations for breathlessness and leg discomfort mBorg/6MWD ratios were developed using multivariable linear regression, accounting for age, and body mass or body mass index. In the COPD cohort, abnormal breathlessness and leg discomfort (mBorg/6MWD>upper limit of normal) showed strong concurrent validity with worse airflow limitation, Medical Research Council breathlessness and COPD Assessment Test scores. Conclusion Normative references for the mBorg/6MWD ratio are presented to assess breathlessness and leg discomfort responses to the 6MWT in COPD.

Introduction: Pulmonary hypertension and other cardiac complications occur frequently due to chronic hypoxia induced by interstitial lung diseases (ILD) or due to connective tissue disorder itself. Two-dimensional (2D) echocardiography is ideal for identifying abnormalities at a given time. In this study, we tried to detect cardiovascular complications in patients with ILD using 2D echocardiography and correlate them with a 6-minute walk test (6 MWT) and spirometry. Materials and Methods: This study was carried out for 18 months including 100 consecutive cases of ILD. The diagnosis was made using the latest criteria as per the disease and high-resolution computed tomography (HRCT) thorax. All patients were evaluated with 2D echocardiography, 6 MWT, and spirometry along with routine investigations. Their results were analyzed using STATA 15.1 software. Result: Cardiovascular involvement was detected in 68% of cases. Pulmonary hypertension predominated with a prevalence of 50%. In spirometry, mean Forced expiratory volume in first second (FEV1)and Forced vital capacity (FVC) were found to be 54.96 (L) and 53.49 (L), respectively, with a predominant restrictive pattern (89%). There was a significant correlation between baseline saturation of oxygen (SpO2) and pulmonary arterial systolic pressure (PASP) with a P value of

Background The three-time stand and walk test (TTSW) is a complex functional task used to determine muscle strength, balance, and fall risk in older individuals. This study hypothesized that TTSW is an appropriate tool for detecting frailty related to falls and the cognition of community-dwelling older adults. The study objectives were to assess the ability of the TTSW to determine frailty by exploring the optimal cut-off score, and to investigate the correlations between TTSW outcomes with falls and cognitive function in 118 community-dwelling older adults. Methods The demographic data of eligible participants were assessed, and the participants were diagnosed with frailty based on the frailty phenotype. The participants then completed the Frail Non-Disabled (FiND) questionnaire, TTSW, Falls Efficacy Scale-International (FES-I), and Mini-Mental State Examination Thai version (MMSE-Thai 2002). Results The results demonstrated that the TTSW outcomes were significantly correlated with FiND, FES-I, and MMSE-Thai 2002 (rho=0.705, r=0.482, and r=-0.510, respectively; p

Six Minute Walk Test (6MWT) is a field exercise test widely used in clinical practice, both in adults and in pediatric patients. The primary aim of the study is to evaluate the physical performance of the subjects and compare them with the predicted Italian values. The secondary aim is to verify the possible relationship between the 6MWT distance (6MWD) and the clinical variables of the sample. Italian children between 6-11 years affected by CF were recruited from 9 regional centres for CF. Short questionnaire assessments about their health state and physical activity routine was administered. Anthropometric characteristics were measured before the test and, peripheral oxygen saturation (SpO2), heart and respiratory rate were measured before and after a 6-minute walk test. The tests were performed according to the American Thoracic Society (ATS) guidelines. 6MWD was compared with the predicted distance calculated by the reference equation for healthy subjects of the same age.A total of 132 children were recruited (70 male) and completed the assessment. The mean (±SD) for 6MWD was 557.4(±69.9), male = 551.4(±80.0), female = 560.4(±63.3), however the predicted distance mean was 605m. A total of 101(76.5%) subjects practice regular physical activity. A total of 31(23%) had a FEV1 lower than their Lower Limits of Normal (LLN). Functional performance on the 6MWT was poorer among the CF patients than among the predicted distance estimated with Italian values. The correlation with the amount of physical activity and 6MWD has been verified.

