Six-Minute Walk Test in Children with Spastic Cerebral Palsy and Children Developing Typically – Article Summary
Title: Six-Minute Walk Test in Children with Spastic Cerebral Palsy and Children Developing Typically
Authors: Diarmaid Fitzgerald, PT, PhD; Claire Hickey, PT, BSc; Eamonn Delahunt, PT, PhD; Michael Walsh, PT, MMedSc; Timothy O’Brien, MCh, FRCSI
Purpose: The purpose of this study was to quantify the Six-Minute Walk Test (6MWT) in a sample of children with spastic cerebral palsy (CP) functioning at GMFCS Levels I to III and their age matched, typically developing children using a standardized test protocol.
Study Population: The population of this study consisted of 145 children with spastic CP and 145 children that were typically developing and screened via the Physical Activity Readiness Questionnaire. All of the children in this study including those with spastic CP and those typically developing were between the ages of 4 and 17 years old.
Methods: Participants body mass and height were measured. A total of 145 children with spastic CP and 137 typically developing children completed a modified 6MWT protocol. These modifications included increasing the length of the course in this study which was 70 meters straight from the starting point to the end point, modifying the turnaround points which were indicated with signs on the wall, and giving no demonstration lap. All evaluations were performed indoors and in the same, straight corridor with a flat, hard surface. No additional comments were given during the testing except for the one standardized comment every minute such as as “you are doing well, you have only one minute to go.”
Outcome Measures: The outcome measure utilized in this study was the 6MWT, which is a standardized self-paced walking test commonly used to assess functional ability in children with CP. The 6MWT was modified as described above in the methods.
Intervention: No intervention was provided during this study.
Results: The results of this study show that the 6MWT can differentiate between walking ability across the four different test groups of children: children with CP GMFCS Level I, children with CP GMFCS Level II, children with CP GMFCS Level III, and typically developing children.
Strengths: The 6MWT, which is a standardized outcome measure, was utilized and all evaluations during this study were completed in the same, straight corridor on a flat, hard surface. The 6MWT has been studied previously in the CP population and has been recommended as a submaximal exercise test for children with CP, GMFCS Levels I to III.
Limitations: Intellectual ability and vital signs were not assessed in this study. Participants with CP with cognitive impairment might not have understood the directions to the 6MWT as well as others which could have affected their scores. Sex differences were not assessed in the data analysis. Furthermore, the children with CP were a sample of convenience from a gait lab database.
Conclusion: A range of reference values for the 6MWT for children with spastic CP, who are ambulatory and functioning at GMFCS Levels I to III, and children who are normally developing were established from this study. In addition, the study’s findings show that height may be a predictor of Six-Minute Walk Distance in children with CP, GMFCS Level I, and age may be a predictor in children classified as GMFCS Level II, but there needs to be more research done to explore significance.
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Hello, Krista!
Great post. I found it interesting that they did not monitor vital signs to get an estimation of age appropriate HR measures for children within the different GMFCS levels. It would be nice to also see future research tease out the potential differences in sex. It can be difficult to adequately power a large study in children with CP to establish reference values but articles like these are often included in systematic reviews which can combine the data from different areas.