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Background and Aims: Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF)., Methods: FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin < 100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation < 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL)., Results: The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5-93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07-0.96; P = .043) was lower with FCM than placebo., Conclusions: In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Introduction: Access to interstitial lung disease programs may not be available in rural settings. Home-based pulmonary rehabilitation (PR) programs have been proposed as an alternative to hospital-based programs., Method: Forty participants with ILD underwent a structured unsupervised home-based pulmonary rehabilitation program from September 2020 to September 2022. Quality of life was assessed using St. George Respiratory Questionnaire (SGRQ) and functional capacity using 6-minute walk test (6MWT). The outcome measures were assessed at baseline and 4 weeks post-unsupervised home-based PR program., Result: We recruited 40 participants with ILD. There was statistically significant improvement in the 6-minute walk distance (353.8 m and 368 m, effect size - 0.5, p  ≤ .001) and quality of life using SGRQ total score (38.6 and 42.35, effect size - 2.5, p  ≤ .001) between before and after receiving home-based PR among all 40 participants with ILD., Conclusion: Four weeks of home-based PR program, using minimal resources, deliver short-term improvements in functional exercise capacity and quality of life among ILD participants. Our home-based PR program resulted in a quarter percentage improvement in functional capacity, and we believe that if consistency is maintained, it will result in similar changes corresponding to the already established Minimal Clinically Important Difference (MCID) of 35 m.

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 groups, while obstructive and mixed patterns were prevalent in the >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.

Background: Identifying the minimal clinically important difference (MCID) contributes to the ability to determine the efficacy of physiotherapy interventions and make good clinical decisions., Purpose: The purpose of this study was to estimate the MCID for 6-minute walking distance (6MWD) among inpatients with subacute cardiac disease using multiple anchor-based methods., Methods: This study was a secondary data analysis using only data from a multicenter longitudinal observational study in which 6MWD was measured at two time points. Based on the changes in 6MWD between baseline measurement and follow-up approximately 1 week after baseline measurement, the global rating of change scales (GRCs) of patients and physiotherapists, anchor method receiver operator operating characteristic curves, predictive models, and adjusted models were used to calculate the MCID., Results: Participants comprised 35 patients. Mean (standard deviation) 6MWD was 228.9 m (121.1 m) at baseline and 270.1 m (125.0 m) at follow-up. MCID for each GRC was 27.5-35.6 m for patients and 32.5-38.6 m for physiotherapists., Conclusion: The MCID in 6MWD in patients with subacute cardiovascular disease is 27.5-38.6 m. This value may be useful in determining the effectiveness of physiotherapy interventions and for decision-making.

Introduction: Hypertensive heart failure (HHF) has a high incidence and poor prognosis., Aim: This article evaluated the efficacy and safety of Vericiguat in HHF and analyzed the relationship between C-reactive protein (CRP) levels and patient prognosis., Methods: 110 HHF patients were divided into Placebo and Vericiguat groups. Cardiac function was assessed by echocardiography and 6-minute walk test (6MWT). Blood samples were collected to detect the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), endothelin (ET-1), nitric oxide (NO), and CRP., Results: Left ventricular end systolic diameter (LVESD) and left ventricular end diastolic dimension (LVEDD) were reduced, the left ventricular ejection fraction (LVEF) and 6MWT were increased, and the serum levels of NT-proBNP, cTnI, ET-1, NO, and CRP were decreased in Vericiguat group as against Placebo group; The total effective rate was 76.4% in Placebo group and 92.7% in Vericiguat group (P < 0.05). The adverse reaction rate was 10.9% and 9.1% (P > 0.05). The proportion of persons with poor prognosis and no improvement of cardiac function in patients with highly expressed CRP before treatment was higher as against patients with low expression of CRP (P < 0.05). Highly expressed CRP is an independent risk factor for poor prognosis., Conclusion: Vericiguat is safe and effective in improving cardiac function in HHF patients., (© 2024. The Author(s).)