Abstract The clinical associations and prognostic implications of the 6-minute walk test (6MWT) distance in patients with rheumatoid arthritis (RA) is yet to be explored. To identify the clinical features and prognostic implications associated with the 6MWT in patients with RA. Cohort study including 387 RA patients who underwent 6MWT. Regression models (linear and logistic) were built to identify independent predictors of shorter 6MWT distance. Cox proportional models were used to study the association of 6MWT distance with cardiovascular outcomes. Patients were subdivided according to 6MWT tertiles: 126 patients walked > 405 m, 129 walked 345-405 m, and 132 walked 55 years), elevated waist circumference, NT-pro BNP > 125 pg/mL, anemia, C-reactive protein ≥ 3 mg/dL, and troponin T ≥ 14 pg/mL were independent predictors of walking shorter distances. Patients walking less than 345 m had higher risk of a subsequent cardiovascular hospitalization or cardiovascular death compared with patients walking 345 m or more (adjusted HR: 2.98, 95%CI: 1.37–6.51, p = 0.006). Older age, abdominal obesity, anemia, cardiac dysfunction, and inflammation were associated with walking shorter distances in patients with RA. Walking less than 345 m in the 6MWT was associated with a poor cardiovascular prognosis. The 6MWT is simple, reproducible, and inexpensive, easily performed in routine practice, and provides important information regarding the patients´ status and outcomes, enabling the monitorization of the therapeutic optimization of the various domains of the RA.

Heart failure (HF) is a chronic disease with high hospitalizations rates and increased mortality. The six-minute walk test (6MWT) is a standardized method to assess the functional health of HF patients by measuring the distance walked in six minutes [1]. The improved 6MWT with new filter algorithms, based on the development of smartphone application [9], can be used everywhere with a good global navigation satellite system (GNSS) signal. This paper tests multiple filtering approaches to reduce the measured distance error in the application.We were able to decrease the average relative error of the application from 4.5% to 2.0%. Additionally, the number of experiments with relative error over our chosen clinically significant difference of 5% is reduced by 90%. Keeping these results in mind, the system can be considered clinically acceptable.

Objectives: To determine the 6-minute walk test (6MWT) for healthy volunteers in our population and find out the factors affecting 6MWT. Furthermore, comparing our results with published National and International data. Study Design: Cross-sectional study. Place and Duration of Study: This study was carried in the physiology department of Rawalpindi Medical College, from 1st July 2019 to 31st December 2019. Materials and Methods: A total of 129 adult healthy volunteers between 18 and 60 years of age were included in this study after the application of inclusion and exclusion criteria. A 6-minute walk test (6MWT) was carried out in a standardized procedure. The height, weight, and BMI were recorded on predesigned Performa. Distance covered in 6-minute, heart rate, systolic BP, Diastolic BP, SPO2, Borg Scale Dyspnea score, Borg Scale Fatigue score were recorded before and after the 6-minute walk test. Correlation and its significance were calculated among anthropometric and physiological variables. Results: Seventy (54%) men and Fifty-nine (46%) women participated in the study. The mean distance covered for all subjects was 430.412±63.0150. The distance covered by the female subject was 388.720±30.104 and 439.533±68.355 by male subjects. The mean age of the subjects was 31.64 ±12.36, while the mean BMI was 22.06 ±4.15. The mean heart rate value before the test is 77.72±1.48 and after the test is 92.84±1.12. The mean systolic BP value before the walk was 122.65±11.75 and after the walk, it was 106.5±9.83. Mean diastolic BP before the walk was 80.55±12.61 and after the walk, it was 76.5±9.83. SPO2 mean value before the walk was 96.23±1.4 and after the walk is 98.2±1.17. Borg scale dyspnea score mean value before the test is 0 ± 0 and after the test it was 0.67±0.76 and Borg scale fatigue score mean value before the walk is 1.32±0.73 and after the walk is 1.62±0.92. A positive correlation was noted with height, while a negative correlation was noted with age and BMI. Gender also showed a significant relationship with the 6MWD. Conclusion: The distance covered in 6-minute is shorter than the studies carried out in different parts of the world. Age, gender, height, and BMI showed a significant relationship with 6MWD. Those reference values for the 6MWD should not be used in our population, as it overestimates the distance and may interfere with the significance of the test.

