Children and adolescents six minute walk test reference values article summary

Posted on: February 28, 2021 | By: mmoore47 | Filed under: Walk tests

Article Title: Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: A Systematic Review


Purpose: The purpose of this systematic review was to compare and contrast the available reference values and six-minute walk test equation predictions in health children/adolescents across multiple studies.


Population: Of the 12 studies included in this systematic review, the total number of included participants across studies was n = 5615. Though there were difference age ranges examined in each of the 12 studies selected, the range across studies was 4-18 years of age. All studies included healthy children/adolescents without musculoskeletal, neurological, cardiovascular or respiratory disorders from 12 different countries. 10 of the 12 studies included both girls and boys. Of the remaining two studies, one examined only girls and one examined only boys.


Methods: Collection of data/studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Potential studies were identified from the following research databases: PubMed, EMBASE, COCHRANE, LILACS, IBECS, PAHO, WHO, WHOLIS, SciELO, and VHL. Search terms within these databases included: “Walk test”, “Children”, “Reference”, and “Adolescent”. Once potential articles were identified, two reviewers independently examined the title and abstract to determine the studies relevancy to review. Inclusion criteria of each study was contingent upon: population age, BMI, and gender, If the 6MWT was in accordance with the American Thoracic Society Guidelines, the length of the corridor in which the 6MWT was performed, Instructions and encouragement provided, average distance walked, side effects, and standardization. If there was a dispute between the two independent reviewers in regards to study eligibility, a third reviewer was brought in to assist.


Outcome measures: Reference value and reference equation for 6MWT for health children in different countries


Results: This systematic review showed that 6MWT reference values and reference equations for healthy children differed between countries.


Strengths: Strengths of this study include the number of subjects included across studies and the availability of 6MWT data from 12 different countries.


Limitations: Limitations of this study include the wide age range of participants included and differences between administration of the 6MWT between studies.


Conclusion: This systematic review found that reference values and reference equations for the 6MWT in healthy children and adolescents are different from country to country. Therefore, the authors recommend that clinicians be careful not to use reference values that are not associated with the country the patient is from or in.


5 responses to “Children and adolescents six minute walk test reference values article summary”

  1. aetherton says:

    It’s very interesting to me that 6MWT reference values differ in children and adolescents based upon country. This is something great to keep in mind when working with individuals from various countries. I’m curious what factors may influence this and if the same is true of adult populations.

  2. mpark6 says:

    Hello Mason,
    I think that it’s very interesting how 6MWT reference values differ between country to country! I wonder it is because of the differences in culture from country to country.

  3. anerenhausen says:

    This test is so widely used and is great that there has been so much research done on it. It is interesting how results vary based on different countries and I am curious if that is due to population demographics or test administration protocols. I can see the importance in using reference values to corresponding country.

  4. kbaker18 says:

    Hi Mason,

    Very interesting how much the norms can range depending on geographic location. This makes me wonder if there are differences in adult 6MWT norms based off of country of residence. It makes sense due to different lifestyles (higher stress, fast paced vs lower stress, less time focused) but I wouldn’t have thought to consider that specific factor when looking at articles. Thanks for the breakdown of information and bringing awareness to these differences.

  5. amaddox2 says:

    Hi Mason! The study I reviewed also attempted to determine appropriate normative values for the 6MWT. The studies in my systematic review similarly found variance in the produced reference values and thus could not determine a specific equation for the selected population in my study. From what I understand, predictor variables used to determine the norms (i.e. height, weight, etc.) are not necessarily applicable to all populations based on pathological changes. It could make sense that cultural and environmental changes may be playing a role in the variances in normative values of different countries as well. Interesting stuff!

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