Home‐based exercise programs may offer a less costly alternative to providing exercise pre‐transplant to a large number of patients. We describe the changes in 6‐minute walk distance (6MWD) in lung ...transplant candidates who participated in a home‐based exercise program and their relationship to post‐transplant outcomes. Retrospectively, we investigated 159 individuals while awaiting transplantation who performed the surgery between 2011 and 2015. Primary outcome was 6MWD at time of assessment for transplant, last test prior to transplant and one‐month post‐transplant. 6MWD decreased by 28 ± 93.9 m between the time of assessment and the last 6MWD prior to transplantation (P < .001). Forty‐one patients (25.8%) increased their 6MWD (mean + 85.8 ± 42.8 m); 72 patients (45.3%) decreased their 6MWD (mean −109.8 ± 71.2 m); and 46 patients (28.9%) had no change in 6MWD (−1.5 ± 15.7 m). There was a moderate correlation (r = .528; P < .001) between the last 6MWD prior to transplant and 6MWD post‐transplant. Change in 6MWD prior to transplant weakly correlated with length of time on mechanical ventilation (r = −.185; P = .034). When adjusted for covariates, change in 6MWD prior to transplant was not associated with length of time on mechanical ventilation, total hospital LOS, or intensive care unit LOS. The majority of the patients were able to either increase or maintain their 6MWD while participating in a home‐based pre‐habilitation program during the waiting list period. Prospective research is needed to evaluate the effects of home‐based pre‐habilitation program for lung candidates.
The 6-minute walk test (6MWT) is a potential tool for assessing the severity of interstitial lung disease (ILD).
To explore the relationship between 6MWT results and traditional measures including ...pulmonary function and chest computed tomography(CT) and to determine factors that might influence the 6-minute walk distance (6MWD).
Seventy-three patients with ILD were enrolled at Peking University First Hospital. All patients underwent 6MWT, pulmonary CT, and pulmonary function tests and their correlations were analyzed. Multivariate regression analysis was used to identify factors that might impact 6MWD. Results: Thirty (41.4%) of the patients were female and the mean age was 66.1 ± 9.6 years. 6MWD was correlated with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO) and DLCO%pred. The decrease in oxygen saturation (SpO2) after the test was correlated with FEV1%pred, FVC%pred, TLC, TLC%pred, DLCO, DLCO%pred and the percentage of normal lung calculated by quantitative CT. The increase in Borg dyspnea scale was correlated with FEV1, DLCO and the percentage of normal lung. The backward multivariate model (F = 15.257, P < 0.001, adjusted R2 = 0.498) indicated that 6MWD was predicted by age, height, body weight, increase in heart rate, and DLCO.
The 6MWT results were closely correlated with pulmonary function and quantitative CT in patients with ILD. However, in addition to disease severity, 6MWD was also influenced by individual characteristics and the degree of patient effort, which should thus be considered by clinicians when interpreting 6WMT results.
Abstract Introduction Systemic arterial hypertension (SAH) is responsible for 9.5 million deaths in the global popu-lation. Lifestyle factors, including physical inactivity, are important modifiable ...risk factors in the development of SAH. Thus, physical exercise has been shown to be effective to control SAH and before the prescription, the six-minute walk test (6-MWT) has been commonly used to assess the physical capacity. Objective To propose reference values for the 6-MWT test in Brazilian people with SAH. Methods A cross-sectional observational study was conducted with 302 hypertensive subjects (62.61 + 10.93 years) admitted to a cardiac rehabilitation program. Participants were divided into different age quartiles and submitted to 6-MWT. The walking distance data was compared between the quartiles and adjusted by mul-tiple linear regression analysis. Results The hypertensive subjects walked 388.07 + 115.03 m during the 6-MWT. No significant difference between the genders was found. However, when the age quartiles were compared, for the 46–59 age group, the women walked less than the men. Intra-group comparisons showed that the distance walked in the 6-MWT decreased with the increase in age, in both men and women. Conclusion The present study provides reference values for the 6-MWT, both for Brazilian men and women of different age groups. This data may be an important parameter for future clinical studies, prevention strategies, and clinical intervention.