Spiroergometric exercise test and a six-minute march test are methods for assessing the exercise capacity. They are used to determine diagnostic and prognostic information, treatment and its effectiveness. The article presents the main parameters evaluated during the tests. The examined disease entities were presented and described, and conclusions from the research were drawn.

BackgroundThe validated Incremental Shuttle Walk Test (ISWT) is widely used for evaluating maximal exercise capacity, with the distance-walked (IWSD) as the primary outcome. However, there are no normative reference values (NRV) and reference equations to predict ISWD for the Singaporean population.ObjectivesThis study aims to establish the NRV and reference equations for ISWD in healthy Singaporeans aged 21 to 80 and investigate the determining variables during ISWT.MethodsThis cross-sectional study recruited community-dwelling healthy subjects aged 21-80 from the community via convenience sampling. Each subject completed two trials of the ISWT according to the standard protocol. Variables measured during the trials included ISWD, pre-and post-test heart rate (HR), oxygen saturation, blood pressure (BP), modified Borg's dyspnoea score and Borg's rate of perceived exertion (RPE).Results199 healthy Singaporean (females = 114, males = 85) participated in the study. The overall median ISWD was 660.0 metres (m) [interquartile range (IQR):440.0-850.0]. The age-stratified mean ISWD ranged from 430.0 m (IQR:350.0-450.0) (aged 60-80) to 480.0 m (IQR:438.0-650.0) (aged 40-59) to 780.0 m (IQR:670.0-960.0) (aged 21-39). Gender, age, weight, height and HR change (highest post-test HR minus pre-test HR) were the most significant variables (p < 0.001). IWSD (m) = 651.4(Height, m) +89.7(Gender, male = 1; female = 0) -6.31(Age, years) -3.61(Weight, kilograms) +2.54(HR change, beats per minute); R2 = 0.741. Previously published ISWT reference equations cannot accurately predict the ISWD in the Singaporean population.ConclusionsThis study investigated the ISWD NRV and established reference equations for healthy Singaporeans aged 21-80. The information would be beneficial in setting performance benchmarks to guide physical assessment, intervention and rehabilitation.

Abstract State-of-the-art estimation methods using inertial measurement units (IMUs) for global continuous gait path and local stepwise gait trajectory during walking have been developed. However, estimation methods for continuous gait trajectory integrating both these aspects with high accuracy are almost lacking. Thus, continuous gait trajectory estimation using a single shank-worn IMU with high accuracy is proposed in this study. This method calculates three-dimensional local stepwise gait trajectory based on IMU measurement data extracted between adjacent middle points of stance phases during walking. Continuous gait trajectory is estimated by concatenating adjacent local stepwise gait trajectories based on relative angles determined according to stride vectors and shank orientations. Evaluation experiments results obtained using the optical motion capture system with 12 healthy participants demonstrated estimation errors in the stride length (− 0.027 (− 0.054 to − 0.006) m) and turning angle (0.7 (− 0.2–1.7)°), and normalized endpoint position error (0.029 (0.019–0.04) m). Comparing with previous reports, the proposed method integrally achieves a continuous gait trajectory with a low estimation error level in both local and global aspects despite the continuous measurement of multiple gait cycles. The proposed simple and low-cost method can be applied in the medical field and contribute to expansion of the application of precise gait information in daily life.

Objective: Inclined surfaces or ramps are the common obstacles faced by elderly and cardiopulmonary disabled in accessing public amenities. Ramp walking is one of the most common functional demands to be met by a common man in the industrialized world. To assess the functional (uphill walking) capacity, we need a different functional stress test over the routinely used 6-min walk test (6MWT). Hence, a new 3-min steep ramp walk test (3MRWT) was constructed to meet the demands similar to an uphill walk and to provide more functional stress than routinely used 6MWT. Methodology: The observational, crossover study design was adopted for this study. Fifteen healthy participants (8 males, 7 females) performed both tests in a randomized order with a washout time of 6 h in between the tests. Walking distance to both ramp and ground, heart rate, blood pressure, saturation (SpO2), dyspnea, and fatigue with Borg exertion scale were compared prior and after the two walk tests. Results: The average distances covered in 6MWT were 510.5 ± 55.06 and 440.65 ± 25.08 meters and in 3MRWT were 270.18 ± 30.8, 230.05 ± 15.06 meters for male and female respectively. The difference between 3MRWT and 6MWT distances covered by the participants was statistically significant (t = 0.893). The mean difference between the heart rate, saturation and perceptions were highly significant (P < 0.001). Conclusion: The study results show that 3MRWT is valid over routinely administered 6MWT and may provide greater functional stress (uphill or ramp walk capacity) in a shorter duration in healthy individuals in assessing the maximal functional capacity in a ramp or uphill walking.