This study aimed to investigate the applicability of the Lactate Threshold (LT) to predict maximal oxygen uptake (˙VO 2max ) and demarcate the boundary between the moderate- to heavy- intensity domain (HR m-h ) in old age in comparison to the most utilized methods. A cross-sectional validation study was conducted. Participants aged 61 to 77 performed a familiarization procedure, an incremental maximal exercise treadmill test (CPX) for ˙VO 2max determination, the Six-minute Walk Test (6MWT), and a discontinuous incremental field test for LT determination. Lower (P<0.01) internal effort was required for LT testing (76±8%HR max ) compared to 6MWT (92±9%HR max ). The application of the 6MWT reference equations overestimated ˙VO 2max by 10-23%. LTs better estimated the ˙VO 2max (r ≈0.90, SEE: ≈3.0] compared to the 6MWT (r=0.68, SEE=5.5). HR m-h determined by the CPX differed (20%; P=0.001) from that obtained by LT. HR m-h stratification indicated participants fall into the very light to the vigorous intensity domains. LT testing is more submaximal than the 6MWT, and is a valuable tool to estimate the ˙VO 2max in older male adults. Implementation of LT testing in physical activity programs might help improving the quality of aerobic exercise training in older men., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: The 20-m 6-min-walk test (6MWT20) is a valid, reliable alternative for functional capacity assessment; however, its responsiveness and minimally important difference (MID) have yet to be investigated. The aim of this study was to assess the responsiveness and MID of the 6MWT20 in individuals with COPD., Methods: Fifty-three subjects completed the study from August 2011-March 2020. The following were assessed: lung function, activities of daily living (ADLs), functional capacity 6MWT20, dyspnea, health status, quality of life, and limitations in ADLs. The primary outcome was the 6MWT20 distance., Results: The study demonstrated that the 6MWT20 is responsive to pulmonary rehabilitation (PR), with an average improvement of 39 ± 36.3 m ( P < .001) and an effect size of 1.07. The learning effect declined to 1.45% after PR, with an intraclass correlation coefficient of 0.99 (95% CI 0.98-0.99). The receiver operating characteristic curve indicated a cutoff point of 20 m for the MID of the 6MWT20 based on the MIDs for the modified St George Respiratory Questionnaire (sensitivity 87%, specificity 69%, area under the curve 0.80 [95% CI 0.66-0.90], P < .001, Youden index 0.56) and the number of steps (sensitivity 92%, specificity 73%, area under the curve 0.83 [95% CI 0.70-0.92], P < .01, Youden index 0.56)., Conclusions: The 6MWT20 is responsive to PR, and the MID for the test is 20 m (17-47 m)., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2023 by Daedalus Enterprises.)

Background: Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited., Objective: To analyze the heart rate (HR) in the stages of the TT and at the peak of the 6-minute walk test (6MWT) as a parameter to prescribe aerobic exercise compared with HR at the first and second ventilatory thresholds (VT1 and VT2) of cardiopulmonary exercise test (CPET)., Methods: Individuals with cardiovascular disease attended three assessment days: 1) anamnesis and CPET; 2) 6MWT; and 3) TT. One-way repeated measures ANOVA or Friedman's test were used to compare HR at VT1 and VT2 with HR at TT stages: last positive (TT+), first equivocal (TT±), and negative (TT-), and at the peak of the 6MWT. Pearson's or Spearman's test assessed correlations between HR at VTs, TT stages, and 6MWT. Statistical significance was set at 5%., Results: The study included 22 cardiac patients (13 men, 61 ± 8 years). HR at VT1 was similar to HR at TT+ (p = 0.987) and TT± (p = 0.154), and moderately correlated with TT+ (r = 0.479, p = 0.024). HR at VT2 was similar to TT- (p = 0.383), with a strong correlation (r = 0.757, p < 0.001). HR at the peak of the 6MWT was significantly different from HR at TT+, TT±, and VT1 (p = 0.001, p = 0.005, and p < 0.001, respectively) but similar to TT- (p = 0.68)., Conclusions: HR at TT+ and TT- reflect HR at VT1 and VT2, respectively, differently from 6MWT, which was similar only to VT2. TT may be an objective test to assist aerobic exercise prescription in cardiac rehabilitation.

Six-minute walk test (6MWT) is the most widely used exercise capacity measurement worldwide in patients with pulmonary hypertension (PH). Although cardiopulmonary exercise testing (CPET) is the gold standard for the assessment of exercise capacity in cardiovascular diseases; the limited accessibility of the device, the need for experience in interpreting the results, and the difficulties in performing CPET in advanced PH have aroused the interest in the application of easier methods for the measurement of exercise capacity. Since then, accumulated data proved that; 6-minutes walking distance (6MWD) can be used to determine exercise capacity and is highly correlated with maximum oxygen consumption (peak VO2) detected by CPET in patients with heart failure and/or PH. Moreover, 6MWT is very easy and practical to apply in all PH subgroups. This review is focused on the application of a reliable 6MWT and the interpretation of the results in patients with PH.

