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Sample records for six-minute walk test

  1. [Six-minute walk test in children with neuromuscular disease.

    PubMed

    Cruz-Anleu, Israel Didier; Baños-Mejía, Benjamín Omar; Galicia-Amor, Susana

    2013-01-01

    Background: neuromuscular diseases affect the motor unit. When they evolve, respiratory complications are common; the six-minute walk test plays an important role in the assessment of functional capacity. Methods: prospective, transversal, descriptive and observational study. We studied seven children with a variety of neuromuscular diseases and spontaneous ambulation. We tested their lung function, and administered a six-minute walk test and a test of respiratory muscle strength to these children. Results: the age was 9.8 ± 2.4 years. All patients were males. Forced vital capacity decreased in three patients (42.8 %), forced expiratory volume during the first second (2.04 ± 1.4 L) and peak expiratory flow (4.33 ± 3.3 L/s) were normal. The maximum strength of respiratory muscles was less than 60 % of predicted values. The distance covered in the six-minute walk test was lower when compared with healthy controls (29.9 %). Conclusions: the six-minute walk test can be a useful tool in early stages of this disease, since it is easy to perform and well tolerated by the patients.

  2. Comparison between the six-minute walk test and the six-minute step test in post stroke patients

    PubMed Central

    2013-01-01

    Background The Stroke remains one of the major chronic diseases worldwide, and is considered a major cause of disability, which results not only in persistent neurological deficits, but also in the high physical deconditioning, nevertheless there are not many forms of assessing functional capacity in this population. We aimed to investigate the feasibility of the Six Minute Walk Teste and the Six-Minute Step Test (6MST) in post-stroke patients and compare the behavior of physiological variables during the 6MST and the Six-Minute Walk Test (6MWT), by correlating the functional performance obtained in both tests. Method The 6MWT was carried out according to the American Thoracic Society (ATS) and the 6MST was performed in six minutes in order to compare it to the 6MWT in a 20 cm step. Was included post-stroke individuals able to walk without aid. All of them did the 6MWT and the 6MST. Results 12 patients participated in the study. There was no statistical difference in the parameters analyzed when tests were compared. There was poor correlation between the functional performance in both tests. Conclusion The 6MWT and the 6MST is feasible for post-stroke patients and physiological responses are equal during the performance of both tests. However, there was no correlation with respect to functional performance, which was assessed by the distance walked in the 6MWT and by the number of steps climbed in the 6MST. PMID:23924407

  3. Comparison between the six-minute walk test and the six-minute step test in post stroke patients.

    PubMed

    da Silva, Talita Dias; Raimundo, Rodrigo Daminello; Ferreira, Celso; Torriani-Pasin, Camila; Monteiro, Carlos Bandeira de Mello; Theodoro Júnior, Osmar Aparecido; Valenti, Vitor E; Adami, Fernando; de Oliveira, Eliane Pires; Barnabé, Viviani; de Abreu, Luiz Carlos

    2013-01-01

    The Stroke remains one of the major chronic diseases worldwide, and is considered a major cause of disability, which results not only in persistent neurological deficits, but also in the high physical deconditioning, nevertheless there are not many forms of assessing functional capacity in this population. We aimed to investigate the feasibility of the Six Minute Walk Teste and the Six-Minute Step Test (6MST) in post-stroke patients and compare the behavior of physiological variables during the 6MST and the Six-Minute Walk Test (6MWT), by correlating the functional performance obtained in both tests. The 6MWT was carried out according to the American Thoracic Society (ATS) and the 6MST was performed in six minutes in order to compare it to the 6MWT in a 20 cm step. Was included post-stroke individuals able to walk without aid. All of them did the 6MWT and the 6MST. 12 patients participated in the study. There was no statistical difference in the parameters analyzed when tests were compared. There was poor correlation between the functional performance in both tests. The 6MWT and the 6MST is feasible for post-stroke patients and physiological responses are equal during the performance of both tests. However, there was no correlation with respect to functional performance, which was assessed by the distance walked in the 6MWT and by the number of steps climbed in the 6MST.

  4. Six-minute walk test in persons with transtibial amputation.

    PubMed

    Lin, Suh-Jen; Bose, Nisha Hathi

    2008-12-01

    This study was to report the within-day test-retest reliability and the measurement properties of the six-minute walk test (6MWT) in persons with lower-limb (transtibial) amputation. Test-retest study design. University research laboratory. Subjects (N=13) with transtibial amputation (9 men and 4 women; mean age, 46 y). Three trials of the 6MWT were conducted within 1 day with 20 to 30 minutes of rest between consecutive trials. Timed Up & Go (TUG) test and timed one-leg balance tests were conducted on another day. (1) Distance, heart rate, symptoms and signs of exercise intolerance during the walk test, (2) times of the TUG test and the one-leg balance test. The intraclass correlation coefficient (ICC3,1) value was .94. Bland and Altman graphs showed no systemic variations between trials and a small learning effect. The peak heart rate approximated 72% to 78% of the age-predicted maximal heart rate. Moderate degrees of correlation were observed in: (1) the 6MWT versus the TUG test (r=-.76, P<.05), and (2) the 6MWT versus the timed prosthetic-leg stance (with eyes open: r=.63, P<.05; with eyes closed: r=.61, P<.05). These findings suggest that the 6MWT could be considered as a reliable measure of functional capacity, involves a moderate degree of exercise intensity, and is related in a moderate degree to postural control abilities in persons with transtibial amputation.

  5. [Use of the six-minute walk test in cardiology].

    PubMed

    Kervio, G; Ville, N S; Leclercq, C; Daubert, J C; Carré, F

    2005-12-01

    The symptom-limited exercise test is nowadays the gold standard to assess the exercise tolerance and the effects of different treatments in patients with chronic heart failure (CHF). A simpler alternative to this test is the 6-minute walk test. The 6-minute walk test is easy to realize and well-tolerated. Moreover, it is reliable just after one familiarization practice and requires standardization. Indeed, its conduction, which is submitted to some security precautions, can be altered by variation factors. The distance walked during the 6 minutes was the only parameter studied during the test. This parameter could allow judging the CHF severity and prognostic. The analyse of cardiorespiratory parameters has shown that the 6-minute walk test relative intensity is near to the peak individual values. Moreover, the cardiac and ventilatory adaptation of patient during this test depends to his own functional capacity. Lastly, the 6-minute walk test is a submaximal constant-load exercise, which should be performed in complement to the symptom-limited exercise test in cardiac patients.

  6. Reliability and feasibility of the six minute walk test in subjects with myotonic dystrophy.

    PubMed

    Kierkegaard, Marie; Tollbäck, Anna

    2007-12-01

    The objective was to describe test-retest reliability and feasibility of the six minute walk test in adult subjects with myotonic dystrophy type 1. Twelve subjects (28-68 years, mean 44) performed three six minute walk tests on two occasions, one week apart. Relative reliability was high (ICC(2.1)=0.99) and absolute reliability values were low (standard error of measurement 12 m, repeatability 33 m). Feasibility was investigated in a sample of 64 subjects (19-70 years, mean 43). Fifty-two subjects were able to perform two tests on the same day. Subjects with severe proximal weakness had difficulties performing repeated tests. A practice trial followed by a second test on the same day can be recommended for most subjects, and the best test should be used for evaluations. In conclusion, even though the study sample was small, the present study indicates that the six minute walk test is reliable and feasible in subjects with myotonic dystrophy type 1.

  7. Cardiac Effect of Interstitial Lung Disease Correlated with Spirometry and Six Minute Walk Test

    PubMed Central

    Agrawal, Mitali Bharat

    2017-01-01

    Introduction The cardiac effect of different pulmonary functions, six minute walk distance, arterial blood gases and saturation in Interstitial Lung Disease (ILD) is not much known. So this study, a tertiary care hospital experience that entails to know the various factors in Pulmonary Hypertension (PH) mentioned above causing PH and their correlation with PH. Aim To study the correlation of PH in patients with ILD with spirometry and six minute walk test (6MWT). Materials and Methods All consecutive patients with confirmed diagnosis of ILD taken over a period of 1½year in tertiary care hospital. 6MWT and spirometry were performed as per the American Thoracic Guidelines. Percent predicted 6 minute walk distance was calculated using Enright et al., and Indian reference equation. PH was diagnosed using 2-D echo. The spirometry variables and 6MWT were then correlated with the mean pulmonary artery pressure. Results There were 75 patients. About 66.66 % had PH on 2-D echo. The mean% predicted six minute walk distance as per the Indian reference equation, pre- and post- exercise PaO2 as well as desaturation had a significant correlation with PH. Spirometry variables Forced Expiratory Volume in First Second (FEV1) and Forced Vital Capacity (FVC) did not correlate with PH. Conclusion Thus, the 6MWT correlated significantly with PH while spirometry did not. PMID:28384908

  8. Six minute walk test Z score: correlations with cystic fibrosis severity markers.

    PubMed

    Stollar, Fabíola; Rodrigues, Joaquim C; Cunha, Maristela T; Leone, Claudio; Adde, Fabíola Villac

    2012-05-01

    The six-minute-walk-test (6MWT) has been increasingly used in cystic fibrosis (CF) patients. However, few studies in children have correlated 6MWT with current parameters used to evaluate CF severity. Moreover, no study transformed the values of distance walked from meters into Z scores to avoid bias like age and gender, which are sources of 6MWT variability. A cross-sectional descriptive study was performed to analyze the correlations (Spearman) among forced expiratory volume in one second (FEV(1)), body mass index (BMI), chest radiography (CXR), chest tomography (CT), and 6MWT Z score (Z-6MWT). Clinically stable CF patients, aged 6-21 years, were included. 34 patients, 14F/20M, mean age 12.1±4.0 years were studied. The mean Z-6MWT was -1.1±1.106. The following correlations versus Z-6MWT were found: FEV(1) (r=0.59, r(2)=0.32, p=0.0002), BMI Z score (r=0.42, r(2)=0.17, p=0.013), CXR (r=0.34, r(2)=0.15, p=0.0472) and CT (r=-0.45, r(2)=0.23, p=0.0073). In conclusion there was a significant, but poor, correlation between the six minute walk test Z score and the cystic fibrosis severity markers currently in use. Copyright © 2011 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  9. [Comparative analysis of the six-minute walk test in healthy children and adolescents].

    PubMed

    Aquino, Evanirso S; Mourão, Flávio A G; Souza, Roberta K V; Glicério, Bráulio M; Coelho, Cristiane C

    2010-01-01

    To perform a comparative analysis of the six-minute walk test in healthy children and adolescents in corridors of 30.5m (100 feet) 20m (65.6 feet) in length. We evaluated 67 participants (36 boys and 31 girls), aged 7 to 14 years old, from public schools of a city in a metropolitan area. All were submitted to four walking tests, two in each of the corridors. The variables analyzed were: walked distance, work rate, mean blood pressure, heart rate and oxygen saturation. Statistical analysis was performed using one-way ANOVA for repeated measures and significance level at p<0.05. The comparison between the tests in each corridor and between the best tests in the different corridors did not show significant differences in the blood pressure, heart rate and oxygen saturation. The walked distance was not statistically different in the two tests on each corridor. However, the participants covered greater distances on the 30.5m corridor (p<0.05) compared to the best test between corridors. However, this increase was less than 10%. Regarding the cardiac overload and the work rate, there were no significant differences between the corridors. There were differences in walked distance between the corridors, however they were less than 10% with no significant changes in the other measured parameters. Therefore, the 20m corridor had a good reproducibility for the population of this study.

  10. Variability of gait speed during six minutes walking test in COPD and cystic fibrosis patients.

    PubMed

    Reychler, Gregory; Debatisse, Margaux; Lebecque, Patrick; Pieters, Thierry; Liistro, Giuseppe; Gohy, Sophie

    2016-09-01

    Recently, gait speed reached an increasing importance in the management of respiratory patients. The aim of this retrospective study was to compare walking speed and physiological adaptations during the 6MWT in COPD and CF patients. 6MWT performed by COPD and CF patients were retrospectively reviewed. Global and sequential walking speeds were measured on six minutes and every sequence of two minutes respectively. Heart rate, oxygen saturation and dyspnea were analyzed. 78 and 246 tests from CF and COPD patients were reviewed respectively. FEV1 (52.3 vs 56.2% pred) and FVC (72.5 vs 73.8% pred) were similar between both diseases. However, 6MWT in patients with CF were characterized by significantly higher heart rate, global walking speed and walking distance (+68%) while dyspnea evolutions and the proportions of patients presenting walking speed decline over the 6min were significantly lower. Walking speed and cardio-respiratory parameters evolution during 6MWT differ between COPD and CF patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. The endurance shuttle walk test: an alternative to the six-minute walk test for the assessment of ambulatory oxygen.

    PubMed

    Revill, S M; Noor, M Z; Butcher, G; Ward, M J

    2010-01-01

    UK guidelines for domiciliary oxygen have suggested the six-minute walk test or shuttle walk tests as suitable functional measures for the clinical assessment of ambulatory oxygen (AO). To date, there is limited evidence that would support the use of shuttle walk tests as assessment tools for AO. The endurance shuttle walk test (ESWT) is used increasingly as an assessment tool within pulmonary rehabilitation (PR) but its potential as an investigative test for AO has not been explored. Using the same test for both PR and AO assessment is appealing since it would improve efficiency and act to standardise outcome measures in this patient population. The aim of this study was to examine the responsiveness and repeatability of the ESWT to AO and to compare the response with that of the six-minute walk test (6MWT). Twenty-three patients with chronic obstructive pulmonary disease (COPD) performed, in random order, the ESWT and the 6MWT on air and whilst breathing AO. Oxygen saturation and Borg ratings of breathlessness and perceived exertion were recorded. On a third day, eleven patients repeated the ESWT with AO in order to measure repeatability. There was a significantly greater change in the ESWT with oxygen than the change recorded from the 6MWT (66 [91] vs 6 [28] m respectively; P < .05). When repeated on a separate day, the mean difference (95% CI) between distances walked on the ESWT with AO was 0.91 (-47, 49) m. The ESWT was more responsive than the 6MWT for detecting improvements in walking endurance whilst breathing AO.

  12. Six-minute walk test before and after a weight reduction program in obese subjects.

    PubMed

    Ekman, Maja J; Klintenberg, M; Björck, U; Norström, F; Ridderstråle, M

    2013-03-01

    OBEJCTIVE: Weight loss and physical activity have shown favorable effects on risks associated with obesity. It is therefore of interest to evaluate exercise capacity and related co-morbidities in obese patients. We present data from obese subjects evaluated by the 6-minute walk test (6MWT) before and after a 7.3 (6.1-8.2) month weight reduction program. 251 subjects completed the test at baseline (BMI 40.6 [36.9-44.6] kg/m(2) ) and 129 (51.4%) repeated the test after intervention (BMI 35.6 [31.2-38.5] kg/m(2) ). The six minute walking distance (6MWD) at baseline (535 [480-580] m) and at follow up (599 [522-640] m) correlated to several cardiovascular risk markers. Age, weight, height, resting heart rate, smoking status, fP-glucose and use of β-blockers explained 43 % of the variance in predicted 6MWD at baseline. The effect of smoking status, fP-glucose, β-blockers, and resting heart rate lost significance at follow up. Presence of diabetes and the metabolic syndrome had a negative influence on 6MWD but did not affect the impact of intervention based on percentage increase in walking distance. Gender had no impact on 6MWD. Reported pain during the test was common but decreased after intervention (57.0% vs. 28.7%, P < 0.001). The 6MWT may be used to evaluate intervention success beyond kilogram weight loss in obese subjects. We present formulas to predict 6MWD and the effect of weight loss on walking distance in clinical practice. Pain is a common problem which has to be considered when giving advice on exercise as a part of weight loss intervention. Copyright © 2012 The Obesity Society.