The six-minute walk test (6MWT) is a useful tool to predict outcomes in patients with advanced lung diseases. Greater distance walked has been shown to have more favorable prognostic value compared to other recorded variables. We reviewed the medical records of 164 patients with advanced lung disease who underwent lung transplant evaluation. Results of the 6MWT (distance walked, oxygen required, and mean gait speed) were recorded and analyzed with respect to mortality. 6MWT mean oxygen (O2) flow via nasal cannula was 3.5 ± 3.7 L/min. The distance walked in meters (m) and % predicted were inversely associated with mortality, OR: 0.995 (0.992-0.998) and 0.970 (0.950-0.990), respectively. Patients who walked < 200 meters (OR: 2.1 (1.1-4.0)) or < 45% of predicted, OR: 2.7 (1.2-5.7) had higher mortality. O2 flow during the test had a direct association with mortality (OR: 1.1 (1.0-1.2). In multivariate analysis, O2 flow > 3.5 L/min remained predictive of mortality, OR: 1.1 (1.0-1.2). Mean gait speed was higher in patient who lived compared with patients who died (mean 0.83 ± 0.35 m/mim vs mean 0.69 ± 0.33 m/min, respectively, p= 0.03). Gait speed was a predictor of survival, OR 3.4 (1.1, 10.6). O2 flow during the 6MWT was an independent predictor of mortality in patients with advanced lung disease. The patients that required more than 3.5 L/m of O2 had a higher mortality. Faster gait speed during the 6MWT was also associated with better survival.

Background: Six minute walk test ( 6 MWT) is an inexpensive, reliable and repeatable test for the functional assessment of subjects with chronic respiratory diseases. Aims and Objectives: 1. To estimate the distance travelled on 6 MWT (6 MWD) by patients with chronic respiratory diseases. 2. To find any correlation between symptoms and 6 MWD in subjects with chronic respiratory diseases.3. To find any correlation between spirometry based functional grading and 6 MWD in chronic respiratory disease subjects. Materials & Methods: A total of forty two subjects were taken into the study who were having chronic respiratory diseases like COPD, Bronchiectasis, Tubercular fibrosis, Bronchial asthma, Diffuse parenchymal lung diseases etc.All the subjects underwent physical, radiological, spirometry and 6 MWT . Subjects were classified according to the grading on breathlessness, spirometry and performance on 6 MWT. Results: Significant correlation was obtained when spirometry based functional grading was compared with impairment on 6 MWT. Significant correlation was also observed when grading of breathlessness was compared with performance on 6 MWT. Conclusion: Study results correlated with other studies. This is a first study which evaluated 6 MWT in different diseases chronically affecting the respiratory system.