Purpose: Timed functional tests have been explored to understand the natural history of Duchenne muscular dystrophy (DMD) and to establish warning signs of loss of gait. This study verified whether the combination of the 10-metre walk test (10MWT) and the motor function measure (MFM) could classify the ambulation status of DMD patients., Method: Thirty-two patients, aged between 5 and 22 years, with independent gait initially evaluated over 11 years participated in the study. Two groups were created: ambulators and non-ambulators. For both groups, we calculated a 10MWT ratio, by dividing the time spent to perform the last evaluation by the penultimate evaluation, and a MFM dimension-1 score (MFM-D1), collected in the same period. For the statistical analysis, the CART algorithm ("rpart" package in R) classified the patients into ambulators and non-ambulators according to two continuous variables: the 10MWT ratio and the MFM-D1 score., Results: The cut-off points were 1.1 for the 10MWT ratio and 26 points for the MFM-D1, which distinguished 70% of the patients as either ambulators or non-ambulators., Conclusion: This simple measurement strategy can be used by therapists to adjust their rehabilitation strategies and goals.Implications for rehabilitationCombination of 10MWT ratio with MFM-D1 reveal an "indicator" for the ambulation status of patients with DMD.Physiotherapists can guide clinical care and prepare the patient and family for loss of gait.CART algorithm describes how we classified the patients according to two continuous variables.70% Of the patients with DMD can be distinguished as either ambulators or non-ambulators.

ABSTRACT Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P

Background: Hip osteoarthritis (OA) can result in joint pain, stiffness, compromised balance, hindered mobility, and decreased functional independence. The Cone Evasion Walk Test (CEW) was designed for evaluating balance by evaluating the capacity to evade obstacles. Consequently, the study's objective was to assess the validity and reliability of the CEW in hip OA patients. Methods: A total of 24 patients with hip OA were enrolled. Patients performed trials for the CEW and the timed up and go test (TUG). Between the trials, patients rested for an hour. The falls within the previous 12-month period were reported. Results: The analysis showed that the CEW has excellent reliability and high validity in hip OA. (p < 0.001). The relative (intraclass correlation [ICC] coefficient) and absolute (SEM and SRD95) reliability of the CEW were 0.96 (0.88–0.98 95% CI), 0.56, and 1.54, respectively. The Spearman correlation coefficient between the CEW and the TUG was 0.74 (p < 0.001) and between the CEW and the falls in the last 12 months was 0.51 (p > 0.05). Conclusions: The CEW is effective for evaluating the function, dynamic balance, and mobility in patients with hip OA and could be a more accurate measure of the dynamic balance activities in the community. [ABSTRACT FROM AUTHOR]

BackgroundPoor functional exercise capacity is common among those with obesity; however, objective measures of exercise capacity are rarely examined in behavioral treatments targeting obese individuals. We examined whether a 4-week acceptance and commitment therapy (ACT) intervention for disinhibited eating or a behavioral weight loss (BWL) intervention improved exercise capacity and explored demographic and disinhibited eating variables related to exercise capacity.MethodsVeterans (n = 61), randomized to receive ACT or BWL, completed an assessment of exercise capacity via the 6-min walk test (6MWT) at baseline and 6-month follow-up. Measures of disinhibited eating patterns and body mass index (BMI), at baseline and post-treatment, were also collected. Change in 6MWT distance and treatment group differences were examined using mixed ANOVAs. Characteristics related to baseline 6MWT and predictors of improvement in 6MWT at 6 months were examined with hierarchical multiple regression.ResultsThere were overall significant improvements on the 6MWT from baseline to 6-month follow-up (F(1,59) = 11.14, p = .001, ηp2 = .159) but no differences between the ACT and BWL groups. Baseline BMI (β = - .33, p = .005) was the only variable related to baseline 6MWT. Improvements on the 6MWT were related to younger age (β = - .41, p = 0.001), female gender (β = .36, p = .001), and treatment-related increases in dietary restraint behaviors (β = .42, p = .001).ConclusionsFunctional exercise capacity improved among participants completing behavioral interventions for weight and disinhibited eating. Improvements in dietary behavior regulatory skills may have generalized to improved regulation in other behavioral domains associated with exercise capacity.