  13. Six-minute walk test in children and adolescents with renal diseases: tolerance, reproducibility and comparison with healthy subjects

    PubMed Central

    Watanabe, Flávia Tieme; Koch, Vera Herminia Kalika; Juliani, Regina Celia Turola Passos; Cunha, Maristela Trevisan

    2016-01-01

    OBJECTIVES: To evaluate exercise tolerance and the reproducibility of the six-minute walk test in Brazilian children and adolescents with chronic kidney disease and to compare their functional exercise capacities with reference values for healthy children. METHODS: This cross-sectional study assessed the use of the six-minute walk test in children and adolescents aged 6-16 with stage V chronic kidney disease. For statistical analysis of exercise tolerance, including examinations of correlations and comparisons with reference values, the longest walked distances were considered. The reproducibility of the six-minute walk test was assessed using intraclass correlation coefficients. RESULTS: A total of 38 patients (14 females and 24 males) were evaluated, including 5 on peritoneal dialysis, 12 on hemodialysis and 21 who had undergone renal transplantation, with a median age of 11.2 years (6.5-16). The median walked distance was 538.5 meters (413-685) and the six-minute walk test was found to be reproducible. The walked distance was significantly correlated with age (r=0.66), weight (r=0.76), height (r=0.82), the height Z score (r=0.41), hemoglobin (r=0.46), hematocrit (r=0.47) and post-test systolic blood pressure (r=0.39). The chronic kidney disease patients predicted walked distance was 84.1% of the reference value according to age, 90.6% according to age-corrected height and 87.4% according to a predictive equation. CONCLUSIONS: The stage V chronic kidney disease patients had a significantly decreased functional exercise capacity, as measured by the six-minute walk test, compared with the healthy pediatric reference values. In addition, the six-minute walk test was shown to be well tolerated, reliable and applicable as a low-cost tool to monitor functional exercise capacity in patients with renal disease. PMID:26872080

  14. Association Between Emphysema Score, Six-Minute Walk and Cardiopulmonary Exercise Tests in COPD

    PubMed Central

    Chen, Li-Fei; Wang, Chun-Hua; Chou, Pai-Chien; Ho, Shu-Chuan; Joa, Wen-Ching; Sheng, Te-Fang; Kuo, Han-Pin

    2012-01-01

    Background: High-resolution computed tomography (HRCT) has allowed in detection of airway wall abnormalities and emphysema, whose extent may correlate with the clinical severity of the disease in patients with chronic obstructive pulmonary disease (COPD). Six minute walk test (6MWT) and cardiopulmonary exercise test (CPET) can determine functional status. Methods: A study was undertaken to investigate whether the extent of emphysema in COPD patients quantitatively confirmed by HRCT scoring was associated with distance walked, inspiratory capacity (IC) changes after exercise, anaerobic threshold of cardiopulmonary exercise and the BODE index (body mass index, airflow obstruction, dyspnea, exercise performance). Results: Seventeen patients with COPD underwent HRCT scanning, 6MWT and CPET. The emphysema score was highly correlated to forced vital capacity (FVC) (r=-0.748, p<0.001), forced expiratory volume in 1 second (FEV1) (r=-0.615, p<0.01), IC post exercise (r=-0.663, p<0.01) and dyspnea score post exercise (r=0.609, p<0.01), but was not associated with the BODE index. The distance walked during 6MWT was inversely correlated to emphysema score (r=-0.557, p<0.05). IC before exercise was highly related to the 6MWT. The change in IC after exercise was associated with the percent decline of oxygen saturation after exercise (r=0.633, p<0.01). Severity of lung emphysema in COPD patients was inversely correlated to VO2 max (r=-0.514, p<0.05) and anaerobic threshold (r=-0.595, p<0.01) of cardiopulmonary exercise. Conclusions: These results suggest that COPD associated with emphysema on HRCT is characterized by more severe lung function impairment, greater exercise impairment and cardiopulmonary dysfunction. PMID:23115601

  15. Oxygen desaturation during the six-minute walk test in COPD patients*

    PubMed Central

    Moreira, Maria Ângela Fontoura; de Medeiros, Gabriel Arriola; Boeno, Francesco Pinto; Sanches, Paulo Roberto Stefani; da Silva, Danton Pereira; Müller, André Frotta

    2014-01-01

    Objective: To evaluate the behavior of oxygen saturation curves throughout the six-minute walk test (6MWT) in patients with COPD. Methods: We included 85 patients, all of whom underwent spirometry and were classified as having moderate COPD (modCOPD, n = 30) or severe COPD (sevCOPD, n = 55). All of the patients performed a 6MWT, in a 27-m corridor with continuous SpO2 and HR monitoring by telemetry. We studied the SpO2 curves in order to determine the time to a 4% decrease in SpO2, the time to the minimum SpO2 (Tmin), and the post-6MWT time to return to the initial SpO2, the last designated recovery time (RT). For each of those curves, we calculated the slope. Results: The mean age in the modCOPD and sevCOPD groups was 66 ± 10 years and 62 ± 11 years, respectively. At baseline, SpO2 was > 94% in all of the patients; none received supplemental oxygen during the 6MWT; and none of the tests were interrupted. The six-minute walk distance did not differ significantly between the groups. The SpO2 values were lowest in the sevCOPD group. There was no difference between the groups regarding RT. In 71% and 63% of the sevCOPD and modCOPD group patients, respectively, a ≥ 4% decrease in SpO2 occurred within the first minute. We found that FEV1% correlated significantly with the ΔSpO2 (r = −0.398; p < 0.001), Tmin (r = −0.449; p < 0.001), and minimum SpO2 (r = 0.356; p < 0.005). Conclusions: In the sevCOPD group, in comparison with the modCOPD group, SpO2 was lower and the Tmin was greater, suggesting a worse prognosis in the former. PMID:25029644

  16. The Six-Minute Walk Test for Adults with Intellectual Disability: A Study of Validity and Reliability

    ERIC Educational Resources Information Center

    Nasuti, Gabriella; Stuart-Hill, Lynneth; Temple, Viviene A.

    2013-01-01

    Background: The Six-Minute Walk Test (6MWT) has been used with clinical and healthy populations to assess functional capacity and cardiovascular fitness. The aim of this study was to determine the test-retest reliability of a modified-6MWT as well as concurrent validity of walk distance with peak oxygen uptake (VO[subscript 2] peak). Method:…

  17. The Six-Minute Walk Test for Adults with Intellectual Disability: A Study of Validity and Reliability

    ERIC Educational Resources Information Center

    Nasuti, Gabriella; Stuart-Hill, Lynneth; Temple, Viviene A.

    2013-01-01

    Background: The Six-Minute Walk Test (6MWT) has been used with clinical and healthy populations to assess functional capacity and cardiovascular fitness. The aim of this study was to determine the test-retest reliability of a modified-6MWT as well as concurrent validity of walk distance with peak oxygen uptake (VO[subscript 2] peak). Method:…

  18. Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review

    PubMed Central

    Cacau, Lucas de Assis Pereira; de Santana-Filho, Valter Joviniano; Maynard, Luana G.; Gomes Neto, Mansueto; Fernandes, Marcelo; Carvalho, Vitor Oliveira

    2016-01-01

    Objective The aim of the study is to compare the available reference values and the six-minute walk test equations in healthy children/adolescents. Our systematic review was planned and performed in accordance with the PRISMA guidelines. We included all studies that established reference values for the six-minute walk test in healthy children/adolescents. Methods To perform this review, a research was performed in PubMed, EMBASE (via SCOPUS) and Cochrane (LILACS), Bibliographic Index Spanish in Health Sciences, Organization Collection Pan-American Health Organization, Publications of the World Health Organization and Scientific Electronic Library Online (SciELO) via Virtual Health Library until June 2015 without language restriction. Results The initial research identified 276 abstracts. Twelve studies met the inclusion criteria and were fully reviewed and approved by both reviewers. None of the selected studies presented sample size calculation. Most of the studies recruited children and adolescents from school. Six studies reported the use of random samples. Most studies used a corridor of 30 meters. All studies followed the American Thoracic Society guidelines to perform the six-minute walk test. The walked distance ranged 159 meters among the studies. Of the 12 included studies, 7 (58%) reported descriptive data and 6 (50%) established reference equation for the walked distance in the six-minute walk test. Conclusion The reference value for the six-minute walk test in children and adolescents ranged substantially from studies in different countries. A reference equation was not provided in all studies, but the ones available took into account well established variables in the context of exercise performance, such as height, heart rate, age and weight. Countries that did not established reference values for the six-minute walk test should be encouraged to do because it would help their clinicians and researchers have a more precise interpretation of the test

  19. Lung function and six-minute walk test performance in individuals with sickle cell disease

    PubMed Central

    Ohara, Daniela G.; Ruas, Gualberto; Walsh, Isabel A. P.; Castro, Shamyr S.; Jamami, Mauricio

    2014-01-01

    Background Sickle Cell Disease (SCD), which is characterized by a mutation in the gene encoding beta hemoglobin, causes bodily dysfunctions such as impaired pulmonary function and reduced functional capacity. Objective To assess changes in pulmonary function and functional capacity in patients with SCD and to identify the relationships between these variables. Method We evaluated sociodemographic, anthropometric, lung function (spirometry), respiratory (manovacuometer), peripheral muscle strength (Handgrip strength - HS) and functional capacity (i.e., the six-minute walk test) parameters in 21 individuals with SCD (average age of 29±6 years). Shapiro-Wilk, paired Student's, Wilcoxon, Pearson and Spearman correlation tests were used for statistical analyses, and the significance threshold was set at p<0.05. Results A total of 47.6% of the study subjects exhibited an altered ventilation pattern, 42.8% had a restrictive ventilatory pattern (RVP) and 4.8% exhibited a mixed ventilatory pattern (MVP). The observed maximal inspiratory pressure (MIP) values were below the predicted values for women (64 cmH2O), and the maximum expiratory pressure (MEP) values, HS values and distance walked during the 6MWT were below the predicted values for both men (103 cmH2O, 39 Kgf and 447 m, respectively) and women (64 cmH2O; 27 Kgf; 405 m, respectively). Positive correlations were observed between maximum voluntary ventilation (MVV) and MEP (r=0.4; p=0.046); MVV and BMI (r=0.6; p=0.003); and between HS and MIP (r=0.7; p=0.001), MEP (r=0.6; p=0.002), MVV (r=0.5; p=0.015), distance walked in the 6MWT (r=0.4; p=0.038) and BMI (r=0.6; p=0.004). Conclusions SCD promoted changes in lung function and functional capacity, including RVPs and a reduction in the distance walked in the 6MWT when compared to the predictions. In addition, significant correlations between the variables were observed. PMID:24675916

  20. Does the six-minute walk test measure walking performance or physical fitness in persons with multiple sclerosis?

    PubMed

    Sandroff, Brian M; Pilutti, Lara A; Motl, Robert W

    2015-01-01

    There is psychometric evidence that supports the six-minute walk (6MW) as a measure of walking performance, whereas other psychometric data support it as a submaximal measure of physical fitness in persons with MS. The current cross-sectional study compared measures of walking performance and physical fitness as head-to-head predictors of 6MW distance in a sample of persons with MS across the disability spectrum. All participants completed the 6MW test, as well as other measures of walking performance (i.e., timed-25 foot walk, gait velocity captured by a GaitRite electronic walkway) and physical fitness (i.e., peak aerobic capacity, lower limb muscular strength). 6MW distance was strongly associated with measures of walking performance and physical fitness, though the correlations were significantly stronger for measures of walking performance than physical fitness (z >  4.04, p <  0.01). Walking performance explained a large portion of variance in 6MW distance (R2 >  0.85), and measures of physical fitness explained minimal variance in 6MW distance over-and-above that of measures of walking performance (ΔR2 <  0.06). The current results suggest that 6MW distance is primarily a measure of walking performance rather than aerobic and muscular fitness in MS.

  1. A comparison of the Endurance Shuttle Walk test and the Six Minute Walk test for assessment of exercise capacity in older people.

    PubMed

    Witham, Miles D; Sugden, Jacqui A; Sumukadas, Deepa; Dryburgh, Moira; McMurdo, Marion E T

    2012-04-01

    The six minute walk test is widely used to measure aerobic exercise capacity in older people, but lack responsiveness to change. We aimed to compare the reliability, responsiveness and completion rates of the six minute walk with a new test of aerobic exercise capacity - the endurance shuttle walk test. Two groups were studied: 18 patients from a Medicine for the Elderly Day Hospital (study 1) receiving physiotherapy, and 15 community dwelling older people (study 2) receiving caffeine or placebo in a crossover study, followed by a weekly exercise programme. Six minute walk test and endurance shuttle walk test were performed at baseline and after interventions. Intraclass correlation coefficients were calculated for reliability, and Cohen's effect sizes were calculated to characterize responsiveness. 6/18 of patients in study 1 completed the baseline shuttle walk successfully. For those completing baseline and week one shuttle walk, similar intraclass correlation coefficients were seen (shuttle walk 0.97; six minute walk 0.90). In study 2, all attendees completed baseline and follow-up shuttle walk. 7/15 managed the maximum shuttle walk time at baseline. Effect sizes for caffeine intervention (0.29 for six minute walk, 0.01 for shuttle walk) and for exercise intervention (0.15 for six minute walk, 0.24 for shuttle walk) were similarly low for both tests. The endurance shuttle walk is no more responsive to change than the six minute walk in older people, is limited by ceiling effects, and cannot be performed successfully by very frail older people.

  2. Six-Minute Walk Test in Evaluation of Children with Pulmonary Arterial Hypertension.

    PubMed

    Zuk, Malgorzata; Migdal, Anna; Jagiellowicz-Kowalska, Dorota; Mazurkiewicz, Katarzyna; Sadel-Wieczorek, Anna; Brzezinska-Rajszys, Grazyna

    2017-04-01

    Six-minute walk test (6MWT) is a submaximal exercise test applied for evaluation of adults with pulmonary arterial hypertension (PAH). It was widely used as an endpoint in the clinical trials. The aim of the study was to assess the usefulness of 6MWT in management of children with PAH and to establish correlations with other clinical features. 164 6MWT were performed in 15 children between 5 and 18 years with PAH confirmed by right heart catheterization (102 in patients with shunt, 62 without shunt). Distance in 6MWT (6MWD)-% of predicted for age and gender, desaturation at the maximum effort, peak heart rate (HR)-% of maximal HR, were compared to the level of NTproBNP, WHO-FC, echocardiography parameters, and events of PAH treatment intensification. 6MWD had low negative correlation with peak HR (τ -0.1 p = 0,03), negative correlation with NTproBNP (τ -0.17 p = 0.002), and no dependence on echocardiography parameters. The presence of shunt was associated with lower 6MWD, lower blood saturation at rest, and higher desaturation after effort. Patients in III/IV WHO-FC achieved higher rest HR and maximal HR in comparison to patients in I/II WHO-FC (63.1 vs. 55.2% p < 0.01) and lower 6MWD (64.3 vs. 77.5% p < 0.01). In 14 out of 20 6MWT performed after treatment intensification, increase of distance was observed. The results of 6MWT were consistent with clinical status (WHO-FC, NTproBNP) but not with echocardiography parameters. 6MWT may be the source of additional information in management of children with PAH.

  3. Spatio-temporal gait disorder and gait fatigue index in a six-minute walk test in women with fibromyalgia.

    PubMed

    Heredia-Jimenez, Jose; Latorre-Roman, Pedro; Santos-Campos, Maria; Orantes-Gonzalez, Eva; Soto-Hermoso, Victor M

    2016-03-01

    Gait disorders in fibromyalgia patients affect several gait parameters and different muscle recruitment patterns. The aim of this study was to assess the gait differences observed during a six-minute walk test between fibromyalgia patients and healthy controls. Forty-eight women with fibromyalgia and 15 healthy women were evaluated. Fibromyalgia patients met the American College of Rheumatology criteria for fibromyalgia selected of an ambulatory care. Both patients and controls had a negative history of musculoskeletal disease, neurological disorders, and gait abnormalities. The 15 controls were healthy women matched to the patients in age, height and body weight. Spatio-temporal gait variables and the rate of perceived exertion during the six-minute walk test (all subjects) and Fibromyalgia Impact Questionnaire (fibromyalgia subjects) were evaluated. All walking sets on the GaitRITE were collected and the gait variables were selected at three stages during the six-minute walk test: two sets at the beginning, two sets at 3 min and two sets at the end of the test. In addition, the Fibromyalgia Impact Questionnaire was used for the fibromyalgia patients. Fibromyalgia patients showed a significant decrease in all spatio-temporal gait variables at each of the three stages and had a lower walk distance covered in the six-minute walk test and higher rate of perceived exertion. No correlations were found between the Fibromyalgia Impact Questionnaire and gait variables. The fibromyalgia and control subjects showed lower gait fatigue indices between the middle and last stages. Gait analysis during a six-minute walk test is a good tool to assess the fatigue and physical symptoms of patients with fibromyalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Six-minute walking distance and decrease in oxygen saturation during the six-minute walk test in pediatric pulmonary arterial hypertension.