Resumo Introdução A hipertensão arterial sistêmica (HAS) é respon-sável por 9,5 milhões de mortes na população mundial. Con-dições do estilo de vida, incluindo a inatividade física, são importantes fatores de risco modificáveis no desenvolvimento da HAS. Desse modo, o exercício físico tem se mostrado eficaz no controle da HAS e, antes da prescrição, o teste de caminhada de seis minutos (TC6) tem sido comumente utilizado para ava-liar a capacidade física. Objetivo Propor valores de referência para o teste de TC6 em brasileiros com HAS. Métodos Realizou-se um estudo observacional transversal com 302 hipertensos (62,61 + 10,93 anos) admitidos em um programa de reabilitação cardíaca. Os participantes foram divididos em diferentes quartis de idade e submetidos ao TC6. Os dados de distância percorrida foram comparados entre os quartis e ajustados por análise de regressão linear múltipla. Resultados Os hipertensos caminharam 388,07 + 115,03 m durante o TC6. Não encontrou-se diferença significativa entre os gêneros. No entanto, quando comparados os quartis de idade, para a faixa etária de 46 a 59 anos, as mulheres caminharam menos do que os homens. As comparações intragrupo mostraram que a distância percorrida no TC6 diminuiu com o aumento da idade, tanto em homens quanto em mulheres. Conclusão O presente estudo fornece valores de referência para o TC6, tanto para homens quanto para mulheres brasileiras de diferentes faixas etárias. Esses dados podem ser um parâmetro importante para futuros estudos clínicos, estratégias de prevenção e intervenção clínica.
Abstract
Objective
There is limited information about gait patterns during prolonged walking in people with multiple sclerosis (PwMS). The aim of this review was to report on gait metrics during and ...immediately after the 6-Minute Walk Test (6MWT) in PwMS with different levels of disability.
Methods
The systematic search was performed in 3 databases (PubMed, Web of Science, and SCOPUS) using keywords related to multiple sclerosis and 6MWT. Studies that reported on quantitative gait outcomes before and after the 6MWT or multiple time points during the 6MWT were included. The Hedges g effect size (ES) was calculated to determine the magnitude of change in each gait parameter.
Results
Fourteen studies (n = 534 PwMS; n = 166 healthy controls) were eligible. Five studies investigated gait parameters prior to and immediately after the 6MWT. Nine studies collected gait measures during the 6MWT. Speed (ES = −0.43 to 0.19), cadence (ES = −0.46 to 0.16), step length (ES = −0.46 to 0.14), stability (ES = −0.35 to 0.33), and regularity (ES = −0.25 to −0.15) decreased in most studies. In the majority of included studies, step time (ES = 0 to 0.35), stance period (ES = 0.12 to 0.58), double support phase (ES = 0.03 to 0.62), variability (ES = −0.19 to 1.13), and asymmetry (ES = −0.79 to 0.62) increased following the 6MWT. The kinetic and kinematic (mainly in dorsiflexion angle ES = −0.08 to −0.36) features of gait were also negatively changed after 6 minutes of walking. Walking speed, cadence, step length, stride length, and stride time after 6MWT at a comfortable speed all increased. Changes in the majority of spatiotemporal parameters were more pronounced in PwMS with moderate-to-severe disability compared with PwMS with mild disability.
Conclusion
Most quantitative gait parameters deteriorated during the 6MWT, especially in PwMS with moderate-to-severe disability.
Impact
The deterioration of gait patterns should be considered when designing therapeutic interventions to increase sustained walking capacity.
MRI is a helpful tool for monitoring disease progression in late‐onset Pompe disease (LOPD). Our study aimed to evaluate if muscle diffusion tensor imaging (mDTI) shows alterations in muscles of LOPD ...patients with <10% fat‐fraction. We evaluated 6 thigh and 7 calf muscles (both legs) of 18 LOPD and 29 healthy controls (HC) with muscle diffusion tensor imaging (mDTI), T1w, and mDixonquant sequences in a 3T MRI scanner. The quantitative mDTI‐values axial diffusivity (λ1), mean diffusivity (MD), radial diffusivity (RD), and fractional anisotropy (FA) as well as fat‐fraction were analyzed. 6‐Minute Walk Test (6‐MWT) data were correlated to diffusion metrics. We found that mDTI showed significant differences between LOPD and HC in diffusion parameters (P < .05). Thigh muscles with <10% fat‐fraction showed significant differences in MD, RD, and λ1‐3. MD positively correlated with 6‐MWT (P = .06). To conclude, mDTI reveals diffusion restrictions in muscles of LOPD with and without fat‐infiltration and reflects structural changes prior to fatty degeneration.
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