BackgroundAmbulatory function predicts morbidity and mortality and may be influenced by cardiopulmonary dysfunction. Persons living with HIV (PLWH) suffer from a high prevalence of cardiac and pulmonary comorbidities that may contribute to higher risk of ambulatory dysfunction as measured by 6-minute walk test distance (6-MWD). We investigated the effect of HIV on 6-MWD.MethodsPLWH and HIV-uninfected individuals were enrolled from 2 clinical centers and completed a 6-MWD, spirometry, diffusing capacity for carbon monoxide (DLCO) and St. George's Respiratory Questionnaire (SGRQ). Results of 6-MWD were compared between PLWH and uninfected individuals after adjusting for confounders. Multivariable linear regression analysis was used to determine predictors of 6-MWD.ResultsMean 6-MWD in PLWH was 431 meters versus 462 in 130 HIV-uninfected individuals (p = 0.0001). Older age, lower forced expiratory volume (FEV1)% or lower forced vital capacity (FVC)%, and smoking were significant predictors of decreased 6-MWD in PLWH, but not HIV-uninfected individuals. Lower DLCO% and higher SGRQ were associated with lower 6-MWD in both groups. In a combined model, HIV status remained an independent predictor of decreased 6-MWD (Mean difference = -19.9 meters, p = 0.005).ConclusionsHIV infection was associated with decreased ambulatory function. Airflow limitation and impaired diffusion capacity can partially explain this effect. Subjective assessments of respiratory symptoms may identify individuals at risk for impaired physical function who may benefit from early intervention.

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 Background Congenital Generalized Lipodystrophy (CGL) is an ultra-rare disease characterized by metabolic disorders. However, the evaluation of functional exercise capacity, cardiovascular (CV) response to exercise, and peripheral arterial disease (PAD) in CGL is scarce. Here we evaluated the performance and CV response to exercise and their association with PAD in CGL compared to healthy individuals. Methods Twelve CGL and 12 healthy subjects matched for age and gender were included. Functional exercise capacity, CV response, and PAD were measured using the six-minute walk test (6MWT) and ankle-brachial index (ABI), respectively. Results At baseline, CGL subjects showed reduced predicted walked distance (6MWD) (p = 0.009) and increased heart rate (HR), systolic (SBP), and diastolic (DBP) pressures compared to healthy subjects (p

The aim of this study is to examine the available scientific evidence on the reliability and criterion validity of 6-minute run walk field-based test when administered to children and adolescents. Systematic searches were performed in three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) from their inception until February 2024, with an update on August 15, 2024. Studies were considered eligible if they provided information on the criterion-related validity and/or reliability of the 6-minute run walk test when conducted by children (aged 12 years and under) and/or adolescents (aged 13 to 17 years). To examine reliability and validity, two separate meta-analyses were implemented. In the meta-analysis focused on criterion-related validity, the five studies included indicated a fair validity (r = 0.56 [95% CI: 0.44–0.66]) and high homogeneity (I2 0%). In the meta-analysis focused on reliability, the pooled data from the five studies employing Pearson’s correlation coefficient (n = 585) revealed strong reliability values (r = 0.82 [95% CI: 0.75–0.87]), albeit with a moderate level of heterogeneity (I2 71% prediction interval 0.55–0.94). The evidence suggests that the 6-minute run walk field-based test demonstrated fair criterion-related validity and strong test-retest reliability when conducted with children and adolescent. [ABSTRACT FROM AUTHOR]

Background: The 6-minute walk test is a common clinical instrument for assessing patient's functional capacity. The 6MWT should be performed preferably indoors, on a flat, straight, hard surfaced corridor usually at least 30 meter long. The test is also used for assessing the effect of therapies such as pulmonary rehabilitation, oxygen therapy, long‐term use of inhaled corticosteroids, and lung volume reduction surgery. The 6MWD in healthy adults has been reported to range from 400 to 700 metres. Method: A total of 300 subjects were included in the study. All the healthy volunteers presenting during the study period were included in the study, provided they met the inclusion and exclusion criteria as above. A written informed consent was taken from all the subjects who were to be included in the study. They were assured about the maintenance of confidentiality and the nature of voluntary participation. Once consent was given, they were included in the study. Result: In the present study, there were 150 males and 150 females. They were comparable in terms of age. The height and weight of males was more than females. It can be concluded from the present study that there is an increase in the hemodynamic parameters immediately after the test. However, the levels return to normal/baseline when measured 4 minutes after the test. Conclusion: The prediction equation developed from distance walked is: 6MWD (females) = 83.76 – (1.42*Age in years) – (3.98*Weight in kgs)+ (426.60*Height in metres). 6MWD (males) = 553.46 – (2.62*Age in years) + (1.82*Weight in kgs) - (38.98*Height in metres. [ABSTRACT FROM AUTHOR]