    PubMed

    Douwes, Johannes M; Hegeman, Anneke K; van der Krieke, Merel B; Roofthooft, Marcus T R; Hillege, Hans L; Berger, Rolf M F

    2016-01-01

    To investigate the prognostic value of the 6-minute walking distance (6-MWD), transcutaneous saturation (tcSO2) and heart rate (HR) obtained during the 6-minute walk test (6-MWT) in pediatric pulmonary arterial hypertension (PAH). This was an observational study with forty-seven pediatric PAH patients, aged ≥7 years, and diagnosed and followed at the national referral center for pediatric PAH in the Netherlands. All patients performed a comprehensive 6-minute walk test (6-MWT), which measures 6-MWD and tcSO2 and HR before ("baseline"), during ("exercise") and 5 min after ("recovery") the walk test. The 6-MWD expressed either in meters or in sex- and age-corrected z-scores, was associated with transplant-free survival, independently from sex, age, and the presence of a shunt-defect. Shorter 6-MWD correlated with higher WHO-FC and increased NT-pro-BNP. Absolute tcSO2 at exercise and tcSO2-decrease during 6-MWT were associated with transplant-free survival, independent from 6-MWD. Combining tcSO2-decrease with 6-MWD provided the strongest prognostic model. Patients with 6-MWD>352 m (the median 6-MWD) had a better outcome than those with smaller 6-MWD. A large tcSO2-decrease during 6-MWT (>19% for patients with and >5% for patients without a shunt defect) identified patients with worse transplant-free survival both in patients with a 6-MWD above and below the median 6-MWD. The 6-MWD is an independent predictor of prognosis in pediatric PAH, that reflects disease severity and clinically relevant exercise-tolerance and therefore qualifies as a treatment goal. The magnitude of tcSO2-decrease during 6-MWT, adjusted for the presence of a shunt, indicates an additional risk factor for prognosis in children with PAH. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Determinants of distance walked during the six-minute walk test in patients undergoing cardiac surgery at hospital discharge

    PubMed Central

    2014-01-01

    Introduction The aim of this study was to identify the determinants of distance walked in six-minute walk test (6MWD) in patients undergoing cardiac surgery at hospital discharge. Methods The assessment was performed preoperatively and at discharge. Data from patient records were collected and measurement of the Functional Independence Measure (FIM) and the Nottingham Health Profile (NHP) were performed. The six-minute walk test (6MWT) was performed at discharge. Patients undergoing elective cardiac surgery, coronary artery bypass grafting or valve replacement were eligible. Patients older than 75 years who presented arrhythmia during the protocol, with psychiatric disorders, muscular or neurological disorders were excluded from the study. Results Sixty patients (44.26% male, mean age 51.53 ± 13 years) were assessed. In multivariate analysis the following variables were selected: type of surgery (P = 0.001), duration of cardiopulmonary bypass (CPB) (P = 0.001), Functional Independence Measure - FIM (0.004) and body mass index - BMI (0.007) with r = 0.91 and r2 = 0.83 with P < 0.001. The equation derived from multivariate analysis: 6MWD = Surgery (89.42) + CPB (1.60) + MIF (2.79 ) - BMI (7.53) - 127.90. Conclusion In this study, the determinants of 6MWD in patients undergoing cardiac surgery were: the type of surgery, CPB time, functional capacity and body mass index. PMID:24885130

  6. Six-minute walk test in children and adolescents with cystic fibrosis.

    PubMed

    Cunha, Maristela Trevisan; Rozov, Tatiana; de Oliveira, Rosangela Caitano; Jardim, José R

    2006-07-01

    The 6-min walk test is a simple, rapid, and low-cost method that determines tolerance to exercise. We examined the reproducibility of the 6-min walk test in 16 children with cystic fibrosis (11 female, 5 male; age range, 11.0 +/- 1.9 years). We related the distance walked and the work performed (distance walked x body weight) with nutritional (body mass index and respiratory muscle strength) and clinical (degree of bronchial obstruction and Shwachman score) status. Patients were asked to walk as far as possible upon verbal command on two occasions. There was no statistical difference between distances walked (582.3 +/- 60 and 598.2 +/- 56.8 m, P = 0.31), heart rate, respiratory rate, pulse oxygen saturation, arterial blood pressure, dyspnea, and percentage of maximal heart rate for age in the two tests. Distance walked correlated (Pearson) with maximal expiratory pressure (98.6 +/- 28.1 cmH2O, r = 0.60, P < 0.01), maximal heart rate (157.9 +/- 10.1 bpm, r = 0.59, P < 0.02), Borg dyspnea scale (1.7 +/- 2.4, r = 0.55, P < 0.03), and double product (blood pressure x heart rate; r = 0.59, P < 0.02). The product of distance walked and body weight (work) correlated (Pearson) with height (r = 0.83, P = 0.000), maximal expiratory pressure (r = 0.64, P < 0.01), systolic blood pressure (r = 0.56, P < 0.02), and diastolic blood pressure (r = 0.55, P < 0.03). We conclude that the 6-min walk test is reproducible and easy to perform in children and adolescents with cystic fibrosis. The distance walked was related to the clinical variables studied. Work in the 6-min walk test may be an additional parameter in the determination of physical capacity.

  7. The six-minute walk--an adequate exercise test for pacemaker patients?

    PubMed

    Langenfeld, H; Schneider, B; Grimm, W; Beer, M; Knoche, M; Riegger, G; Kochsiek, K

    1990-12-01

    In many pacemaker patients bicycle and treadmill ergometry are not practicable. As an alternative, we performed a 6-minute walk on a 20-m corridor in 97 pacemaker patients, who were asked to walk as far as possible determining their speed by themselves. Results were compared with those of bicycle ergometry in 42 of these patients and with treadmill exercise of a group of 92 other pacemaker patients. In the 6-minute walk, performance and maximal heart rate were slightly lower (49 +/- 18 W; 96 +/- 23 beats/min) than in bicycle (57 +/- 16 W; 110 +/- 26 beats/min) and treadmill ergometry (50 +/- 37 W; 102 +/- 35 beats/min). A good correlation was found between walking and bicycling (r = 0.74) and in subgroups of patients with different pacemaker indications. All patients preferred the walk to bicycle ergometry considering it to be more related to daily physical activity. In conclusion, a 6-minute walk is a simple and physiological exercise test for nearly all pacemaker patients with good correlation to other types of exercise. It seems to be preferable to other tests because of its better acceptance and practicability.

  8. Physiologic responses during the six minute walk test in obese and non-obese COPD patients.

    PubMed

    Bautista, Jennifer; Ehsan, Mohsin; Normandin, Edgar; Zuwallack, Richard; Lahiri, Bimalin

    2011-08-01

    Although obesity is a common co-morbid condition in COPD, relatively little is known how it may affect functional exercise capacity. Accordingly, we compared physiologic responses during a 6 min walk test in 10 obese and 10 non-obese COPD patients matched by gender, age, and spirometric severity category. Patients first exercised on a treadmill to determine maximal exercise responses, then following a rest period they completed a 6 min walk test. Breath by-breath analyses of expired air via a facemask was obtained using a portable, battery operated device. Oxygen consumption (VO(2)), carbon dioxide production (VCO(2)), tidal volume (VT), respiratory rate (RR), minute ventilation (VE), and inspiratory capacity (IC) were compared. The mean FEV1 in the obese and non-obese groups was 52 ± 13 and 58 ± 18 percent of predicted, respectively, and the BMI of the obese patients was 37 ± 02 kg/m(2). Obese patients had shorter 6 min walk distances than non-obese patients (247 ± 73 vs 348 ± 51 m, respectively, p = 0.003), but walk-work, defined as 6 min walk distance × weight (in kg), was not different. There were no significant between-group differences in any exercise variable measured during the 6 min walk test. In both groups, VO(2) and VE increased linearly over the first 2-3 min, then plateaued at approximately 80% of maximum. Although 6 min walk distance is shorter in obese COPD patients, their physiologic responses are similar to those of non-obese patients.

  9. Modified Six-Minute Walk Test: Number of Steps per Second

    PubMed Central

    Burioka, Naoto; Imada, Akari; Kiyohiro, Akiko; Sugitani, Fumika; Fujii, Takenori; Hosaka, Akari; Nakamoto, Sachiko; Amisaki, Takashi; Shimizu, Eiji

    2014-01-01

    ABSTRACT The 6-min walk test (6MWT) has been used to examine subjective dyspnea, predict mortality and measure clinical outcomes in studies of patients with chronic pulmonary or heart disease. Although the 6MWT is useful to assess the general ability to perform daily physical activity, it is difficult to evaluate time-dependent responses. To improve the 6MWT, we devised a new index, which is the number of steps walked per second (NSPS). We performed the 6MWT in 11 healthy subjects and 7 patients with chronic obstructive pulmonary disease (COPD) and calculated the NSPS. The mean NSPS was significantly higher in the healthy subjects than in the COPD patients, while the coefficient of variation of the NSPS was significantly smaller in healthy subjects compared with COPD patients. Calculation of the NSPS was useful to evaluate the walking pattern. This modified 6MWT may be helpful for assessing the efficacy of rehabilitation and drug therapy for COPD. PMID:25067880

  10. Use of the six-minute walk test to characterize golden retriever muscular dystrophy.

    PubMed

    Acosta, Austin R; Van Wie, Emiko; Stoughton, William B; Bettis, Amanda K; Barnett, Heather H; LaBrie, Nicholas R; Balog-Alvarez, Cynthia J; Nghiem, Peter P; Cummings, Kevin J; Kornegay, Joe N

    2016-12-01

    Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder in which loss of the dystrophin protein causes progressive skeletal/cardiac muscle degeneration and death within the third decade. For clinical trials and supportive animal studies, DMD disease progression and response to treatment must be established using outcome parameters (biomarkers). The 6-minute walk test (6MWT), defined as the distance an individual can walk in 6 minutes, is commonly used in DMD clinical trials and has been employed in dogs to characterize cardiac and respiratory disease severity. Building on methods established in DMD and canine clinical studies, we assessed the 6MWT in dogs with the DMD genetic homolog, golden retriever muscular dystrophy (GRMD). Twenty-one cross-bred golden retrievers were categorized as affected (DMD mutation and GRMD phenotype), carrier (female heterozygous for DMD mutation and no phenotype), and normal (wild type DMD gene and normal phenotype). When compared to grouped normal/carrier dogs, GRMD dogs walked shorter height-adjusted distances at 6 and 12 months of age and their distances walked declined with age. Percent change in creatine kinase after 6MWT was greater in GRMD versus normal/carrier dogs at 6 months, providing another potential biomarker. While these data generally support use of the 6MWT as a biomarker for preclinical GRMD treatment trials, there were certain limitations. Results of the 6MWT did not correlate with other outcome parameters for GRMD dogs when considered alone and an 80% increase in mean distance walked would be necessary to achieve satisfactory power. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Norepinephrine Remains Increased in the Six-Minute Walking Test after Heart Transplantation

    PubMed Central

    Guimarães, Guilherme Veiga; Avila, Veridiana D’; Bocchi, Edimar Alcides; Carvalho, Vitor Oliveira

    2010-01-01

    OBJECTIVE: We sought to evaluate the neurohormonal activity in heart transplant recipients and compare it with that in heart failure patients and healthy subjects during rest and just after a 6-minute walking test. INTRODUCTION: Despite the improvements in quality of life and survival provided by heart transplantation, the neurohormonal profile is poorly described. METHODS: Twenty heart transplantation (18 men, 49±11 years and 8.5±3.3 years after transplantation), 11 heart failure (8 men, 43±10 years), and 7 healthy subjects (5 men 39±8 years) were included in this study. Blood samples were collected immediately before and during the last minute of the exercise. RESULTS: During rest, patients’ norepinephrine plasma level (659±225 pg/mL) was higher in heart transplant recipients (463±167 pg/mL) and heathy subjects (512±132), p<0.05. Heart transplant recipient’s norepinephrine plasma level was not different than that of healthy subjects. Just after the 6-minute walking test, the heart transplant recipient’s norepinephrine plasma level (1248±692 pg/mL) was not different from that of heart failure patients (1174±653 pg/mL). Both these groups had a higher level than healthy subjects had (545±95 pg/mL), p<0.05. CONCLUSION: Neurohormonal activity remains increased after the 6-minute walking test after heart transplantation. PMID:20613934

  12. Comparing Two Conditions of Administering the Six-Minute Walk Test in People with Multiple Sclerosis

    PubMed Central

    Sandroff, Brian M.; Pilutti, Lara A.; Dlugonski, Deirdre; Learmonth, Yvonne C.; Pula, John H.

    2014-01-01

    Objective: This quasi-experimental study was conducted to determine whether differences existed in the total distance walked and energy expended between two conditions of administering the 6-Minute Walk test (6MW) across different levels of disability in people with multiple sclerosis (MS). Methods: The sample comprised 160 individuals with MS. One group of participants (n = 82) completed a 6MW while wearing a portable metabolic unit (K4b2, Cosmed, Italy) in a square hallway with four corridors and performing 90° turns. Another group (n = 78) completed a 6MW while wearing the same metabolic unit in a single corridor and performing 180° turns. Main outcome measures included total distance walked (in feet) and oxygen consumption (in milliliters per minute) expressed as 30-second averages for 1 minute before the 6MW and over the entire 6MW. Disability status was assessed using the Patient-Determined Disease Steps scale. Results: Participants undertaking the 6MW in a single corridor (1412 ft) walked 37 ft (2.7%) farther than those undertaking the test in a square hallway (1375 ft), but this difference was not statistically significant (F = 0.45, P = .51). Those completing the 6MW in a single corridor expended more energy than those completing the 6MW in the square hallway with four corridors (F = 3.41, P < .01). Conclusions: Either protocol is acceptable, but researchers should be aware of the additional physiological demands when administering the 6MW in a single corridor with 180° turns. PMID:24688354

  13. Six minute walk test: a simple and useful test to evaluate functional capacity in patients with heart failure.

    PubMed

    Rostagno, Carlo; Gensini, Gian Franco

    2008-09-01

    In heart failure survival is closely related to functional capacity. Peak O2 consumption at cardiopulmonary exercise test (CPET) is considered the gold standard for the evaluation of exercise tolerance. Since >70% of patients with heart failure, usually elderly or with significant comorbidities, are referred to Departments of Internal Medicine where facilities for cardiopulmonary test are rarely available, CPET may be performed in <5% of the patients. Six-minute walk test (6MWT) has been proposed as a simple, inexpensive, reproducible alternative to CPET. The 6MWT reproduces the activity of daily life and this is particularly relevant in elderly patients who usually develop symptoms below their theoretical maximal exercise capacity. Despite some limits 6MWT is attractive for patients referred to Departments of Internal Medicine allowing an objective evaluation of exercise tolerance, a better prognostic evaluation and a guide to evaluate response to medical treatment.

  14. Hypoxemia and arrhythmia during daily activities and six-minute walk test in fibrotic interstitial lung diseases.

    PubMed

    Park, Jeong Hyun; Jegal, Yangjin; Shim, Tae Sun; Lim, Chae-Man; Lee, Sang Do; Koh, Younsuck; Kim, Woo Sung; Kim, Won Dong; du Bois, Roland; Do, Kyung-Hyun; Kim, Dong Soon

    2011-03-01

    We performed 24-hr monitoring of pulse oximetric saturation (SpO(2)) with ECG and six-minute walk test (6MWT) in 19 patients with fibrotic interstitial lung diseases (ILD) to investigate; 1) The frequency and severity of hypoxemia and dysrhythmia during daily activities and 6MWT, 2) safety of 6MWT, and 3) the parameters of 6MWT which can replace 24-hr continuous monitoring of SpO(2) to predict hypoxemia during daily activities. All patients experienced waking hour hypoxemia, and eight of nineteen patients spent > 10% of waking hours in hypoxemic state. Most patients experienced frequent arrhythmia, mostly atrial premature contractions (APCs) and ventricular premature contractions (VPCs). There were significant correlation between the variables of 6MWT and hypoxemia during daily activities. All of the patients who desaturated below 80% before 300 meters spent more than 10% of waking hour in hypoxemia (P = 0.018). In contrast to waking hour hypoxemia, SpO(2) did not drop significantly during sleep except in the patients whose daytime resting SpO(2) was already low. In conclusion, patients with fibrotic ILD showed significant period of hypoxemia during daily activities and frequent VPCs and APCs. Six-minute walk test is a useful surrogate marker of waking hour hypoxemia and seems to be safe without continuous monitoring of SpO(2).

  15. Protocol Variations and Six-Minute Walk Test Performance in Stroke Survivors: A Systematic Review with Meta-Analysis

    PubMed Central

    Dunn, A.; Marsden, D. L.; Nugent, E.; Van Vliet, P.; Spratt, N. J.; Attia, J.; Callister, R.

