3 and 6 minute walk test update
There have not been any new updates regarding the 6-minute walk test norms since last year. However, there have been new studies published that indicate it is a valid test for the pediatric population. Also, I was not able to find any normative values for the 3 minute walk test in the pediatric or adult population.
Citation of Article:
Den boer SL, Flipse DH, Van der meulen MH, et al. Six-Minute Walk Test as a Predictor for Outcome in Children with Dilated Cardiomyopathy and Chronic Stable Heart Failure. Pediatr Cardiol. 2016
Article Summary:
The purpose of the article was to see if the 6 minute walk test could be a predictive outcome in children with dilated cardiomyopathy. There were 49 participants with dilated cardiomyopathy who were 6 years and older who performed the 6 minute walk test. The patients were instructed to walk back and forth on an 8 m track at a self-chosen speed. The objective was to walk as far as possible with no running during a 6 minute time period. The researched converted the 6 minute walk distance to a percentage using the age and gender specific normal values. By using a univariable Cox regression analysis, the researchers determined a higher 6MWD% resulted in a lower risk of death or transplantation. They determined patients with a 6MWD% less than 63% had a 2 year transplant free survival of 73%. If the patient had a percentage greater than or equal to 63%, their transplant free survival rate was 92%.
Some strengths of this article were that the participants were of various ages between 7 and 15 so it represented almost half of the pediatric age range. All participants with a cardiomyopathy could be included and no single diagnosis was excluded except for if they had a structural heart defect or neuromuscular disease. Some weaknesses of this article were that it was a small samples size but given the population in the Netherlands with this diagnosis, it was a good percentage (88%). The researchers used an 8 m track instead of a 30 m track, which is recommended by the American Thoracic Society guidelines. Therefore due to the small track size, the participants had to make more turns during the walk, which may have skewed the results. The study was conducted at seven different centers so the consistency of the way the tests was administered may have been different per participant. In conclusion, children with a dilated cardiomyopathy, the 6 minute walk test is a good predictor to identify children with a higher risk of death or heart transplantation.
4 responses to “3 and 6 minute walk test update”
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I’m familiar with the 6 minute walk test in the adult population and its benefits for evaluation and I’m excited to find there are norms out there to apply this test to the pediatric population. I’m surprised there were not norms available for the 3 minute version given a children’s tendency to have a shortened attention span. It can be challenging to gather child’s attention for more than 2-3 minutes for this reason. Did the article mention evaluators running into this problem when having children complete the test?
I agree with the above comment, I think it would be incredibly difficult to hold a child’s attention for 6 minutes of the same task with no talking, etc. Three minutes would be much more realistic but I’m not sure it really gives you a picture of endurance even for a child. Were either of these concerns addressed in the article?
It is shocking to me that scores from this type of test can be predictive of not needing a transplant with percentages of 92%! I find it interesting that they cannot run during this time but can walk as fast as they want. I never considered using the 6-min walk test on an adult who had the capability to run so it is interesting that children who can run are discouraged from doing so during the test. Did anything in the article address if the children were actually capable of running?
Shea and Meredith H, the article did not mention having any problems with controlling their attention during the test. I do agree that a 3 minute test would be more realistic with this population. I believe the main hold back was that there are norms for the 6 minute walk test to compare to, whereas, there are no established ones for the 3 minute walk test.
Meredith S, the article did not state if the children were capable of running. It did mention the participants were allowed to slow down the pace or stop which indicates some were probably did well with a fast walk, just not running.