Purpose: Remediation of gait problems is a key feature of neurological physiotherapy We aimed to investigate the inter-rater reliability and agreement of the Six Minute Walk Test (6MWT) and Ten Meter Walk Test (10MWT), at comfortable walking speed, in hospitalized acute ischemic stroke patients., Method: Forty acute first-time patients with brain stem or hemispheric ischemic stroke aged 67.4 ± 12.5 (SD), able to walk with or without an assistive device, were tested by one of three physiotherapists. Test-retest reliability was evaluated using a one-way random effects single measures model (1,1) absolute agreement-type Interclass Correlation Coefficient (ICC). Agreement was evaluated using the Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC)., Results: Both tests demonstrated good reliability; ICC 1,1 0.83 (CI 95% 0.70-0.90) (6MWT) and 0.76 (CI 95% 0.59-0.87) (10MWT). The 6MWT-SEM was 27.2 m (m) and the SDC was 75.4 m. The 10MWT-SEM was 0.36 meters per second (m/s) and the SDC was 1.0 m/s., Conclusion: Both tests demonstrated good inter-rater reliability, confirming their discriminative ability on a group of hospitalized first-time acute ischemic stroke patients. However, the measurement error was large for both tests, which is likely due to spontaneous neurological recovery and stress in the acute phase severely affecting the individual-level agreement estimate.

Objectives: The six-minute walk test (6MWT) is a commonly used measure of functional capacity. This study is the first to investigate the test-retest reliability, minimal detectable difference (MDD) and the minimal clinically important difference (MCID) for people attending a persistent pain service. Relationships between change in 6MWT performance and change in self-reported physical, functional and psychological outcome measures were also explored., Methods: A cross-sectional repeated measures design was used with people having >9 months of pain attending an 8-week outpatient persistent pain programme. For reliability and MDD, 27 people were recruited, for MCID calculations, 32 people were recruited. The MCID was examined by dichotomising people into "improvers", or "non-improvers" based upon the Global Rating of Change (GRC) in physical abilities score., Results: The mean (SD) 6MWT distance was 389.4 (93.6) m at programme start, and 427.8 (83.0) m at week eight completion. The test-retest reliability was good (intraclass correlation coefficient = 0.89) and the MDD = 86.1 m. As there was no relationship between change in 6MWT distance and GRC physical abilities at week eight (r = 0.132, p = 0.472) the MCID could not be calculated. Furthermore, no relationships were found between change in 6MWT distance and other self-reported measures. Changes in GRC physical abilities and 6MWT were frequently discordant, with increased 6MWT for 7/11 "GRC non-improvers" and decreased 6MWT for 7/21 "GRC improvers"., Conclusions: Amongst this cohort, change in physical ability may or may not be reflected by self-reported change. Objective tests of physical ability are recommended for people attending pain services, and validated tests should align with intervention aims., (© 2022 John Wiley & Sons Ltd.)