    2015-01-01

    Objective. To investigate the use of the six-minute walk test (6MWT) for stroke survivors, including adherence to 6MWT protocol guidelines and distances achieved. Methods. A systematic search was conducted from inception to March 2014. Included studies reported a baseline (intervention studies) or first instance (observational studies) measure for the 6MWT performed by stroke survivors regardless of time after stroke.  Results. Of 127 studies (participants n = 6,012) that met the inclusion criteria, 64 were also suitable for meta-analysis. Only 25 studies made reference to the American Thoracic Society (ATS) standards for the 6MWT, and 28 reported using the protocol standard 30 m walkway. Thirty-nine studies modified the protocol walkway, while 60 studies did not specify the walkway used. On average, stroke survivors walked 284 ± 107 m during the 6MWT, which is substantially less than healthy age-matched individuals. The meta-analysis identified that changes to the ATS protocol walkway are associated with reductions in walking distances achieved. Conclusion. The 6MWT is now widely used in stroke studies. The distances achieved by stroke patients indicate substantially compromised walking ability. Variations to the standard 30 m walkway for the 6MWT are common and caution should be used when comparing the values achieved from studies using different walkway lengths. PMID:25685596

  16. Six-minute walk test and respiratory muscle strength in patients with uncontrolled severe asthma: a pilot study*

    PubMed Central

    Pereira, Luiz Fernando Ferreira; Mancuzo, Eliane Viana; Rezende, Camila Farnese; Côrrea, Ricardo de Amorim

    2015-01-01

    OBJECTIVE: To evaluate respiratory muscle strength and six-minute walk test (6MWT) variables in patients with uncontrolled severe asthma (UCSA). METHODS: This was a cross-sectional study involving UCSA patients followed at a university hospital. The patients underwent 6MWT, spirometry, and measurements of respiratory muscle strength, as well as completing the Asthma Control Test (ACT). The Mann-Whitney test was used in order to analyze 6MWT variables, whereas the Kruskal-Wallis test was used to determine whether there was an association between the use of oral corticosteroids and respiratory muscle strength. RESULTS: We included 25 patients. Mean FEV1 was 58.8 ± 21.8% of predicted, and mean ACT score was 14.0 ± 3.9 points. No significant difference was found between the median six-minute walk distance recorded for the UCSA patients and that predicted for healthy Brazilians (512 m and 534 m, respectively; p = 0.14). During the 6MWT, there was no significant drop in SpO2. Mean MIP and MEP were normal (72.9 ± 15.2% and 67.6 ± 22.2%, respectively). Comparing the patients treated with at least four courses of oral corticosteroids per year and those treated with three or fewer, we found no significant differences in MIP (p = 0.15) or MEP (p = 0.45). CONCLUSIONS: Our findings suggest that UCSA patients are similar to normal subjects in terms of 6MWT variables and respiratory muscle strength. The use of oral corticosteroids has no apparent impact on respiratory muscle strength. PMID:26176518

  17. Heart Rate Recovery in the First Minute at the Six-Minute Walk Test in Patients with Heart Failure

    PubMed Central

    Lindemberg, Sabrina; Chermont, Sergio; Quintão, Mônica; Derossi, Milena; Guilhon, Sergio; Bernardez, Sabrina; Marchese, Luana; Martins, Wolney; Nóbrega, Antônio Claudio L.; Mesquita, Evandro Tinoco

    2014-01-01

    Background Heart rate recovery at one minute of rest (HRR1) is a predictor of mortality in heart failure (HF), but its prognosis has not been assessed at six-minute walk test (6MWT) in these patients. Objective This study aimed to determine the HRR1 at 6MWT in patients with HF and its correlation with six-minute walk distance (6MWD). Methods Cross-sectional, controlled protocol with 161 individuals, 126 patients with stable systolic HF, allocated into 2 groups (G1 and G2) receiving or not β-blocker and 35 volunteers in control group (G3) had HRR1 recorded at the 6MWT. Results HRR1 and 6MWD were significantly different in the 3 groups. Mean values of HRR1 and 6MWD were: HRR1 = 12 ± 14 beat/min G1; 18 ± 16 beat/min G2 and 21 ± 13 beat/min G3; 6MWD = 423 ± 102 m G1; 396 ± 101m G2 and 484 ± 96 m G3 (p < 0.05). Results showed a correlation between HRR1 and 6MWD in G1(r = 0.3; p = 0.04) and in G3(r = 0.4; p= 0.03), but not in G2 (r= 0.12; p= 0.48). Conclusion HRR1 response was attenuated in patients using βB and showed correlation with 6MWD, reflecting better exercise tolerance. HRR1 after 6MWT seems to represent an alternative when treadmill tests could not be tolerated. PMID:24714794

  18. Transthoracic echocardiographic and cardiopulmonary exercise testing parameters in Eisenmenger's syndrome. Association with six-minute walk test distance.

    PubMed

    Gungor, H; Fatih Ayik, M; Engin, C; Yagdi, T; Atay, Y; Ozbaran, M; Nalbantgil, S

    2014-08-01

    The six-minute walk test (6MWT) evaluates the functional exercise capacity in patients with cardiopulmonary disease. We aimed to investigate the association between 6MWT distance and transthoracic echocardiographic (TTE) findings as well as cardiopulmonary exercise testing (CPET) parameters in Eisenmenger's syndrome (ES) patients waiting for heart-lung transplantation on their initial admission to our center. A total of 23 patients with ES (12 women, 11 men; mean age, 28.2 ± 8.1 years) were included in the study. The correlation between 6MWT distance and CPET and TTE findings was retrospectively analyzed. The most frequent underlying heart diseases were ventricular septal defect (VSD) with complex congenital heart disease (n = 10, 43 %) and isolated VSD (n = 7, 30 %). The 6MWT distance was 349.7 ± 77.4 m in the study group. An inverse correlation was found between 6MWT distance and systolic pulmonary arterial pressure (SPAP) measured with TTE (r = - 0.445; p = 0.03). All patients underwent CPET at the first visit. Mean VO2 max was 14.9 ± 3.3 ml/kg/min and the VE/VCO2 rate was 50.4 ± 9.2 %. No significant correlation was observed between 6MWT and CPET findings. SPAP, which did not display any correlation with CPET findings, was the only independent predictor of 6MWT distance. We suggest that 6MWT distance may be more suitable than CPET in the follow-up of ES patients. Further prospective, randomized, controlled trials are necessary to make more robust interpretations of this issue.

  19. Exercise training improves breathing strategy and performance during the six-minute walk test in obese adolescents.

    PubMed

    Mendelson, Monique; Michallet, Anne-Sophie; Perrin, Claudine; Levy, Patrick; Wuyam, Bernard; Flore, Patrice

    2014-08-15

    We aimed to examine ventilatory responses during the six-minute walk test in healthy-weight and obese adolescents before and after exercise training. Twenty obese adolescents (OB) (age: 14.5±1.7 years; BMI: 34.0±4.7kg·m(-2)) and 20 age and gender-matched healthy-weight adolescents (HW) (age: 15.5±1.5 years; BMI: 19.9±1.4kg·m(-2)) completed six-minute walk test during which breath-by-breath gas analysis and expiratory flow limitation (expFL) were measured. OB participated in a 12-week exercise-training program. Comparison between HW and OB participants showed lower distance achieved during the 6MWT in OB (-111.0m, 95%CI: -160.1 to 62.0, p<0.05) and exertional breathlessness was greater (+0.78 a.u., 95%CI: 0.091-3.27, p=0.039) when compared with HW. Obese adolescents breathed at lower lung volumes, as evidenced by lower end expiratory and end inspiratory lung volumes during exercise (p<0.05). Prevalence of expFL (8 OB vs 2 HW, p=0.028) and mean expFL (14.9±21.9 vs 5.32±14.6% VT, p=0.043, in OB and HW) were greater in OB. After exercise training, mean increase in the distance achieved during the 6MWT was 64.5 meters (95%CI: 28.1-100.9, p=0.014) and mean decrease in exertional breathlessness was 1.62 (95%CI: 0.47-2.71, p=0.05). Obese adolescents breathed at higher lung volumes, as evidenced by the increase in end inspiratory lung volume from rest to 6-min exercise (9.9±13.4 vs 20.0±13.6%TLC, p<0.05). Improved performance was associated with improved change in end inspiratory lung volume from rest to 6-min exercise (r=0.65, p=0.025). Our results suggest that exercise training can improve breathing strategy during submaximal exercise in obese adolescents and that this increase is associated with greater exercise performance. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children.

    PubMed

    Andrade, Lívia Barboza de; Silva, Diogo A R G; Salgado, Taíza L B; Figueroa, José N; Lucena-Silva, Norma; Britto, Murilo C A

    2014-01-01

    to compare physical performance and cardiorespiratory responses in the six-minute walk test (6MWT) in asthmatic children with reference values for healthy children in the same age group, and to correlate them with intervening variables. this was a cross-sectional, prospective study that evaluated children with moderate/severe asthma, aged between 6 and 16 years, in outpatient follow-up. Demographic and spirometric test data were collected. All patients answered the pediatric asthma quality of life (QoL) questionnaire (PAQLQ) and level of basal physical activity. The 6MWT was performed, following the American Thoracic Society recommendations. Comparison of means was performed using Student's t-test and Pearson's correlation to analyze the 6MWT with study variables. The significance level was set at 5%. 40 children with moderate or severe asthma were included, 52.5% males, 70% with normal weight and sedentary. Mean age was 11.3±2.1 years, mean height was 1.5±0.1 m, and mean weight was 40.8±12.6 Kg. The mean distance walked in the 6MWT was significantly lower, corresponding to 71.9%±19.7% of predicted values; sedentary children had the worst values. The difference between the distance walked on the test and the predicted values showed positive correlation with age (r=0.373, p=0.018) and negative correlation with cardiac rate at the end of the test (r=-0.518, p<0.001). Regarding QoL assessment, the values in the question about physical activity limitations showed the worst scores, with a negative correlation with walked distance difference (r=-0.311, p=0.051). asthmatic children's performance in the 6MWT evaluated through distance walked is significantly lower than the predicted values for healthy children of the same age, and is directly influenced by sedentary life style. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Prognostic value of the six-minute walk test in end-stage renal disease life expectancy: a prospective cohort study

    PubMed Central

    de Moraes Kohl, Leandro; Signori, Luis Ulisses; Ribeiro, Rodrigo Antonini; Silva, Antonio Marcos Vargas; Moreira, Paulo Ricardo; Dipp, Thiago; Sbruzzi, Graciele; Lukrafka, Janice Luisa; Plentz, Rodrigo Della Méa

    2012-01-01

    OBJECTIVES: The six-minute walk test has been widely used to evaluate functional capacity and predict mortality in several populations. Thus, the aim of this study was to evaluate the prognostic value of the six-minute walk test for the life expectancy of end-stage renal disease patients. METHODS: Patients over 18 years old who underwent hemodialysis for at least six months were included. Patients with hemodynamic instability, smoking, chronic obstructive pulmonary disease, physical incapacity and acute myocardial stroke in the preceding three months were excluded. RESULTS: Fifty-two patients (54% males; 36±11 years old) were followed for 144 months. The distance walked in the six-minute walk test was a survival predictor for end-stage renal disease patients. In the multivariate analysis, for each 100 meters walked with a 100-meter increment, the hazard ratio was 0.53, with a 95% confidence interval of 0.37-0.74. There was a positive correlation between the distance walked in the six-minute walk test and peak oxygen consumption (r = 0.508). In the multivariate analysis, each year of dialysis treatment represented a 10% increase in death probability; in the severity index analysis, each point on the scale represented an 11% increase in the death risk. CONCLUSIONS: We observed that survival increased approximately 5% for every 100 meters walked in the six-minute walk test, demonstrating that the test is a viable option for evaluating the functional capacity in patients with end-stage renal disease. PMID:22760895

  2. [Peak oxygen uptake during the six-minute walk test in diffuse interstitial lung disease and pulmonary hypertension].

    PubMed

    Blanco, Isabel; Villaquirán, Claudio; Valera, José Luis; Molina-Molina, María; Xaubet, Antoni; Rodríguez-Roisin, Robert; Barberà, Joan A; Roca, Josep

    2010-03-01

    The six-minute walk test (6MWT) is widely used in evaluating diffuse interstitial lung disease (ILD) and pulmonary hypertension (PH). However, their physiological determining factors have not been well defined. To evaluate the physiological changes that occur in ILD and PH during the 6MWT, and compare them with the cardiopulmonary exercise test (CPET). Thirteen patients with ILD and 14 with PH were studied using the 6MWT and CPET on an ergometer cycle. The respiratory variables were recorded by means of telemetry during the 6MWT. Oxygen consumption (VO(2)), respiratory and heart rate reached a plateau from minute 3 of the 6MWT in both diseases. The VO(2) did not differ from the peak value in the CPET (14+/-2 and 15+/-2 ml/kg/min, respectively, in ILD; 16+/-6 and 16+/-6 ml/kg/min, in PH). The arterial oxygen saturation decreased in both diseases, although it was more marked in ILD (-12+/-5%, p<0,01). The ventilatory equivalent for CO(2) (V(E)/VCO(2)) in PH during the 6MWT was strongly associated with functional class (FC) (85+/-14 in FC III-IV, 44+/-6 in FC I-II; p<0,001). The 6MWT in ILD and PH behaves like a maximal effort test, with similar VO(2) to the CPET, demonstrating a limit in oxygen transport capacity. Monitoring using telemetry during the 6MWT may be useful for the clinical evaluation of patients with ILD or PH. Copyright 2009 SEPAR. Published by Elsevier Espana. All rights reserved.

  3. Usefulness of the desaturation-distance ratio from the six-minute walk test for patients with COPD.

    PubMed

    Fujimoto, Yukari; Oki, Yutaro; Kaneko, Masahiro; Sakai, Hideki; Misu, Shogo; Yamaguchi, Takumi; Mitani, Yuji; Yasuda, Hisafumi; Ishikawa, Akira

    2017-01-01

    A straightforward, noninvasive method is needed to assess emphysema and pulmonary hypertension (PH) in COPD patients. The desaturation-distance ratio (DDR) is an index derived from the distance traveled and level of desaturation during a six-minute walk test (6MWT); it has previously been shown to be associated with percentage of forced expiratory volume in the first second of expiration (%FEV1.0) and percentage of diffusion capacity of the lung for carbon monoxide (%DLCO). The aim of this study was to examine the associations between DDR and emphysema and PH. We collected the following data for 74 stable COPD outpatients: lung function tests (%FEV1.0 and %DLCO), 6MWT distance and desaturation, and area of emphysema on computed tomography (percentage of low attenuation area). Enlargement of the pulmonary artery (PA) was assessed by the ratio of the diameter of the PA to that of the aorta (PA:A ratio) as an index of PH. DDR was calculated by the distance traveled and the degree of desaturation reached during a 6MWT. The relationships between study outcomes were assessed with Spearman's rank-correlation analysis. Receiver operating characteristic (ROC) curves were used to determine the threshold values with the optimum cutoff points for predicting severe or very severe airway obstruction, pulmonary diffusing capacity disorder, moderate or severe emphysema, and enlargement of the PA. DDR correlated significantly with %FEV1.0, %DLCO, %LAA, and PA:A ratio. DDR showed high accuracy (area under the ROC curve >0.7) for predicting severe or very severe airway obstruction, pulmonary diffusing capacity disorder, moderate or severe emphysema, and enlargement of the PA. The results suggest that DDR is a good index of emphysema and PH in COPD patients. The 6MWT is widely used to assess COPD, and DDR could help with the early diagnosis of COPD.

  4. Six-minute walk test as a tool for assessing the quality of life in patients undergoing coronary artery bypass grafting surgery.

    PubMed

    Baptista, Vanessa Cristina; Palhares, Luciana Campanatti; de Oliveira, Pedro Paulo Martins; Silveira Filho, Lindemberg Mota; Vilarinho, Karlos Alexandre de Souza; Severino, Elaine Soraya Barbosa de Oliveira; Lavagnoli, Carlos Fernando Ramos; Petrucci, Orlando

    2012-01-01

    To assess the quality of life in patients undergoing myocardial revascularization using the six-minute walk test. Prospective observational study with patients who undergoing CABG. The clinical variables, the sixminute walk test, and the SF-36 test were recorded. The patients were assessed at the preoperative time and at 2 months of postoperative period. According their six-minute walk test results, the patients were divided into two groups: group walked more than 350 meters (> 350 meters Group) and the group walked less than 350 meters (< 350 meters Group) at the preoperative time. Eight-seven patients were included. Age was comparable in both groups (59 ± 9.5 years vs. 61 ± 9.3 years; respectively, P = 0.24). The group walked > 350 meters distance was higher than the < 350 meters group after 2 months of operation (436 ± 78 meters vs. 348 ± 87 meters; P <0.01). The quality of life was lower in the < 350 meters group compared to the > 350 meters group in the preoperative period in the following domains: functional capabilities, limitations due to physical aspects, overall health feelings, vitality, and social aspects. Quality of life improved after two months in both groups. The six-minute walk test at the preoperative time is associated with the quality of life after two months of coronary artery bypass grafting. In overall, quality of life has improved in all patients. The improvement in the quality of life was greater in those patients who walked distances lower than 350 meters at the preoperative time.

  5. Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six-Minute Walk Test

    PubMed Central

    2014-01-01

    Background Although the Six-Minute Walk Test (6MWT), as recommended by the American Thoracic Society, is widely used as a measure of functional endurance, it may not be applicable in some settings and populations. We sought to examine, therefore, performance over the first 2 minutes and the full 6 minutes of the 6MWT. Specifically, we investigated completion rates, distances walked, test-retest reliability, and the relationship between distances walked over the first 2 and the full 6 minutes of the 6MWT. Methods Community-dwelling children and adults age 3–85 years (n = 337) were asked to walk back and forth on a 15.24 meter (50 ft) course as far as possible without running over a 6 minute period. Test completion and the distance covered by the participants at 2 and 6 minutes were documented. The reliability of distances covered at 2 and 6 minutes was determined by retesting a subsample of 54 participants 6 to 10 days later. The relationship between distances covered at 2 and 6 minutes was determined for the 330 participants completing the 6MWT. Results All 337 participants completed at least 2 minutes of walking, but 7 children less than 5 years of age ceased walking before 6 minutes had elapsed. For the remaining 330 participants the mean distance walked was 186 meters at 2 minutes and 543 meters at 6 minutes. The distances covered at 2 and 6 minutes were reliable between sessions (intraclass correlation coefficients = 0.888 and 0.917, respectively). The distances covered over 2 and 6 minutes were highly correlated (r = 0.968). Conclusions The completion rate, values obtained, test-retest reliability, and relationship of the distances walked in 2 and 6 minutes support documentation of 2 minute distance during the 6MWT. The findings also provide support for use of a Two-Minute Walk Test as the endurance component in the Motor Battery of the NIH Toolbox. PMID:24767634

  6. Six-Minute Walk Test as a Predictor for Outcome in Children with Dilated Cardiomyopathy and Chronic Stable Heart Failure.

