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The six-minute walking test in children with cystic fibrosis: reliability and validity.
Pediatr Pulmonol 1996; 22(2):85-9PP

Abstract

There is a need to judge general exercise tolerance in children with cystic fibrosis (CF) under normal daily activity conditions and -when more extensive testing is required-in an exercise laboratory in a specialized center. We investigated the reproducibility, validity, and criterion for a 6-minute walking test, which simulates normal childhood activities. In Part A, we evaluated the reproducibility of a 6-minute walking test in 23 children (12 girls and 11 boys; ages 11.1 +/- 2.2 years; range, 8.2 15.6 years) with mild symptoms of CF [forced expiratory volume in 1 second (FEV1) 94.4 +/- 16.5% of predicted values (range, 60.6-129.7); body weight Z-score -0.71 +/- 0.81 (range, -1.73-0.93)]. The subjects performed two standardized 6-minute walking tests with 1 week between tests. There was no significant difference between the two walking distances reached (737 +/- 85 versus 742 +/- 90 meters; P = 0.56), and there was a strong correlation between the two walking distances reached by the individuals (r = 0.90, P < 0.0001). In Part B, the validity of the walking test was evaluated in 15 children (6 girls and 9 boys; ages 14.5 +/- 2.0 years; range, 10.2-16.9 years) with moderate symptoms of CF [FEV1 = 58 +/- 16.0% of predicted values, (range, 41.1-89.4); RV/TLC ratio = 46.3 +/- 6.5% (range, 31.6-57.2); body weight Z-score: -1.29 +/- 0.60 (range, -2.20-0.14)]. They underwent standardized maximum incremental exercise testing on a cycle ergometer and a 6-minute walking test. Postexertional lactate values exceeded threshold values (as described in the literature) in all patients but one. Correlation analysis (Pearson) showed a significant correlation between the walking distance reached (WD = 697 +/- 104 meters), and the maximum workload (Wmax = 118 +/- 44 watt; r = 0.76, P < 0.001) or the maximum oxygen uptake (1,688 +/- 495 ml; r = 0.76, P < 0.001), the latter two being determined on a cycle ergometer, RV/TLC% showed a significant negative correlation (r = -0.72, P < 0.01) with WD. Stepwise multiple regression analysis showed a multiple regression coefficient of R = 0.84 (P < 0.001) for Wmax and RV/TLC % as the independent variables vs. WD as the dependent variable. We conclude that the 6-minute walking test is a valid and useful test in children with mild to moderate symptoms of CF to assess their exercise tolerance and endurance. Exercise test results correlated negatively with pulmonary hyperinflation expressed by the RV/TLC ratio.

Authors+Show Affiliations

Department of Pediatric Physiotherapy, University Children's Hospital Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8875580

Citation

Gulmans, V A., et al. "The Six-minute Walking Test in Children With Cystic Fibrosis: Reliability and Validity." Pediatric Pulmonology, vol. 22, no. 2, 1996, pp. 85-9.
Gulmans VA, van Veldhoven NH, de Meer K, et al. The six-minute walking test in children with cystic fibrosis: reliability and validity. Pediatr Pulmonol. 1996;22(2):85-9.
Gulmans, V. A., van Veldhoven, N. H., de Meer, K., & Helders, P. J. (1996). The six-minute walking test in children with cystic fibrosis: reliability and validity. Pediatric Pulmonology, 22(2), pp. 85-9.
Gulmans VA, et al. The Six-minute Walking Test in Children With Cystic Fibrosis: Reliability and Validity. Pediatr Pulmonol. 1996;22(2):85-9. PubMed PMID: 8875580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The six-minute walking test in children with cystic fibrosis: reliability and validity. AU - Gulmans,V A, AU - van Veldhoven,N H, AU - de Meer,K, AU - Helders,P J, PY - 1996/8/1/pubmed PY - 2000/6/22/medline PY - 1996/8/1/entrez SP - 85 EP - 9 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 22 IS - 2 N2 - There is a need to judge general exercise tolerance in children with cystic fibrosis (CF) under normal daily activity conditions and -when more extensive testing is required-in an exercise laboratory in a specialized center. We investigated the reproducibility, validity, and criterion for a 6-minute walking test, which simulates normal childhood activities. In Part A, we evaluated the reproducibility of a 6-minute walking test in 23 children (12 girls and 11 boys; ages 11.1 +/- 2.2 years; range, 8.2 15.6 years) with mild symptoms of CF [forced expiratory volume in 1 second (FEV1) 94.4 +/- 16.5% of predicted values (range, 60.6-129.7); body weight Z-score -0.71 +/- 0.81 (range, -1.73-0.93)]. The subjects performed two standardized 6-minute walking tests with 1 week between tests. There was no significant difference between the two walking distances reached (737 +/- 85 versus 742 +/- 90 meters; P = 0.56), and there was a strong correlation between the two walking distances reached by the individuals (r = 0.90, P < 0.0001). In Part B, the validity of the walking test was evaluated in 15 children (6 girls and 9 boys; ages 14.5 +/- 2.0 years; range, 10.2-16.9 years) with moderate symptoms of CF [FEV1 = 58 +/- 16.0% of predicted values, (range, 41.1-89.4); RV/TLC ratio = 46.3 +/- 6.5% (range, 31.6-57.2); body weight Z-score: -1.29 +/- 0.60 (range, -2.20-0.14)]. They underwent standardized maximum incremental exercise testing on a cycle ergometer and a 6-minute walking test. Postexertional lactate values exceeded threshold values (as described in the literature) in all patients but one. Correlation analysis (Pearson) showed a significant correlation between the walking distance reached (WD = 697 +/- 104 meters), and the maximum workload (Wmax = 118 +/- 44 watt; r = 0.76, P < 0.001) or the maximum oxygen uptake (1,688 +/- 495 ml; r = 0.76, P < 0.001), the latter two being determined on a cycle ergometer, RV/TLC% showed a significant negative correlation (r = -0.72, P < 0.01) with WD. Stepwise multiple regression analysis showed a multiple regression coefficient of R = 0.84 (P < 0.001) for Wmax and RV/TLC % as the independent variables vs. WD as the dependent variable. We conclude that the 6-minute walking test is a valid and useful test in children with mild to moderate symptoms of CF to assess their exercise tolerance and endurance. Exercise test results correlated negatively with pulmonary hyperinflation expressed by the RV/TLC ratio. SN - 8755-6863 UR - https://www.unboundmedicine.com/medline/citation/8875580/The_six_minute_walking_test_in_children_with_cystic_fibrosis:_reliability_and_validity_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=8755-6863&amp;date=1996&amp;volume=22&amp;issue=2&amp;spage=85 DB - PRIME DP - Unbound Medicine ER -