The 6-minute walk test (6MWT) is widely used to assess walking capacity among persons with stroke. Whether a shorter and more convenient test, the 2-minute walk test (2MWT) could replace it, was tested. Two retrospective analyses were conducted. The first one was performed on a sample of 20 persons with stroke who performed both the 2MWT and the 6MWT, and the second one, on a group of 82 persons with stroke who performed the 6MWT while measuring the distance covered each minute. Linear regression models were applied to test the validity of 2MWT with regard to 6MWT. In the first group, distances covered during the 2MWT were highly predictive of the distances covered during the 6MWT (estimated adjusted R ² = 0.98; P  < 0.001). In the second group, distances covered by participants during the first 2 min of the 6MWT were highly and linearly related to the distances they covered during the whole 6MWT (estimated adjusted R ² = 0.98; P  < 0.001). Furthermore, the distance covered during the first 2 min of the whole 6MWT allowed us to predict 98% of the variance of the 6MWT. Given its good metric properties and its practical advantages, clinicians and researchers could reasonably use the 2MWT when assessing the walking capacity of persons with stroke, instead of the 6MWT., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: The 6-minute walk test (6MWT) has been used for over 30 years to assess exercise capacity in patients with respiratory disease, and more recently, in those with heart failure. However, despite being a simple and reproducible test of real-world exercise capacity, its use in patients with ischemic heart disease (IHD) is less well accepted. We sought to review systematically the evidence surrounding the 6MWT in IHD. Methods: We searched the Medline, PubMed, Embase, and Scopus databases for the following key terms: “six minute walk test/6 minute walk test/6MWT” and “angina/coronary artery disease/coronary disease/IHD/ischemic heart disease.” We followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to select publications for full-text review and analyzed the collated data. Results: A total of 1228 unique papers were found, of which 71 were chosen for full-text review and 37 for detailed analysis. Most (23) concerned the effect on 6MWT distance (6MWTd) of cardiac rehabilitation, with measurements commenced after an intervention (acute myocardial infarction, n = 4; open heart surgery (OHS), n = 5; percutaneous coronary intervention (PCI), n = 3; or other, n = 11). The effect on 6MWTd of OHS was investigated in 6 studies and of PCI in one study. The 6MWT is a useful measurement of physical capacity; data are limited on its ability to assess benefit following PCI. Conclusions: The 6MWT has been studied inconsistently in IHD. The majority of data are on patients before and after CR. Data are limited concerning the effect on 6MWTd of OHS or PCI. The available data support the 6MWT as a measure of change in performance status following coronary intervention. More work is required to confirm this hypothesis. Résumé: Contexte: Le test de marche de 6 minutes (TM6) est utilisé depuis plus de 30 ans pour évaluer la tolérance à l’effort chez les patients atteints de maladies respiratoires, et maintenant également utilisé auprès des patients atteints d’insuffisance cardiaque. Toutefois, bien qu’il s’agisse d’un test simple et facile à reproduire de la tolérance à l’effort en contexte réel, son utilisation est moins bien acceptée auprès des patients présentant une cardiopathie ischémique (CI). Notre objectif était de réaliser une revue systématique des données probantes au sujet du TM6 chez les patients atteints de CI. Méthodologie: Nous avons effectué une recherche dans les bases de données Medline, PubMed, Embase et Scopus en utilisant les mots-clés suivants : « six minute walk test/6 minute walk test/6MWT » [test de marche de six minutes/test de marche de 6 minutes/TM6] et « angina/coronary artery disease/coronary disease/IHD/ischemic heart disease » [angine/coronaropathie/CI/cardiopathie ischémique]. Nous avons suivi les lignes directrices « Preferred Reporting Items for Systematic Reviews and Meta-analysis » pour sélectionner les articles à soumettre à un examen du texte intégral et nous avons analysé les données obtenues. Résultats: Au total, 1 228 articles différents ont été repérés; 71 d’entre eux ont été sélectionnés pour un examen du texte intégral, puis 37 ont été soumis à une analyse plus détaillée. La plupart de ces articles (23) portaient sur l’effet de la distance au TM6 (dTM6) sur la réadaptation cardiaque, et les mesures débutaient après une intervention (infarctus aigu du myocarde, n = 4; chirurgie à cœur ouvert [CCO], n = 5; intervention coronarienne percutanée [ICP], n = 3; autre type d’intervention, n = 11). L’effet sur la dTM6 d’une CCO a été évalué dans six études et l’effet d’une ICP a été évalué dans une étude. La dTM6 est une mesure utile de la tolérance à l’effort, mais les données restent limitées sur sa capacité à évaluer les effets bénéfiques d’une ICP. Conclusions: L’utilisation du TM6 n’a pas été étudiée de façon systématique en contexte de CI. La majorité des données portent sur les patients avant et après la réadaptation cardiaque, mais il y a peu de données probantes sur l’effet d’une CCO ou d’une ICP sur la dTM6. Les données dont on dispose corroborent l’utilisation du TM6 comme mesure d’un changement des capacités après une intervention coronarienne. D’autres travaux de recherche devront être réalisés pour confirmer cette hypothèse.

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.