    PubMed

    den Boer, Susanna L; Flipse, Daniël H K; van der Meulen, Marijke H; Backx, Ad P C M; du Marchie Sarvaas, Gideon J; Ten Harkel, Arend D J; van Iperen, Gabriëlle G; Rammeloo, Lukas A J; Tanke, Ronald B; Helbing, Willem A; Takken, Tim; Dalinghaus, Michiel

    2017-03-01

    Cardiopulmonary exercise testing is an important tool to predict prognosis in children and adults with heart failure. A much less sophisticated exercise test is the 6 min walk test, which has been shown an independent predictor for morbidity and mortality in adults with heart failure. Therefore, we hypothesized that the 6 min walk test could be predictive for outcome in children with dilated cardiomyopathy. We prospectively included 49 children with dilated cardiomyopathy ≥6 years who performed a 6 min walk test. Median age was 11.9 years (interquartile range [IQR] 7.4-15.1), median time after diagnosis was 3.6 years (IQR 0.6-7.4). The 6 min walk distance was transformed to a percentage of predicted, using age- and gender-specific norm values (6MWD%). For all patients, mean 6MWD% was 70 ± 21%. Median follow-up was 33 months (IQR 14-50). Ten patients reached the combined endpoint of death or heart transplantation. Using univariable Cox regression, a higher 6MWD% resulted in a lower risk of death or transplantation (hazard ratio 0.95 per percentage increase, p = 0.006). A receiver operating characteristic curve was generated to define the optimal threshold to identify patients at highest risk for an endpoint. Patients with a 6MWD% < 63% had a 2 year transplant-free survival of 73%, in contrast to a transplant-free survival of 92% in patients with a 6MWD% ≥ 63% (p = 0.003). In children with dilated cardiomyopathy, the 6 min walk test is a simple and feasible tool to identify children with a higher risk of death or heart transplantation.

  7. Aerobic intensity and pacing pattern during the six-minute walk test in patients with multiple sclerosis.

    PubMed

    Dalgas, Ulrik; Kjølhede, Tue; Gijbels, Domien; Romberg, Anders; Santoyo, Carme; de Noordhout, Benoit Maertens; Knuts, Kathy; Feys, Peter

    2014-01-01

    To examine the aerobic intensity level and pacing pattern during the 6-min walk test (6MWT) in persons with multiple sclerosis, taking into account time of day, fatigue, disability level and multiple sclerosis subtype. Cross-sectional study. Eighty multiple sclerosis patients (Expanded Disability Status Scale, EDSS ≤ 6.5). Participants performed the 6MWT at 3 different time-points (morning, noon, afternoon) during 1 day. Heart rate and pacing strategy (distance covered every minute) were registered. A sub-group analysis determined the effects of fatigue, disability level and multiple sclerosis subtype. The relative aerobic intensity was constant throughout the day (67 ± 10% of estimated maximal heart rate). In all sub-groups heart rate increased and distance walked declined after the first minute (p < 0.001). The mild EDSS sub-group showed a slightly larger increase throughout the 6MWT in heart rate development, while no differences were seen in sub-groups of fatigue and multiple sclerosis subtype. In most sub-groups walking speed was fastest in the first minute and constant during the final 4 minutes. In patients with multiple sclerosis aerobic intensity is moderate during the 6MWT and unaffected by time of day. Disability may have some influence on aerobic intensity, but not on pacing strategy during the 6MWT, whereas neither fatigue nor multiple sclerosis subtype has any effect.

  8. Usefulness of the Six-Minute Walk Test after Continuous Axial Flow Left Ventricular Device Implantation to Predict Survival

    PubMed Central

    Hasin, Tal; Topilsky, Yan; Kremers, Walter K.; Boilson, Barry A.; Schirger, John A.; Edwards, Brooks S.; Clavell, Alfredo L.; Rodeheffer, Richard J.; Frantz, Robert P.; Joyce, Lyle; Daly, Richard; Stulak, John M.; Kushwaha, Sudhir S.; Park, Soon J.; Pereira, Naveen L.

    2012-01-01

    The goal of this study was to describe predictors and significance of poor exercise tolerance after left ventricular assist device (LVAD) implantation. Despite LVAD therapy some patients continue to exhibit exercise intolerance. The predictors and outcomes of these patients are unknown. A retrospective review of 65 LVAD recipients who performed a 6-minute walk test (6MWT) was conducted. Patients walking <300m were considered having poor exercise tolerance. There were 20 patients who exhibited poor exercise tolerance (221±45m) compared to 45 patients with better exercise tolerance (406±76m). Post-operatively, poor performers were not easily identified by functional symptoms alone since 42% of these patients reported NYHA Class 1 or 2 symptoms. Preoperative NYHA class, inotrope therapy, and intra-aortic balloon pump use were similar between the 2 groups. Multivariable analysis using all adequately powered (n>50) univariate predictors identified diabetes mellitus (OR=10.493, p=0.003) and elevated 1-month right atrial pressure (OR=2.985 for every 5mmHG, P=0.003) as significant predictors of poor performance (<300m, AUC=0.85). The poorly performing group had increased mortality (p=0.011), with 21% increased risk of overall mortality for every 10 meters short of 300m (fitted cox model: HR=1.211, p=0.0001). The distance walked in meters in a post-operative 6MWT was the strongest predictor of late post-LVAD mortality (p=0.0002). In conclusion, despite similar severity of heart failure preoperatively, some LVAD recipients may have persistent exercise intolerance post operatively as assessed by 6MWT that is independently associated with subsequent reduced survival. PMID:22819427

  9. Six-Minute Walk Test for Persons with Mild or Moderate Disability from Multiple Sclerosis: Performance and Explanatory Factors

    PubMed Central

    Fry, Donna K.; Pfalzer, Lucinda A.

    2011-01-01

    ABSTRACT Purpose: The primary purpose of this study was to determine the extent to which health factors, functional measures, and pulmonary impairment explain performance on 6-Minute Walk Test (6MWT) distance in ambulatory persons with multiple sclerosis (MS). Another purpose was to determine the effect of disability and age on 6MWT performance and explanatory factors. Methods: A cross-sectional study design was used to evaluate factors that explain performance on the 6MWT in 64 community-dwelling persons with MS-related disability (Expanded Disability Status Scale [EDSS] 3.8±1.6). Of the 64 participants, 43 (67.2%) exhibited mild disability (EDSS <4.0) and 21 (32.8%) had moderate disability (EDSS 4.0–6.5). A regression analysis compared 6MWT performance to measures of health factors (EDSS, number of medications, number of comorbidities, resting HR, systolic and diastolic blood pressure [BP]); physical performance (functional stair test [FST], sit-to-stand test [SST], static standing balance [BAL], Fatigue Severity Scale [FSS], Activities-specific Balance Confidence [ABC] Scale); and pulmonary function (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], maximal voluntary ventilation [MVV], maximal inspiratory pressure [MIP], maximal expiratory pressure [MEP]). Results: EDSS, ABC, FST, SST, BAL, MVV, MIP, and MEP were significantly associated with 6MWT distance after adjusting for age. Multiple step-wise linear regression analysis revealed that ABC, FST, and BAL were significant and independent explanatory factors of 6MWT distance. ABC and FST explained 75% of the variance in 6MWT performance (R2=0.75). Curvilinear regression analysis revealed that the FST is the most significant explanatory factor for 6MWT distance, explaining 79% of the variance (R2=0.79). Conclusions: 6MWT performance in persons with MS was explained by balance confidence (ABC) and stair-climbing ability (FST). The ABC and FST may be practical clinical measures for

  10. Could peak oxygen uptake be estimated from proposed equations based on the six-minute walk test in chronic heart failure subjects?

    PubMed

    Ribeiro-Samora, Giane A; Montemezzo, Dayane; Pereira, Danielle A G; Tagliaferri, Thaysa L; Vieira, Otávia A; Britto, Raquel R

    To evaluate the agreement between the measured peak oxygen uptake (VO2peak) and the VO2peak estimated by four prediction equations based on the six-minute walk test (6MWT) in chronic heart failure patients. Thirty-six chronic heart failure patients underwent cardiopulmonary exercise testing and the 6MWT to assess their VO2peak. Four previously published equations that include the variable six-minute walk distance were used to estimate the VO2peak: Cahalin, 1996a (1); Cahalin, 1996b (2); Ross, 2010 (3); and Adedoyin, 2010 (4). The agreement between the VO2peak in the cardiopulmonary exercise testing and the estimated values was assessed using the Bland-Altman method. A p-value of <0.05 was considered statistically significant. All estimated VO2peak values presented moderate correlation (ranging from 0.55 to 0.70; p<0.001) with measured VO2peak values. Equations 2, 3, and 4 underestimated the VO2peak by 30%, 15.2%, and 51.2%, respectively, showing significant differences from the actual VO2peak measured in the cardiopulmonary exercise testing (p<0.0001 for all), and the limits of agreement were elevated. The VO2peak estimated by equation 1 was similar to that measured by the cardiopulmonary exercise testing, and despite the agreement, bias increased as VO2peak increased. Only equation 1 showed estimated VO2peak similar to the measured VO2peak; however, a large limits of agreement range (∼3 METs) does not allow its use to estimate maximal VO2peak. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Role of the cardio-pulmonary exercise test and six-minute walking test in the evaluation of exercise performance in patients with late-onset Pompe disease.

    PubMed

    Crescimanno, G; Modica, R; Lo Mauro, R; Musumeci, O; Toscano, A; Marrone, O

    2015-07-01

    In patients with late-onset Pompe disease, we explored the role of the Cardiopulmonary Exercise Test (CPET) and the Six-Minute Walking Test (6MWT) in the assessment of exercise capacity and in the evaluation of the effects of enzyme replacement therapy (ERT). Eight patients affected by late-onset Pompe disease, followed up at the Centre for Neuromuscular Diseases and treated with ERT, underwent a baseline evaluation with a spirometry, a CPET and a 6MWT. Four of them were restudied after 36 months of treatment. Three patients showed a reduction in exercise capacity as evaluated by peak oxygen uptake (VO2) measured at the CPET and Distance Walked (DW) measured at the 6MWT (median % predicted: 67.1 [range 54.3-99.6] and 67.3 [56.6-82.6], respectively). Cardiac and respiratory limitations revealed by the CPET were correlated to peak VO2, but not to the DW. Nevertheless, percent of predicted values of peak VO2 and DW were strongly correlated (rho = 0.85, p = 0.006), and close to identity. In the longitudinal evaluation forced vital capacity decreased, while peak VO2 and DW showed a trend to a parallel improvement. We concluded that although only the CPET revealed causes of exercise limitation, which partially differed among patients, CPET and 6MWT showed a similar overall degree of exercise impairment. That held true in the longitudinal assessment during ERT, where both tests demonstrated similar small improvements, occurring despite deterioration in forced vital capacity.

  12. Evaluation of functional capacity for exercise in children and adolescents with sickle-cell disease through the six-minute walk test.

    PubMed

    Hostyn, Sandro V; Carvalho, Werther B de; Johnston, Cíntia; Braga, Josefina A P

    2013-01-01

    To evaluate lung functional capacity (FC) for physical exercise in children and adolescents with sickle cell disease (SCD) through the six-minute walk test (6MWT). A cross-sectional prospective study was performed to evaluate the FC of 46 patients with SCD through the 6MWT. The following parameters were assessed: heart rate (HR), respiratory rate (RR), peripheral pulse oxygen saturation (SpO2), peak expiratory flow (PEF), blood pressure (systolic and diastolic), dyspnea, and leg fatigue (modified Borg scale) at rest, in the end of the test, and ten minutes after the 6MWT. The total distance walked was also recorded. For statistical analysis, the parametric variables were analyzed using the paired Student's t-test, analysis of variance (ANOVA), and Bonferroni multiple comparisons, with a significance level set at p ≤ 0.05. The 46 patients were aged age 9.15±3.06 years, presented baseline Hb of 9.49±1.67g/dL, and walked 480.89±68.70 m. SCD diagnosis was as follows: group 1- HbSS (n=20)/HbSβ(0)-thalassemia (n=3) and group 2 - HbSC (n=20)/HbSβ(+)-thalassemia (n=3). Regarding total distance walked, patients in group 1 walked a shorter distance than patients in group 2 (459.39±57.19 vs. 502.39±73.60 m; p=0.032). There was no statistical difference regarding PEF in the three moments of evaluation. The SpO2 in ambient air and SpO2 with O2 differed between groups 1 and 2 (p<0.001 vs. p=0.002), as well as the RR (p=0.001). These patients showed a lower FC for exercise than that predicted for the age range in the literature. Patients diagnosed with HbSS/Sβ0-thalassemia had a lower performance in the test than those with HbSC/Sβ(+)-thalassemia regarding total distance walked, RR, and SpO2 after the 6MWT. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. Association between Six Minute Walk Test and All-Cause Mortality, Coronary Heart Disease-Specific Mortality, and Incident Coronary Heart Disease

    PubMed Central

    Yazdanyar, Ali; Aziz, Michael M; Enright, Paul L; Edmundowicz, Daniel; Boudreau, Robert; Sutton-Tyrell, Kim; Kuller, Lewis; Newman, Anne B

    2015-01-01

    Objectives To examine the association between six-minute walk test (6 MWT) performance and all-cause mortality, coronary heart disease mortality, and incident coronary heart disease in older adults. Methods We conducted a time-to-event analysis of 1,665 Cardiovascular Health Study participants with a 6 MWT and without prevalent cardiovascular disease. Results During a mean follow-up of 8 years, there were 305 incident coronary heart disease events, 504 deaths of which 100 were coronary heart disease-related deaths. The 6 MWT performance in the shortest two distance quintiles was associated with increased risk of all-cause mortality (290-338 meters: HR 1.7; 95% CI, 1.2-2.5; <290 meters: HR 2.1; 95% CI, 1.4-3.0). The adjusted risk of coronary heart disease mortality incident events among those with a 6 MWT <290 meters was not significant. Discussion Performance on the 6 MWT is independently associated with all-cause mortality and is of prognostic utility in community-dwelling older adults. PMID:24695552

  14. Six-minute walk test as a prognostic tool in stable coronary heart disease: data from the Heart and Soul Study

    PubMed Central

    Beatty, Alexis L.; Schiller, Nelson B.; Whooley, Mary A.

    2012-01-01

    Background The prognostic value of the six-minute walk test (6MWT) in patients with stable coronary heart disease (CHD) is unknown. We sought to determine whether the 6MWT predicted cardiovascular events in ambulatory patients with CHD. Methods We measured 6MWT distance and treadmill exercise capacity in 556 outpatients with stable CHD between September 2000 and December 2002. Participants were followed for a median of 8.0 years for cardiovascular events (heart failure, myocardial infarction, and death). Results Cardiovascular events occurred in 39% (218/556) of participants. Patients in the lowest quartile of 6MWT distance (87–419 meters) had 4 times the rate of events as those in the highest quartile (544–837 meters) (unadjusted HR 4.29, 95%CI 2.83–6.53, p<0.0001). Each standard deviation (SD) decrease in 6MWT distance (104 meters) was associated with a 55% higher rate of cardiovascular events (age-adjusted HR 1.55, 95%CI 1.35–1.78). After adjustment for traditional risk factors and cardiac disease severity measures (ejection fraction, inducible ischemia, diastolic dysfunction, NT-proBNP, and CRP), each SD decrease in 6MWT was associated with a 30% higher rate of cardiovascular events (HR 1.30, 95%CI 1.10–1.53). When added to traditional risk factors, the 6MWT resulted in category-free net reclassification improvement of 39% (95%CI 19%–60%). The discriminative ability of 6MWT was similar to treadmill exercise capacity for predicting cardiovascular events (c-statistics both 0.72, p =0.29). Conclusions Distance walked on 6MWT predicted cardiovascular events in patients with stable CHD. The addition of a simple 6MWT to traditional risk factors improved risk prediction and was comparable to treadmill exercise capacity. PMID:22710902

  15. Resting and exercise haemodynamics in relation to six-minute walk test in patients with heart failure and preserved ejection fraction.

    PubMed

    Wolsk, Emil; Kaye, David; Borlaug, Barry A; Burkhoff, Daniel; Kitzman, Dalane W; Komtebedde, Jan; Lam, Carolyn S P; Ponikowski, Piotr; Shah, Sanjiv J; Gustafsson, Finn

    2017-09-26

    Patients with heart failure and preserved ejection fraction (HFpEF) are characterized by functional impairment and an abnormal haemodynamic response to exercise. The six-minute walk test (6MWT) serves as a standardized test for functional capacity quantification in heart failure patients, and is associated with cardiovascular outcomes. However, as the association between 6MWT and haemodynamic parameters during rest and exercise in HFpEF patients is unknown, we sought to elucidate this relationship. Overall, 64 patients enrolled in the REDUCE LAP-HF trial completed a 6MWT at baseline. Univariate and multivariable linear regression models were used to assess the associations between 6MWT and measured or derived haemodynamic variables at baseline, during light/moderate exercise (20 W), and at peak supine exercise. The average 6MWT distance was 318 ± 106 m. At rest, in a multivariable model, only pulmonary capillary wedge pressure (PCWP) was significantly associated with 6MWT [coefficient: -5.4, 95% confidence interval (CI) -10.4, -0.5, P = 0.033]. During light/moderate exercise, mean pulmonary artery pressure was associated with 6MWT in a multivariable model (coefficient: -3.5, 95% CI -6.8, -0.3, P = 0.033). During peak exercise, central venous pressure, cardiac index (CI), and PCWP/CI correlated with 6MWT; however, workload corrected PCWP was the only variable independently associated with 6MWT (coefficient: -0.8, 95% CI -1.3, -0.4, P < 0.001). The variance in 6MWT was modestly explained by measured or derived haemodynamic variables at rest or at any stage of exercise (r(2)  = 7-17%). Workload corrected PCWP correlated best with 6MWT performance in HFpEF patients. Baseline haemodynamic variables were modestly correlated with 6MWT, suggesting that 6MWT performance in HFpEF patients may be significantly influenced by extra-cardiac factors. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  16. Device-measured physical activity versus six-minute walk test as a predictor of reverse remodeling and outcome after cardiac resynchronization therapy for heart failure.