Abstract Background RYR1-related Myopathies (RYR1-RM) comprise a group of rare neuromuscular diseases (NMDs) occurring in approximately 1/90000 people in the US pediatric population. RYR1-RM result from pathogenic mutations in the ryanodine receptor isoform-1 (RYR1) gene where consequent RyR1 protein calcium dysregulation leads to impaired excitation-contraction coupling, oxidative and nitrosative stress, and mitochondrial depletion. These physiological deficits perpetuate RyR1 dysfunction causing further muscle injury, muscle weakness, and muscle fatigue. Muscle weakness and fatigue are two primary complaints in patients with RYR1-RM and are major symptoms that limit the ability of individuals to perform activities of daily living. The six-minute walk test (6MWT) is an endurance test with high reliability and validity used to measure walking capacity, disease progression, and more recently, fatigability in NMDs with limited results in RYR1-RM. Therefore, the purpose of our study is to objectively assess disease progression and fatigability in RYR1-RM affected individuals using the 6MWT. We hypothesized that 6MWT distance and fatigability would not change significantly between 0 and 6-month visits in RYR1-RM patients, given the clinically reported stable or slowly progressive nature of the disease. We also hypothesized participants would show fatigability during the 6MWT, given muscle weakness and fatigue are the two primary complaints of affected individuals. Results As expected, paired t-test analyses revealed no significant difference between total distance traveled (p = .608) or percent change in speed (p = .141) at 0-months compared with the 6-month visit. Fatigability was observed given the decline in speed between the first and last minute of the 6MWT at the 6-month time point (p ≤ .0005,). Although this decline was not significant at baseline, a significant decline in speed from the 1st minute did occur at minutes 2, 3, and 4 during the baseline visit. Conclusion In this RYR1-RM cohort, the 6MWT showed disease stability over a 6-month period but revealed fatigability during the test. Given these results, the 6MWT may be a promising endpoint for evaluating fatigability and therapeutic efficacy in the 6-month treatment phase of our current n-acetylcysteine trial in this population. Improvement post intervention could be attributed to the intervention rather than variability in disease progression. Trial Registration Clinical Trials.gov, NCT02362425, Registered 13 February 2015-Prospectively registered.

Background: Gait speed is an informative marker of individual’s functional capacity and health status. Neck pain is suggested to be associated with impaired gait speed. However, there is limited evidence for a clinical assessment of gait speed in patients with neck pain. Objectives: To investigate maximum gait speed using the timed 10 meter walk test in individuals with and without neck pain. Relationships between gait speed and characteristics of neck pain were also determined. Materials and methods: Twenty six men and women aged between 18 and 59 years with chronic neck pain and 26 healthy controls of similar age and gender were recruited into the study. Participants were instructed to walk barefoot at their maximum speed along a 10 meter walk way. Time was recorded for the intermediate 6 meters. Test was performed twice and mean maximum gait speed was calculated for analysis. Results: Participants with neck pain demonstrated a slower gait speed during walking at maximum speed compared to the control group (p

Objective: To assess the functional ability and vitals of young children using six-minute walk test. Method: The analytical cross-sectional study was conducted from October 2019 to January 2020 at public and private schools of Rawalpindi and Islamabad after approval from the ethics review committee of Riphah College of Rehabilitation Sciences, Westridge Campus Rawalpindi, Pakistan, and comprised healthy children aged 7-12 years who were subjected to the six-minute walk test according to standardised guidelines. Data was collected using a semi-structured questionnaire. Anthropometric measurements, distance walked in six minutes, heart rate, respiratory rate, oxygen saturation, and rate of perceived exertion were the outcome variables. Data was analysed using SPSS 26. Results: Of the 376 subjects, 225(59.8%) were boys and 151(40.2%) were girls. The mean age of the sample was 9.25±1.64 years. Mean distance covered by the children was 482.63±119.76 metres. Public school students performed better than those studying in private schools (p=0.001). The difference in gender terms was non-significant (p=0.926). Significant difference was observed in mean heart rate and respiratory rate post-walk (p0.05). Conclusion: The level of functional ability of the young students improved with age and was better among those studying at public schools. Besides, anthropometric and physiological parameters influenced the text performance. Key Words: Children, Six-minute walk test, Heart rate, Perceived exertion.

Introduction: Proprioceptive Neuromuscular Facilitation (PNF) of respiratory muscles was found to improve lung function and haemodynamic parameters in mechanically ventilated patients. It has been proven that respiratory PNF had immediate significant effects in Chronic Obstructive Pulmonary Disease (COPD) patients. As pulmonary rehabilitation for COPD patients is a long-term hospital based service, there arises a need to provide a therapy that provides optimal benefit in short term. Aim: To study the effect of short term respiratory PNF on Peak Expiratory Flow Rate (PEFR) and six-minute walk test in patients with stable COPD. Materials and Methods: This quasi-experimental study was carried out in the Department of Physical Medicine and Rehabilitation, Rajah Muthiah Medical College and Hospital at Annamalai University, Chidambaram, Tamil Nadu, India. Twelve male COPD patients attending Medicine Department outpatient service between December 2020 to January 2021 were conveniently recruited. They were assessed for their PEFR using peak flow meter and exercise tolerance by six-minute walk test. They were treated with three respiratory PNF techniques namely, intercostal stretch, vertebral pressure high and anterior stretch by lifting posterior basal area for five consecutive days. Each treatment session lasted for about 30-40 minutes. The post intervention assessment of PEFR and six-minute walk was made. The pre and post intervention data were statistically analysed using paired samples t-test. Results: In this study, the mean age of the participants was 63.0±5.80 years. The mean post intervention measurement of PEFR (226.67±51.09 L/min) and six-minute walk distance (271.92±50.55 m) was found to be significantly higher (p=0.001) than the mean pre interventional values (165.42±46.19; 219.58±43.24 respectively). Conclusion: Implementation of respiratory PNF techniques on short term basis optimally improves the functional exercise capacity and PEFR in patients with stable COPD.