Background and Purpose: The purpose of this study was to investigate the 3-meter backward walk test (3MBWT) in individuals with Parkinson Disease (PD) to determine the following: (1) concurrent validity with other gait velocity measures and (2) interrater and intrarater reliability of in-person and video assessment. Methods: A convenience sample of 25 people with PD participated. Forward gait velocity was measured using a computerized walkway (Zeno Walkway System), the 10-meter walk test (10MWT), and 4-meter walk test (4MWT). Backward gait velocity was measured using the 3MBWT. Concurrent validity was assessed using Pearson’s correlations. Reliability was assessed using intra-class correlation coefficients (ICC(2,1)). Results: All relationships between the 3MBWT and gait outcome measures were significant. The 3MBWT demonstrated strong correlations with the 4MWT dual task (r = .795, p=<.001) and moderate correlations with 4MWT comfortable walking speed (r = .658, p < .001), 4MWT fast walking speed (r = .601,p=.002), 10MWT comfortable walking speed (r = .512, p = .009), and 10MWT dual task (r = .535, p = .006). A low yet significant correlation was noted with the 10MWT fast walking speed (r = .398, p = .049). Association between the 3MBWT and the Zeno Walkway System revealed moderate correlations. All reliability tests were significant at p < .001. Interrater reliability ICC(2,1) values were very high for 3MBWT (ICC(2,1) = 0.93, [0.83–0.91]). Intrarater reliability was also very high (ICC(2,1) = 0.96 [0.90–0.98]). Conclusion: The 3MBWT demonstrates validity and reliability as a tool for assessing gait speed in the posterior direction in people with PD. [ABSTRACT FROM AUTHOR]

Introduction: Fibrosing interstitial lung diseases (ILDs) often progress despite treatment and become life-threatening, with lung transplant (LTx) remaining the only curative option. Six-minute walk distance (6MWD) is increasingly recognized as reliable predictor of clinical course, especially when longitudinally considered. The use of reference equations to express 6MWD as percent predicted (6MWD%) has not been previously studied in fibrosing ILDs. We sought to investigate whether the prognostic power of 6MWD% is superior to that of 6MWD expressed in meters (6MWD-m)., Methods: A retrospective, multicenter cohort analysis was conducted on both idiopathic pulmonary (IPF) and non-IPF fibrosing ILD patients. Patients were divided into a discovery (n = 211) and a validation (n = 260) cohort. Longitudinal changes of 6MWD% and lung function parameters were simultaneously considered. LTx-free survival at 3 years from baseline was the endpoint. Competing risks of death and LTx were considered., Results: Baseline 6MWD% and its longitudinal changes were significant predictors of LTx-free survival and independent from lung function variables. In both cohorts, on multivariate cox proportional hazard regression analysis, receiver operating characteristics analysis and Kaplan-Meier estimates, 6MWD% was consistently, but only slightly superior to 6MWD-m as a predictor of LTx-free survival., Conclusion: 6MWD% has only a slight, yet detectable advantage over 6MWD-m as a predictor of survival in fibrosing ILDs. Utilizing 6MWD% may aid in risk stratification, treatment monitoring, and LTx timing optimization. However, available reference equations do have predicting limitations. Refined predictive equations and standardizing reporting practices are therefore needed to further enhance the clinical utility of 6MWD% in fibrosing ILDs., (© 2024. The Author(s).)

Introduction: Morbid obesity is associated with alterations in the ability to walk, however, the behavior of the 6-minute walk test in subjects with increases in body mass index is unknown., Objective: To describe the behavior of the 6-minute walk test in subjects with normal body mass index to morbid obesity., Methods: Through an analytical cross-sectional design, subjects of both genders from 18 to 60 years old with body mass index were studied: Normal (BMI:18.5-24.9); overweight (BMI:25-29.9); obesity (BMI:30-39.9); morbid obesity (BMI:>40) kg/m 2 . A 6-minute walk test was performed, demographic variables and pathological personal history were delimited. BMI categories were analyzed with one-way ANOVA and Bonferroni adjustment, and gender with t-test, both for independent groups, and Pearson's correlations for the various variables., Results: 480 subjects of both genders were studied in four groups. Age: men 43 ± 11 and women 45 ± 10 years old. Percentage diabetes mellitus (6.7%), arterial hypertension (18.3%). Meters walked men vs. women by body mass index (normal: 483 ± 56 vs. 449 ± 61; overweight: 471 ± 55 vs. 441 ± 44; obesity: 455 ± 70 vs. 421 ± 47; morbid obesity: 443 ± 49 vs. 403 ± 54, p < 0.05). Correlation body mass index-meters walked: r: -0.446 (p < 0.0001)., Conclusions: Meters walked in the 6-minute walk test decreased as body mass index increased. The male gender walked more meters in all categories.