    PubMed

    Vegh, Eszter Maria; Kandala, Jagdesh; Orencole, Mary; Upadhyay, Gaurav A; Sharma, Ajay; Miller, Alexandra; Merkely, Bela; Parks, Kimberly A; Singh, Jagmeet P

    2014-05-01

    Implanted devices can provide objective assessment of physical activity over prolonged periods. The purpose of this study was to investigate the prognostic value of device-measured physical activity data compared with a six-minute walk test (6MWT) in predicting clinical response to cardiac resynchronization therapy (CRT). This was a single-center study in which patients who underwent CRT for standard indications were evaluated. Daily physical activity and 6MWT were evaluated postimplant at 1, 3, and 6 months. The primary end point was a composite of heart failure hospitalization, transplant, left ventricular (LV) assist device, and all-cause death at 3 years. Echocardiographic response, defined as a ≥10% improvement in LV ejection fraction (LVEF), at 6 months was the secondary end point. About 164 patients were included: average age was 67.3 ± 12.9 years, 77% were men, baseline LVEF was 25% ± 7%. Kaplan-Meier curves showed superior freedom from the composite end point in the highest tertile of both 6MWT and physical activity compared with the lowest tertile (41 vs 23 cases, respectively, p <0.001) for 6MWT and for activity (22 vs 7 cases, respectively, p = 0.001). In an adjusted multivariate model, independent predictors of improved clinical outcome included 1-month physical activity (hazard ratio 0.546, 95% confidence interval [CI] 0.361 to 0.824, p = 0.004) and 6MWT (hazard ratio 0.581, 95% CI 0.425 to 0.795, p = 0.001). An additional hour of higher activity at 1 month translated to a 1.38 times (95% CI 1.075 to 1.753, p = 0.011) higher likelihood of improved echocardiographic response. In conclusion, device-based measures of physical activity may be useful in predicting echocardiographic reverse remodeling and long-term clinical outcome in patients receiving CRT.

  17. Reproducibility of the six-minute walk test and Glittre ADL-test in patients hospitalized for acute and exacerbated chronic lung disease

    PubMed Central

    José, Anderson; Dal Corso, Simone

    2015-01-01

    Background: The 6-minute walk test (6MWT) and the Glittre ADL-test (GT) are used to assess functional capacity and exercise tolerance; however, the reproducibility of these tests needs further study in patients with acute lung diseases. Objectives: The aim of this study was to investigate the reproducibility of the 6MWT and GT performed in patients hospitalized for acute and exacerbated chronic lung diseases. Method: 48 h after hospitalization, 81 patients (50 males, age: 52±18 years, FEV1: 58±20% of the predicted value) performed two 6MWTs and two GTs in random order on different days. Results: There was no difference between the first and second 6MWT (median 349 m [284-419] and 363 m [288-432], respectively) (ICC: 0.97; P<0.0001). A difference between the first and second tests was found in GT (median 286 s [220-378] and 244 s [197-323] respectively; P<0.001) (ICC: 0.91; P<0.0001). Conclusion: Although both the 6MWT and GT were reproducible, the best results occurred in the second test, demonstrating a learning effect. These results indicate that at least two tests are necessary to obtain reliable assessments. PMID:26039036

  18. Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study.

    PubMed

    Andrianopoulos, Vasileios; Wouters, Emiel F M; Pinto-Plata, Victor M; Vanfleteren, Lowie E G W; Bakke, Per S; Franssen, Frits M E; Agusti, Alvar; MacNee, William; Rennard, Stephen I; Tal-Singer, Ruth; Vogiatzis, Ioannis; Vestbo, Jørgen; Celli, Bartolome R; Spruit, Martijn A

    2015-09-01

    In addition to the six-min walk distance (6 MWD), other six-min walk test (6 MWT) derived variables, such as mean walk-speed (6MWSpeed), 6-min walk-work (6 MWW), distance-saturation product (DSP), exercise-induced oxygen desaturation (EID), and unintended stops may be useful for the prediction of mortality and hospitalization in patients with chronic obstructive pulmonary disease (COPD). We studied the association between 6 MWT-derived variables and mortality as well as hospitalization in COPD patients and compared it with the BODE index. A three-year prospective study (ECLIPSE) to evaluate the prognostic value of 6 MWT-derived variables in 2010 COPD patients. Cox's proportional-hazard regressions were performed to estimate 3-year mortality and hospitalization. During the follow-up, 193 subjects died and 622 were hospitalized. An adjusted Cox's regression model of hazard ratio [HR] for impaired 6 MWT-derived variables was significant referring to: mortality (6 MWD ≤334 m [2.30], 6MWSpeed ≤0.9 m/sec [2.15], 6 MWW ≤20000 m kg [2.17], DSP ≤290 m% [2.70], EID ≤88% [1.75], unintended stops [1.99]; and hospitalization (6 MWW ≤27000 m kg [1.23], EID ≤88% [1.25], BODE index ≥3 points [1.40]; all p ≤ 0.05). The 6 MWT-derived variables have an additional predictive value of mortality in patients with COPD. The 6 MWW, EID and the BODE index refine the prognosis of hospitalization.

  19. Six-minute walk test as a prognostic tool in stable coronary heart disease: data from the heart and soul study.

    PubMed

    Beatty, Alexis L; Schiller, Nelson B; Whooley, Mary A

    2012-07-23

    The prognostic value of the 6-minute walk test (6MWT) in patients with stable coronary heart disease is unknown. We sought to determine whether the 6MWT predicted cardiovascular events in ambulatory patients with coronary heart disease. We measured 6MWT distance and treadmill exercise capacity in 556 outpatients with stable coronary heart disease from September 11, 2000, through December 20, 2002. Participants were followed up for a median of 8.0 years for cardiovascular events (heart failure, myocardial infarction, and death). Cardiovascular events occurred in 218 of 556 participants (39.2%). Patients in the lowest quartile of 6MWT distance (87-419 m) had 4 times the rate of events as those in the highest quartile (544-837 m) (unadjusted hazard ratio, 4.29; 95% CI, 2.83-6.53; P < .001). Each SD decrease in 6MWT distance (104 m) was associated with a 55% higher rate of cardiovascular events (age-adjusted hazard ratio, 1.55; 95% CI, 1.35-1.78). After adjustment for traditional risk factors and cardiac disease severity measures (ejection fraction, inducible ischemia, diastolic dysfunction, amino-terminal portion of the prohormone of brain-type natriuretic peptide, and C-reactive protein), each SD decrease in 6MWT was associated with a 30% higher rate of cardiovascular events (hazard ratio, 1.30; 95% CI, 1.10-1.53). When added to traditional risk factors, the 6MWT resulted in category-free net reclassification improvement of 39% (95% CI, 19%-60%). The discriminative ability of the 6MWT was similar to that of treadmill exercise capacity for predicting cardiovascular events (C statistics both 0.72; P = .29). Distance walked on the 6MWT predicted cardiovascular events in patients with stable coronary heart disease. The addition of a simple 6MWT to traditional risk factors improved risk prediction and was comparable with treadmill exercise capacity.

  20. Oral Chinese Herbal Medicine Combined with Pharmacotherapy for Stable COPD: A Systematic Review of Effect on BODE Index and Six Minute Walk Test

    PubMed Central

    Chen, Xiankun; May, Brian; Di, Yuan Ming; Zhang, Anthony Lin; Lu, Chuanjian; Xue, Charlie Changli; Lin, Lin

    2014-01-01

    This systematic review evaluated the effects of Chinese herbal medicine (CHM) plus routine pharmacotherapy (RP) on the objective outcome measures BODE index, 6-minute walk test (6MWT), and 6-minute walk distance (6MWD) in individuals with stable chronic obstructive pulmonary disease (COPD). Searches were conducted of six English and Chinese databases (PubMed, EMBASE, CENTRAL, CINAHL, CNKI and CQVIP) from their inceptions until 18th November 2013 for randomized controlled trials involving oral administration of CHM plus RP compared to the same RP, with BODE Index and/or 6MWT/D as outcomes. Twenty-five studies were identified. BODE Index was used in nine studies and 6MWT/D was used in 22 studies. Methodological quality was assessed using the Cochrane Risk of Bias tool. Weaknesses were identified in most studies. Six studies were judged as ‘low’ risk of bias for randomisation sequence generation. Twenty-two studies involving 1,834 participants were included in the meta-analyses. The main meta-analysis results showed relative benefits for BODE Index in nine studies (mean difference [MD] −0.71, 95% confidence interval [CI] −0.94, −0.47) and 6MWT/D in 17 studies (MD 54.61 meters, 95%CI 33.30, 75.92) in favour of the CHM plus RP groups. The principal plants used were Astragalus membranaceus, Panax ginseng and Cordyceps sinensis. A. membranaceus was used in combination with other herbs in 18 formulae in 16 studies. Detailed sub-group and sensitivity analyses were conducted. Clinically meaningful benefits for BODE Index and 6MWT were found in multiple studies. These therapeutic effects were promising but need to be interpreted with caution due to variations in the CHMs and RPs used and methodological weakness in the studies. These issues should be addressed in future trials. PMID:24622390

  1. Minimal important improvement thresholds for the six-minute walk test in a knee arthroplasty cohort: triangulation of anchor- and distribution-based methods.

    PubMed

    Naylor, J M; Mills, K; Buhagiar, M; Fortunato, R; Wright, R

    2016-09-13

    The 6-minute walk test (6MWT) is a commonly used metric for measuring change in mobility after knee arthroplasty, however, what is considered an improvement after surgery has not been defined. The determination of important change in an outcome assessment tool is controversial and may require more than one approach. This study, nested within a combined randomised and observational trial, aimed to define a minimal important improvement threshold for the 6MWT in a knee arthroplasty cohort through a triangulation of methods including patient-perceived anchor-based thresholds and distribution-based thresholds. Individuals with osteoarthritis performed a 6MWT pre-arthroplasty then at 10 and 26 weeks post-surgery. Each rated their perceived improvement in mobility post-surgery on a 7-point transition scale anchored from "much better" to "much worse". Based on these responses the cohort was dichotomised into 'improved' and 'not improved'. The thresholds for patient-perceived improvements were then identified using two receiver operating curve methods producing sensitivity and specificity indices. Distribution-based change thresholds were determined using two methods utilising effect size (ES). Agreement between the anchor- and distribution-based methods was assessed using kappa. One hundred fifty-eight from 166 participants in the randomised cohort and 222 from 243 in the combined randomised and observational cohort were included at 10 and 26 weeks, respectively. The slightly or more patient-perceived improvement threshold at 26 weeks (an absolute improvement of 26 m) was the only one to demonstrate sensitivity and specificity results both better than chance. At 10- and 26-weeks, the ES based on the mean change score divided by the baseline standard deviation (SD), was an absolute change of 24.5 and 37.9 m, respectively. The threshold based on a moderate ES (a 0.5 SD of the baseline score) was a change of 55.0 and 55.4 m at 10- and 26-weeks, respectively. The level

  2. Gait and six-minute walk performance in persons with multiple sclerosis.

    PubMed

    Pilutti, Lara A; Dlugonski, Deirdre; Sandroff, Brian M; Suh, Yoojin; Pula, John H; Sosnoff, Jacob J; Motl, Robert W

    2013-11-15

    The six-minute walk (6 MW) has been established as a clinic-based, performance measure of walking endurance that reflects community ambulation in multiple sclerosis (MS). Consequently, identifying the contribution of variables to 6 MW performance may provide targets for improving real-life walking in MS, and these variables may differ as a function of disability. This study examined cadence and stride length as gait variables that explain differences in 6 MW performance between persons with MS and controls, and by level of disability. 256 community-residing persons with MS and 49 non-MS controls performed a standard 6 MW test and completed 2 trials of comfortable walking on an electronic walkway for quantifying gait. Regression analyses indicated that cadence and stride length explain differences in 6 MW performance between MS and controls, and by level of disability in MS. The contribution of cadence and stride length to walking endurance differed as a function of disability, such that cadence and to a greater extent stride length explained variance in 6 MW performance in mild MS, whereas cadence and stride length explained approximately an equivalent amount of variance in 6 MW performance in moderate-to-severe MS. We provide evidence for intervention strategies that are specific to disability level to improve walking endurance in MS.

  3. Reference equations for the six-minute walk distance based on a Brazilian multicenter study.

    PubMed

    Britto, Raquel R; Probst, Vanessa S; de Andrade, Armele F Dornelas; Samora, Giane A R; Hernandes, Nidia A; Marinho, Patrícia E M; Karsten, Marlus; Pitta, Fabio; Parreira, Veronica F

    2013-01-01

    It is important to include large sample sizes and different factors that influence the six-minute walking distance (6MWD) in order to propose reference equations for the six-minute walking test (6 MWT). To evaluate the influence of anthropometric, demographic, and physiologic variables on the 6 MWD of healthy subjects from different regions of Brazil to establish a reference equation for the Brazilian population. In a multicenter study, 617 healthy subjects performed two 6 MWTs and had their weight, height, and body mass index (BMI) measured, as well as their physiologic responses to the test. Delta heart rate (∆HR), perceived effort, and peripheral oxygen saturation were calculated by the difference between the respective values at the end of the test minus the baseline value. Walking distance averaged 586 ± 106 m, 54 m greater in male compared to female subjects (p<0.001). No differences were observed among the 6 MWD from different regions. The quadratic regression analysis considering only anthropometric and demographic data explained 46% of the variability in the 6 MWT (p<0.001) and derived the equation: 6 MWD(pred)=890.46-(6.11 × age)+(0.0345 × age(2))+(48.87 × gender)-(4.87 × BMI). A second model of stepwise multiple regression including ∆HR explained 62% of the variability (p<0.0001) and derived the equation: 6 MWD(pred)=356.658-(2.303 × age)+(36.648 × gender)+(1.704 × height)+(1.365×∆HR). The equations proposed in this study, especially the second one, seem adequate to accurately predict the 6 MWD for Brazilians.

  4. Reference equations for the six-minute walk distance based on a Brazilian multicenter study

    PubMed Central

    Britto, Raquel R.; Probst, Vanessa S.; de Andrade, Armele F. Dornelas; Samora, Giane A. R.; Hernandes, Nidia A.; Marinho, Patrícia E. M.; Karsten, Marlus; Pitta, Fabio; Parreira, Veronica F.

    2013-01-01

    Background It is important to include large sample sizes and different factors that influence the six-minute walking distance (6MWD) in order to propose reference equations for the six-minute walking test (6MWT). Objective To evaluate the influence of anthropometric, demographic, and physiologic variables on the 6MWD of healthy subjects from different regions of Brazil to establish a reference equation for the Brazilian population. Method In a multicenter study, 617 healthy subjects performed two 6MWTs and had their weight, height, and body mass index (BMI) measured, as well as their physiologic responses to the test. Delta heart rate (∆HR), perceived effort, and peripheral oxygen saturation were calculated by the difference between the respective values at the end of the test minus the baseline value. Results Walking distance averaged 586±106m, 54m greater in male compared to female subjects (p<0.001). No differences were observed among the 6MWD from different regions. The quadratic regression analysis considering only anthropometric and demographic data explained 46% of the variability in the 6MWT (p<0.001) and derived the equation: 6MWDpred=890.46-(6.11×age)+(0.0345×age2)+(48.87×gender)-(4.87×BMI). A second model of stepwise multiple regression including ∆HR explained 62% of the variability (p<0.0001) and derived the equation: 6MWDpred=356.658-(2.303×age)+(36.648×gender)+(1.704×height)+(1.365×∆HR). Conclusion The equations proposed in this study, especially the second one, seem adequate to accurately predict the 6MWD for Brazilians. PMID:24271092

  5. Test-retest reliability and minimal detectable change scores for the timed "up & go" test, the six-minute walk test, and gait speed in people with Alzheimer disease.

    PubMed

    Ries, Julie D; Echternach, John L; Nof, Leah; Gagnon Blodgett, Michelle

    2009-06-01

    With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability of outcome measures for people with this disease is necessary. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups with mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were studied. This was a prospective, nonexperimental, descriptive methodological study. Background data collected for 51 people with AD included: use of an assistive device, Mini-Mental Status Examination scores, and FAST scale scores. Each participant engaged in 2 test sessions, separated by a 30- to 60-minute rest period, which included 2 TUG trials, 1 6MWT trial, and 2 gait speed trials using a computerized gait assessment system. A specific cuing protocol was followed to achieve optimal performance during test sessions. Test-retest reliability values for the TUG, the 6MWT, and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately (intraclass correlation coefficients > or = .973); however, individual variability of performance also was high. Calculated MDC scores at the 90% confidence interval were: TUG=4.09 seconds, 6MWT=33.5 m (110 ft), and gait speed=9.4 cm/s. The 2 groups were significantly different in performance of clinical tests, with the participants who were more cognitively impaired being more physically and functionally impaired. A single researcher for data collection limited sample numbers and prohibited blinding to dementia level. The TUG, the 6MWT, and gait speed are reliable outcome measures for use with people with AD, recognizing that individual variability of performance is high. Minimal detectable change

  6. Association of waist circumference with impaired six-minute walk in type 2 diabetes mellitus is independent of cardiac function.