Introduction: The 2-Minute Walk Test (2MWT) is a simple, practical, and less time consuming test. Patients do not get fatigued while performing this test as a part of routine physical examination. 2MWT shows an excellent correlation with other walk tests and can be used as an alternative test in patients with multiple co-morbidities. The reliability of a test is a must for its recommendation to be used in clinics as well as research. Measurement properties have been reported in different populations for 2MWT. However, no data exist for 2MWT in patients with Knee Osteoarthritis (KOA). Aim: To establish the test-retest reliability and Minimal Detectable Change (MDC) scores for the 2MWT in patients with bilateral KOA. Materials and Methods: A prospective test-retest research study designed to assess the reliability of 2MWT. Eighty-two patients with KOA (27 males and 55 females) were included in the study. Health status was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The Numeric Pain Rating Scale (NPRS) and WOMAC were assessed on two consecutive days. Participants performed 2MWT on two different occasions with 48 hours difference in between. Both sessions were conducted for 45 minutes each on a 30 meter walking pathway. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: 2MWT showed an excellent test-retest reliability. Intraclass Correlation Coefficient (ICC) for 2MWT were 0.98. Test-retest reliability assessed by two trials of 2MWT showed 1st trial mean±SD of 154.33±19.59 m and 2nd trial mean±SD of 156.69±19.68 m. Mean difference±SD between both trials was 2.36±2.74, which was statistically significant (p

Objetivos – Averiguar se o Four Square Step Test (FSST) e o L-Test constituem uma alternativa ao 6-Minute Walk Test (6MWT) para a avaliação de desempenho em amputados de membro inferior. Métodos – Estudo transversal e analítico com 19 participantes amputados de membro inferior avaliados por meio do FSST, L-Test e 6MWT. Resultados – Houve uma correlação negativa moderada entre o FSST e o 6MWT (r=-0,611; p=0,005) e uma correlação negativa forte entre o L-Test e o 6MWT (r=-0,798; p=0,000). Dos preditores do 6MWT, apenas foi identificado como tal o L-Test, obtendo-se para este modelo um R2 ajustado =0,616 (R2 Change=0,637, F Change (1, 17)=29,827; p=0,00001). Conclusões – Os participantes que obtiveram os melhores resultados no L-Test foram os que obtiveram melhores resultados na distância percorrida, sendo que um segundo a mais no L-Test corresponde a uma diminuição em média de 9,537 metros no 6MWT. Foi possível verificar que o L-Test constitui uma alternativa ao 6MWT, o que por si só constitui uma enorme vantagem, pois precisa de um espaço e tempo bastante mais reduzidos para a sua realização; em ortoprotesia constitui uma mais-valia, pois na maior parte dos casos os espaços existentes são de pequena dimensão.

The study conducted research aimed at assessing the influence of physical activity on peak expiratory flow (PEF) and the 6-minute walk test (6MTW). The research was carried out at the Department of Systemic Rehabilitation - Post Covid at the Pj-Med Rehabilitation Hospital in Popielówek from June 2021 to April 2022. The inclusion criteria for the studies was a positive PCR test performed up to one year after the end of treatment. Exclusion criteria - active inflammation (CRP

Abstract Pulmonary rehabilitation is based on a thorough patient assessment, including peripheral oxygen saturation (SpO2) and heart rate (HR) at rest and on exertion. To understand whether exercise-field tests identify patients who desaturate (SpO2