    PubMed

    Wang, Ying; Yang, Hong; Nolan, Mark; Negishi, Kazuaki; Burgess, John; Marwick, Thomas H

    2016-04-01

    Subclinical left ventricular dysfunction has been associated with impaired exercise capacity in type 2 diabetes mellitus. In this community-based study of 274 asymptomatic T2DM patients (71±4 years, 55% men) with preserved ejection fraction, a comprehensive resting echocardiogram was performed to gather sensitive systolic and diastolic function parameters (including speckle tracking echocardiography), and a standard six-minute walk test was performed. Tertiles of increasing waist circumference were associated with worsening walk distance. In this community-based study, we found an association of waist circumference with impaired exercise capacity, independent of age, gender, diabetes duration, insulin and angiotensin blockade, LV mass, systolic and diastolic function.

  7. Quantifying Six-Minute Walk Induced Gait Deterioration with Inertial Sensors in Multiple Sclerosis Subjects

    PubMed Central

    Dandu, Sriram Raju; Patek, Stephen D.; Lach, John C.; Goldman, Myla D.

    2016-01-01

    Background The six-minute walk (6MW) is a common walking outcome in multiple sclerosis (MS) thought to measure fatigability in addition to overall walking disability. However, direct evidence of 6MW induced gait deterioration is limited by the difficulty of measuring qualitative changes in walking. Objectives This study aims to (1) define and validate a measure of fatigue-related gait deterioration based on data from body-worn sensors; and (2) use this measure to detect gait deterioration induced by the 6MW. Methods Gait deterioration was assessed using the Warp Score, a measure of similarity between gait cycles based on dynamic time warping (DTW). Cycles from later minutes were compared to baseline cycles in 89 subjects with MS and 29 controls. Correlation, corrected (partial) correlation, and linear regression were used to quantify relationships to walking and fatigue outcomes. Results Warp Scores rose between minute 3 and minute 6 in subjects with mild and moderate disability (p < 0.001). Statistically significant correlations (p < 0.001) to the MS walking scale (MSWS-12), modified fatigue impact scale (MFIS) physical subscale, and cerebellar and pyramidal functional system scores (FSS) were observed even after controlling for walking speed. Regression of MSWS-12 scores on Warp Scores and walking speed explained 73.9% of response variance. Correlations to individual MSWS-12 and MFIS items strongly suggest a relationship to fatigability. Conclusion The Warp Score has been validated in MS subjects as an objective measure of fatigue-related gait deterioration. Progressive changes to gait cycles induced by the 6MW often appeared in later minutes, supporting the importance of sustained walking in clinical assessment. PMID:27479220

  8. Quantifying six-minute walk induced gait deterioration with inertial sensors in multiple sclerosis subjects.

    PubMed

    Engelhard, Matthew M; Dandu, Sriram Raju; Patek, Stephen D; Lach, John C; Goldman, Myla D

    2016-09-01

    The six-minute walk (6MW) is a common walking outcome in multiple sclerosis (MS) thought to measure fatigability in addition to overall walking disability. However, direct evidence of 6MW induced gait deterioration is limited by the difficulty of measuring qualitative changes in walking. This study aims to (1) define and validate a measure of fatigue-related gait deterioration based on data from body-worn sensors; and (2) use this measure to detect gait deterioration induced by the 6MW. Gait deterioration was assessed using the Warp Score, a measure of similarity between gait cycles based on dynamic time warping (DTW). Cycles from later minutes were compared to baseline cycles in 89 subjects with MS and 29 controls. Correlation, corrected (partial) correlation, and linear regression were used to quantify relationships to walking and fatigue outcomes. Warp Scores rose between minute 3 and minute 6 in subjects with mild and moderate disability (p<0.001). Statistically significant correlations (p<0.001) to the MS walking scale (MSWS-12), modified fatigue impact scale (MFIS) physical subscale, and cerebellar and pyramidal functional system scores (FSS) were observed even after controlling for walking speed. Regression of MSWS-12 scores on Warp Scores and walking speed explained 73.9% of response variance. Correlations to individual MSWS-12 and MFIS items strongly suggest a relationship to fatigability. The Warp Score has been validated in MS subjects as an objective measure of fatigue-related gait deterioration. Progressive changes to gait cycles induced by the 6MW often appeared in later minutes, supporting the importance of sustained walking in clinical assessment. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Effect of wearing a dorsiflexion assist orthosis on mobility, perceived fatigue and exertion during the six-minute walk test in people with multiple sclerosis: a randomised cross-over protocol.

    PubMed

    McLoughlin, James; Barr, Christopher; Sturnieks, Daina; Lord, Stephen; Crotty, Maria

    2012-05-25

    Fatigue in combination with gait and balance impairments can severely limit daily activities in people with multiple sclerosis (PWMS). Generalised fatigue has a major impact on walking ability, with moderately disabled PWMS experiencing difficulty in walking extended distances. Localised motor fatigue in the ankle dorsiflexors can lead to foot drop, further reducing functional ambulation. The aim of this study is to evaluate the effect of a simple dynamic dorsiflexion assist orthosis on walking-induced fatigue, gait, balance and functional mobility in PWMS. A randomised cross-over trial will be conducted with 40 community dwelling PWMS with mild to moderate mobility disability. Participants will initially be screened for disease severity, balance, strength, depression and fatigue at the South Australian Motion Analysis Centre. On two non-consecutive occasions, within two weeks, participants will undergo either the 6-minute walk test (6MWT) or the 6MWT while wearing a dorsiflexion ankle orthosis (with a randomised condition order). Distance walked, perceived exertion, perceived fatigue and the physiological cost of walking (the primary outcome measures) will be compared between the two walking conditions. Additional pre- and post-6MWT assessments for the two conditions will include tests of strength, reaction time, gait and balance. This study will increase our understanding of motor fatigue on gait and balance control in PWMS and elucidate the effect of a Dynamic Ankle Orthosis on fatigue-related balance and gait in PWMS. It will also examine relationships between mobility and balance performance with perceived fatigue levels in this group. ACTRN12612000218897.

  10. Echocardiographic Predictors for Worsening of Six-Minute Walk Distances in Patients With Systemic Sclerosis (Scleroderma).

    PubMed

    Kusunose, Kenya; Yamada, Hirotsugu; Nishio, Susumu; Hirata, Yukina; Seno, Hiromitsu; Saijo, Yoshihito; Ise, Takayuki; Tobiume, Takeshi; Yamaguchi, Koji; Yagi, Shusuke; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

    2017-07-15

    Change in 6-minute walk distance (6MWD) has been used as a clinical marker in pulmonary hypertension. Determinants and worsening of 6MWD remain a matter of debate because nonpulmonary factors have an impact on the 6MWD. We hypothesized that future reduction of 6MWD in patients with systemic sclerosis (SSc) was more closely associated with cardiac dysfunction. We prospectively performed standard clinical and echocardiographic evaluations in SSc patients with the 6-minute walk test at enrollment. Features associated with the 6MWD were sought in a multiple linear regression analysis and compared using standardized β. Worsening of the 6MWD was defined as a 15% reduction and served as the primary outcome. Eighty-one patients were included. In the multivariate analysis, baseline 6MWD was related to SSc severity score (β = -0.250, p = 0.024), left atrial volume index (β = -0.222, p = 0.046), right ventricular fractional area change (β = 0.252, p = 0.025), and the ratio of mean pulmonary artery pressure and cardiac output (β = -0.31, p = 0.002). During follow-up, 20 patients reached the primary outcome. In sequential Cox models, a model based on right ventricular fractional area change at baseline (chi-square 4.8) was improved by left atrial volume index (chi-square 10.3, p = 0.007). In conclusion, determinants and worsening of 6MWD are explained by cardiac factors. When using the 6MWD as a clinical marker in pulmonary hypertension patients, their left ventricular diastolic function and right ventricular systolic function should be taken into consideration. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Impaired Economy of Gait and Decreased Six-Minute Walk Distance in Parkinson's Disease

    PubMed Central

    Katzel, Leslie I.; Ivey, Frederick M.; Sorkin, John D.; Macko, Richard F.; Smith, Barbara; Shulman, Lisa M.

    2012-01-01

    Changes in the biomechanics of gait may alter the energy requirements of walking in Parkinson's Disease (PD). This study investigated economy of gait during submaximal treadmill walking in 79 subjects with mild to moderate PD and the relationship between gait economy and 6-minute walk distance (6 MW). Oxygen consumption (VO2) at the self-selected treadmill walking speed averaged 64% of peak oxygen consumption (VO2 peak). Submaximal VO2 levels exceeded 70% of VO2 peak in 30% of the subjects. Overall the mean submaximal VO2 was 51% higher than VO2 levels expected for the speed and grade consistent with severe impairment in economy of gait. There was an inverse relationship between economy of gait and 6MW (r = −0.31, P < 0.01) and with the self-selected walking speed (r = −0.35, P < 0.01). Thus, the impairment in economy of gait and decreased physiologic reserve result in routine walking being performed at a high percentage of VO2 peak. PMID:21922051

  12. The Utility of Preoperative Six-Minute-Walk Distance in Lung Transplantation

    PubMed Central

    Englum, Brian R.; Snyder, Laurie D.; Worni, Mathias; Osho, Asishana A.; Gulack, Brian C.; Palmer, Scott M.; Davis, R. Duane; Hartwig, Matthew G.

    2015-01-01

    Rationale: The use of 6-minute-walk distance (6MWD) as an indicator of exercise capacity to predict postoperative survival in lung transplantation has not previously been well studied. Objectives: To evaluate the association between 6MWD and postoperative survival following lung transplantation. Methods: Adult, first time, lung-only transplantations per the United Network for Organ Sharing database from May 2005 to December 2011 were analyzed. Kaplan-Meier methods and Cox proportional hazards modeling were used to determine the association between preoperative 6MWD and post-transplant survival after adjusting for potential confounders. A receiver operating characteristic curve was used to determine the 6MWD value that provided maximal separation in 1-year mortality. A subanalysis was performed to assess the association between 6MWD and post-transplant survival by disease category. Measurements and Main Results: A total of 9,526 patients were included for analysis. The median 6MWD was 787 ft (25th–75th percentiles = 450–1,082 ft). Increasing 6MWD was associated with significantly lower overall hazard of death (P < 0.001). Continuous increase in walk distance through 1,200–1,400 ft conferred an incremental survival advantage. Although 6MWD strongly correlated with survival, the impact of a single dichotomous value to predict outcomes was limited. All disease categories demonstrated significantly longer survival with increasing 6MWD (P ≤ 0.009) except pulmonary vascular disease (P = 0.74); however, the low volume in this category (n = 312; 3.3%) may limit the ability to detect an association. Conclusions: 6MWD is significantly associated with post-transplant survival and is best incorporated into transplant evaluations on a continuous basis given limited ability of a single, dichotomous value to predict outcomes. PMID:26067395

  13. The utility of preoperative six-minute-walk distance in lung transplantation.

    PubMed

    Castleberry, Anthony W; Englum, Brian R; Snyder, Laurie D; Worni, Mathias; Osho, Asishana A; Gulack, Brian C; Palmer, Scott M; Davis, R Duane; Hartwig, Matthew G

    2015-10-01

    The use of 6-minute-walk distance (6MWD) as an indicator of exercise capacity to predict postoperative survival in lung transplantation has not previously been well studied. To evaluate the association between 6MWD and postoperative survival following lung transplantation. Adult, first time, lung-only transplantations per the United Network for Organ Sharing database from May 2005 to December 2011 were analyzed. Kaplan-Meier methods and Cox proportional hazards modeling were used to determine the association between preoperative 6MWD and post-transplant survival after adjusting for potential confounders. A receiver operating characteristic curve was used to determine the 6MWD value that provided maximal separation in 1-year mortality. A subanalysis was performed to assess the association between 6MWD and post-transplant survival by disease category. A total of 9,526 patients were included for analysis. The median 6MWD was 787 ft (25th-75th percentiles = 450-1,082 ft). Increasing 6MWD was associated with significantly lower overall hazard of death (P < 0.001). Continuous increase in walk distance through 1,200-1,400 ft conferred an incremental survival advantage. Although 6MWD strongly correlated with survival, the impact of a single dichotomous value to predict outcomes was limited. All disease categories demonstrated significantly longer survival with increasing 6MWD (P ≤ 0.009) except pulmonary vascular disease (P = 0.74); however, the low volume in this category (n = 312; 3.3%) may limit the ability to detect an association. 6MWD is significantly associated with post-transplant survival and is best incorporated into transplant evaluations on a continuous basis given limited ability of a single, dichotomous value to predict outcomes.

  14. Six-Minute Walk Distance Predictors, Including CT Scan Measures, in the COPDGene Cohort

    PubMed Central

    Rambod, Mehdi; Porszasz, Janos; Make, Barry J.; Crapo, James D.

    2012-01-01

    Background: Exercise tolerance in COPD is only moderately well predicted by airflow obstruction assessed by FEV1. We determined whether other phenotypic characteristics, including CT scan measures, are independent predictors of 6-min walk distance (6MWD) in the COPDGene cohort. Methods: COPDGene recruits non-Hispanic Caucasian and African American current and ex-smokers. Phenotyping measures include postbronchodilator FEV1 % predicted and inspiratory and expiratory CT lung scans. We defined % emphysema as the percentage of lung voxels < −950 Hounsfield units on the inspiratory scan and % gas trapping as the percentage of lung voxels < −856 Hounsfield units on the expiratory scan. Results: Data of the first 2,500 participants of the COPDGene cohort were analyzed. Participant age was 61 ± 9 years; 51% were men; 76% were non-Hispanic Caucasians, and 24% were African Americans. Fifty-six percent had spirometrically defined COPD, with 9.3%, 23.4%, 15.0%, and 8.3% in GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I to IV, respectively. Higher % emphysema and % gas trapping predicted lower 6MWD (P < .001). However, in a given spirometric group, after adjustment for age, sex, race, and BMI, neither % emphysema nor % gas trapping, or their interactions with FEV1 % predicted, remained a significant 6MWD predictor. In a given spirometric group, only 16% to 27% of the variance in 6MWD could be explained by age, male sex, Caucasian race, and lower BMI as significant predictors of higher 6MWD. Conclusions: In this large cohort of smokers in a given spirometric stage, phenotypic characteristics were only modestly predictive of 6MWD. CT scan measures of emphysema and gas trapping were not predictive of 6MWD after adjustment for other phenotypic characteristics. PMID:21960696

  15. The asthma six-minute provocation test and mountain climbing in children.

    PubMed

    Wekesa, M; Langhof, H; Sack, P

    1994-01-01

    We investigated the intensity of exercise in the asthma six-minute provocation test (ASMT) for asthmatic patients and mountain climbing. Six asthmatic boys with mean age 11.7 +/- 2.1 years and mean weight 44.5 +/- 13.2 kg participated in this study. HR, FEV1 and RR values were recorded. In both forms of exercise, the participants achieved intensities of over 160 beats/min. EIA was diagnosed in five of them after the SSMT. There was not much variability in the PEFR values observed during mountain climbing. The rise in systolic pressure was within normal. The echocardiogram (ECG) was not pathologic. Further investigations are required to establish the suitability of mountain climbing as an appropriate form of sport for asthmatics.

  16. Validity of the six-minute step test of free cadence in patients with chronic obstructive pulmonary disease

    PubMed Central

    Pessoa, Bruna V.; Arcuri, Juliano F.; Labadessa, Ivana G.; Costa, Joyce N. F.; Sentanin, Anna C.; Di Lorenzo, Valéria A. Pires

    2014-01-01

    Objectives: to evaluate the concurrent validity of the six-minute step test (6MST) in assessing exercise capacity of COPD patients using the six-minute walk test (6MWT) as a gold-standard. The predictive validity of the 6MST was assessed to determine a cut-off point for identification of low exercise capacity. Method: thirty-two COPD patients (50-87 years old) with mild to very severe obstruction performed the 6MST and 6MWT twice. Results: Concurrent validity: a strong positive correlation (Pearson) between the number of ascents on the first (T1), second (T2) and the best of both (T1 or T2) tests during the 6MWT was observed. Although a moderate negative correlation with BODE index and FEV1 was found, it was considered insufficient to test the validity, therefore ROC curves were not applied. The predictive validity (ROC) of the 6MST to identify low physical capacity (compared with the 6MWT) using the performance of T1 or T2, or solely T1 was considered accurate, and the area under the curve was 0.8 (IC95% 0.62-0.98) and 0.85 (IC95% 0.70-0.99), respectively. To classify patients, the cut-off points of 86 and 78 steps were chosen, with both values showing 90% of sensitivity and specificity of 64% and 68% for T1 or T2, or solely T1, respectively. Conclusion: The number of steps on the 6MST was valid to verify exercise capacity in COPD patients and the cut-off point of 78 steps was able to identify patients with poor exercise tolerance. Values under this cut-off point are considered to identify patients with a poorer prognosis. PMID:25003275

  17. Relationship between sarcopenia, six-minute walk distance and health-related quality of life in liver transplant candidates.

    PubMed

    Yadav, Anitha; Chang, Yu-Hui; Carpenter, Sarah; Silva, Alvin C; Rakela, Jorge; Aqel, Bashar A; Byrne, Thomas J; Douglas, David D; Vargas, Hugo E; Carey, Elizabeth J

    2015-02-01

    Sarcopenia, or loss of skeletal muscle mass, is associated with increased mortality and morbidity in liver transplant (LT) candidates. Six-minute walk distance (6MWD) and health-related quality of life (HRQOL) as assessed by short form 36 scores (SF-36) also impact clinical outcomes in these patients. This study explored the relationship between the sarcopenia, 6MWD, and HRQOL in LT candidates. Sarcopenia was evaluated based on skeletal muscle mass index (SMI) quantified from abdominal computed tomography. Patients were followed until death, removal from the wait list or the end of the study period. Two hundred and thirteen patients listed for LT were included. The mean SMI, 6MWD and mean gait speed were 54.3 ± 9.7, 370.5 m and 1 m/s, respectively. Sarcopenia was noted in 22.2% of LT candidates. There was no correlation between sarcopenia, 6MWD, and SF-36 scores. The 6MWD, but not sarcopenia, was an independent predictor of mortality (hazard ratio = 2.1 [0.9-4.7]). In summary, sarcopenia did not emerge as a significant predictor of waitlist mortality and also failed to correlate with either functional capacity or HRQOL in LT candidates. In patients with ESLD awaiting LT, 6MWD appears to be a more useful prognostic indicator than the presence of sarcopenia.

  18. Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients

    PubMed Central

    Grosbois, JM; Riquier, C; Chehere, B; Coquart, J; Béhal, H; Bart, F; Wallaert, B; Chenivesse, C

    2016-01-01

    Introduction Exercise tolerance testing is an integral part of the pulmonary rehabilitation (PR) management of patients with chronic obstructive pulmonary disease (COPD). The 6-minute stepper test (6MST) is a new, well-tolerated, reproducible exercise test, which can be performed without any spatial constraints. Objective The aim of this study was to compare the results of the 6MST to those obtained during a 6-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET) in a cohort of COPD patients. Methods Ninety-one COPD patients managed by outpatient PR and assessed by 6MST, 6MWT, and CPET were retrospectively included in this study. Correlations between the number of steps on the 6MST, the distance covered on the 6MWT, oxygen consumption, and power at the ventilatory threshold and at maximum effort during CPET were analyzed before starting PR, and the improvement on the 6MST and 6MWT was compared after PR. Results The number of steps on the 6MST was significantly correlated with the distance covered on the 6MWT (r=0.56; P<0.0001), the power at maximum effort (r=0.46; P<0.0001), and oxygen consumption at maximum effort (r=0.39; P<0.005). Performances on the 6MST and 6MWT were significantly improved after PR (570 vs 488 steps, P=0.001 and 448 vs 406 m, respectively; P<0.0001). Improvements of the 6MST and 6MWT after PR were significantly correlated (r=0.34; P=0.03). Conclusion The results of this study show that the 6MST is a valid test to evaluate exercise tolerance in COPD patients. The use of this test in clinical practice appears to be particularly relevant for the assessment of patients managed by home PR. PMID:27099483

  19. Six-minute walk distance is an independent predictor of hospital readmission in patients with chronic heart failure.

    PubMed

    Tabata, Minoru; Shimizu, Ryosuke; Kamekawa, Daisuke; Kato, Michitaka; Kamiya, Kentaro; Akiyama, Ayako; Kamada, Yumi; Tanaka, Shinya; Noda, Chiharu; Masuda, Takashi

    2014-01-01

    Patients with chronic heart failure (CHF) are frequently readmitted to the hospital due to disease progression. Although a shorter 6-minute walk distance (6MWD) is correlated with poor prognosis, 6MWD is not considered a clinical indicator for predicting hospital readmission.We investigated whether 6MWD measured at the time of hospital discharge predicted readmission due to heart failure in CHF patients.Patients admitted to the hospital for the first time due to heart failure were enrolled. After 6MWD was measured at discharge, patients were followed-up for 3 years. Clinical characteristics, 6MWD and readmission due to heart failure were evaluated in 252 patients (68.5 ± 11.8 years old, 162 males). Significant factors that affected readmission were extracted and cut-off values were determined using multivariate logistic regression analysis and receiver operating characteristic curves.Of 252 CHF patients, 103 were readmitted within 3 years. 6MWD at the time of discharge was significantly shorter in readmitted patients than non-readmitted patients (P < 0.001) and was a significant predictor of readmission (P < 0.001). The odds ratio for readmission was 1.22 (P < 0.001) with each 10-meter decrease in 6MWD. The 6MWD cut-off value was determined to be 390 meters, with a sensitivity of 0.75 and a specificity of 0.77.6MWD measured at the time of discharge is an independent predictor of hospital readmission in CHF patients, with a cut-off value of 390 meters.

  20. Six-Minute-Walk Distance and Accelerometry Predict Outcomes in Chronic Obstructive Pulmonary Disease Independent of Global Initiative for Chronic Obstructive Lung Disease 2011 Group

    PubMed Central

    Smith, Patrick J.; Babyak, Michael A.; Mabe, Stephanie K.; Martinu, Tereza; Welty-Wolf, Karen E.; Emery, Charles F.; Palmer, Scott M.; Blumenthal, James A.

    2015-01-01

    Rationale: The 2011 combined Global Initiative for Chronic Obstructive Lung Disease (GOLD) assessment incorporates symptoms, exacerbation history, and spirometry in discriminating risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Six-minute-walk distance (6MWD) and accelerometry also have been used to assess disease severity in COPD. The association between these measures and the risks of hospitalization and mortality in the context of GOLD 2011 is unknown. Objectives: To describe changes in exercise tolerance and physical activity over time in patients with COPD and to test the hypothesis that lower baseline 6MWD or accelerometry step count is associated with increased risk of COPD-related hospitalization or all-cause mortality, independent of GOLD 2011 group. Methods: Physical function and medical outcomes were prospectively assessed in 326 patients with moderate to severe COPD in INSPIRE-II, a randomized controlled trial of a coping skills training intervention. Cox models were used to determine if GOLD 2011 group, 6MWD, or accelerometry steps were associated with risk of COPD-related hospitalization or all-cause mortality. Measurements and Main Results: Physical function declined over time in GOLD group D but remained stable in groups A, B, and C. GOLD classification was associated with time to death or first COPD-related hospitalization. Baseline 6MWD was more strongly associated with time to death or first COPD-related hospitalization (hazard ratio, 0.50 [95% confidence interval, 0.34, 0.73] per 150 m, P = 0.0003) than GOLD 2011 classification. A similar relationship was observed for accelerometry steps (hazard ratio, 0.80 [95% confidence interval, 0.70, 0.92] per 1,000 steps, P = 0.002). Conclusions: Exercise tolerance and daily physical activity are important predictors of hospitalization and mortality in COPD, independent of GOLD 2011 classification. Physical function may represent a modifiable risk factor that

  1. Six-minute Stepper Test to Set Pulmonary Rehabilitation Intensity in Patients with COPD - A Retrospective Study.

    PubMed

    Bonnevie, Tristan; Gravier, Francis-Edouard; Leboullenger, Marie; Médrinal, Clément; Viacroze, Catherine; Cuvelier, Antoine; Muir, Jean-François; Tardif, Catherine; Debeaumont, David

    2017-04-07

    Pulmonary rehabilitation (PR) improves outcomes in patients with chronic obstructive pulmonary disease (COPD). Optimal assessment includes cardiopulmonary exercise testing (CPET), but consultations are limited. Field tests could be used to individualize PR instead of CPET. The six-minute stepper test (6MST) is easy to set up and its sensitivity and reproducibility have previously been reported in patients with COPD. The aim of this study was to develop a prediction equation to set intensity in patients attending PR, based on the 6MST. The following relationships were analyzed: mean heart rate (HR) during the first (HR1-3) and last (HR4-6) 3 minutes of the 6MST and HR at the ventilatory threshold (HRvt) from CPET; step count at the end of the 6MST and workload at the Ventilatory threshold (VT) (Wvt); and forced expiratory volume in 1 second and step count during the 6MST. This retrospective study included patients with COPD referred for PR who underwent CPET, pulmonary function evaluations and the 6MST. Twenty-four patients were included. Prediction equations were HRvt = 0.7887 × HR1-3 + 20.83 and HRvt = 0.6180 × HR4-6 + 30.77. There was a strong correlation between HR1-3 and HR4-6 and HRvt (r = 0.69, p < 0.001 and r = 0.57, p < 0.01 respectively). A significant correlation was also found between step count and LogWvt (r = 0.63, p < 0.01). The prediction equation was LogWvt = 0.001722 × step count + 1.248. The 6MST could be used to individualize aerobic training in patients with COPD. Further prospective studies are needed to confirm these results.

  2. Can a Six-Minute Walk Distance Predict Right Ventricular Dysfunction in Patients with Diffuse Parenchymal Lung Disease and Pulmonary Hypertension?

    PubMed

    Ussavarungsi, Kamonpun; Lee, Augustine S; Burger, Charles D

    2016-09-01

    Pulmonary hypertension (PH) is commonly observed in patients with diffuse parenchymal lung disease (DPLD). The purpose of this study was to explore the influence of the 6-minute walk test (6MWT) as a simple, non-invasive tool to assess right ventricular (RV) function in patients with DPLD and to identify the need for an echocardiogram (ECHO) to screen for PH. We retrospectively reviewed 48 patients with PH secondary to DPLD, who were evaluated in the PH clinic at the Mayo Clinic in Jacksonville, Florida, from January 1999 to December 2014. Fifty-two percent of patients had RV dysfunction. They had a significantly greater right heart pressure by ECHO and mean pulmonary arterial pressure (MPAP) from right heart catheterization (RHC) than those with normal RV function. A reduced 6-minute walk distance (6MWD) did not predict RV dysfunction (OR 0.995; 95% CI 0.980-1.001, p = 0.138). In addition, worsening restrictive physiology, heart rate at one-minute recovery and desaturation were not different between patients with and without RV dysfunction. However, there were inverse correlations between 6MWD and MPAP from RHC (r = -0.41, 
p = 0.010), 6MWD and RV systolic pressure (r = -0.51, p < 0.001), and 6MWD and MPAP measured by ECHO (r = -0.46, p =0.013). We also found no significant correlation between 6MWD and pulmonary function test parameters. Our single-center cohort of patients with PH secondary to DPLD, PH was found to have an impact on 6MWD. In contrast to our expectations, 6MWD was not useful to predict RV dysfunction. Interestingly, a severe reduction in the 6MWD was related to PH and not to pulmonary function; therefore, it may be used to justify an ECHO to identify patients with a worse prognosis.

  3. Accelerating Ground-Test Cycle Time: The Six-Minute Model Change and Other Visions for the 21st Century

    NASA Technical Reports Server (NTRS)

    Kegelman, Jerome T.

    1998-01-01

    The advantage of managing organizations to minimize product development cycle time has been well established. This paper provides an overview of the wind tunnel testing cycle time reduction activities at Langley Research Center (LaRC) and gives the status of several improvements in the wind tunnel productivity and cost reductions that have resulted from these activities. Processes have been examined and optimized. Metric data from monitoring processes provides guidance for investments in advanced technologies. The most promising technologies under implementation today include the use of formally designed experiments, a diverse array of quick disconnect technology and the judicious use of advanced electronic and information technologies.

  4. Six-minute walking distance improvement after pulmonary rehabilitation is associated with baseline lung function in complex COPD patients: a retrospective study.

    PubMed

    Zanini, Andrea; Chetta, Alfredo; Gumiero, Federico; Della Patrona, Sabrina; Casale, Silvia; Zampogna, Elisabetta; Aiello, Marina; Spanevello, Antonio

    2013-01-01

    Conflicting results have been so far reported about baseline lung function, as predicting factor of pulmonary rehabilitation (PR) efficacy. To ascertain whether or not baseline lung function could predict a benefit in terms of a significant change in 6-min walk test (6 MWT) after PR. Seventy-five stable moderate-to-severe COPD inpatients with comorbidities (complex COPD), allocated to a three-week PR program, were retrospectively evaluated. Pulmonary function, 6 MWT, dyspnea (BDI/TDI), and quality of life (EQ-VAS) were assessed before and after PR program. The patients were divided into two groups depending on the change in 6 MWT (responders > 30 m and nonresponders ≤ 30 m). Logistic regression analysis was used. Results. After PR, 6 MWT performance all outcome measures significantly improved (P < 0.01). Compared to nonresponders (N = 38), the responders (N = 37) had lower values in baseline lung function (P < 0.01). Logistic regression analysis showed that FEV1 < 50% pred and TL, CO < 50% pred were independent predictors of PR efficacy. Our study shows that in stable moderate-to-severe complex COPD inpatients, baseline lung function may predict the response to PR in terms of 6 MWT. We also found that complex COPD patients with poor lung function get more benefit from PR.

  5. Prediction of Cardiorespiratory Fitness in Older Men Infected with the Human Immunodeficiency Virus: Clinical Factors and Value of the Six-Minute Walk Distance

    PubMed Central

    Oursler, Krisann K.; Katzel, Leslie I.; Smith, Barbara A.; Scott, Wayne B.; Russ, David W.; Sorkin, John D.

    2010-01-01

    OBJECTIVES To investigate factors related to cardiorespiratory fitness in older human immunodeficiency virus (HIV)-infected patients and to explore the utility of 6-minute walk distance (6-MWD) in measuring fitness. DESIGN Cross-sectional study in clinic-based cohort. SETTING Veterans Affairs Medical Center, Baltimore, Maryland. PARTICIPANTS Forty-three HIV-infected men, median age 57 (range 50–82), without recent acquired immunodeficiency syndrome–related illness and receiving antiretroviral (ARV) therapy. MEASUREMENTS Peak oxygen utilization (VO2peak) according to treadmill graded exercise testing, 6-MWD, grip strength, quadriceps maximum voluntary isometric contraction, cross-sectional area, muscle quality, and muscle adiposity. RESULTS There was a moderate correlation between VO2peak (mean ± SD; 18.4 ± 5.6 mL/kg per minute) and 6-MWD (514 ± 91 m) (r = 0.60, P<.001). VO2peak was lower in subjects with hypertension (16%, P<.01) and moderate anemia (hemoglobin 10–13 gm/dL; 15%, P = .09) than in subjects without these conditions. CD4 cell count (median 356 cells/mL, range 20–1,401) and HIV-1 viral load (84% nondetectable) were not related to VO2peak. Among muscle parameters, only grip strength was an independent predictor of VO2peak. Estimation of VO2peak using linear regression, including age, 6-MWD, grip strength, and hypertension as independent variables, explained 61% of the variance in VO2peak. CONCLUSION Non-AIDS-related comorbidity predicts cardiorespiratory fitness in older HIV-infected men receiving ARV therapy. The 6-MWD is a valuable measure of fitness in this patient population, but a larger study with diverse subjects is needed. PMID:19793156

  6. Effect of encouragement on walking test performance.

    PubMed Central

    Guyatt, G H; Pugsley, S O; Sullivan, M J; Thompson, P J; Berman, L; Jones, N L; Fallen, E L; Taylor, D W

    1984-01-01

    Walking tests, frequently used to document effects of treatment on exercise capacity, have never been standardised. We studied the effects of encouragement on walking test performance in a randomised study that controlled for the nature of the underlying disease, time of day, and order effects. We randomised 43 patients with chronic airflow limitation or chronic heart failure or both to receive or not receive encouragement as they performed serial two and six minute walks every fortnight for 10 weeks. Simple encouragement improved performance (p less than 0.02 for the six minute walk), and the magnitude of the effect was similar to that reported for patients in studies purporting to show beneficial effects of therapeutic manoeuvres. Age and test repetition also affected performance. These results demonstrate the need for careful standardisation of the performance of walking tests, and suggest caution in interpreting studies in which standardisation is not a major feature of the study design. PMID:6505988

  7. Prediction of Cardiorespiratory Fitness by the Six-Minute Step Test and Its Association with Muscle Strength and Power in Sedentary Obese and Lean Young Women: A Cross-Sectional Study

    PubMed Central

    Bonjorno Junior, José Carlos; de Oliveira, Cláudio Ricardo; Luporini, Rafael Luís; Mendes, Renata Gonçalves; Zangrando, Katiany Thais Lopes; Trimer, Renata; Arena, Ross

    2015-01-01

    Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO2peak) prediction from the six-minute step test (6MST) has not been established for sedentary females. It is recognized that lower-limb muscle strength and power play a key role during functional activities. The aim of this study was to investigate cardiorespiratory responses during the 6MST and CPX and to develop a predictive equation to estimate VO2peak in both lean and obese subjects. Additionally we aim to investigate how muscle function impacts functional performance. Lean (LN = 13) and obese (OB = 18) women, aged 20–45, underwent a CPX, two 6MSTs, and isokinetic and isometric knee extensor strength and power evaluations. Regression analysis assessed the ability to predict VO2peak from the 6MST, age and body mass index (BMI). CPX and 6MST main outcomes were compared between LN and OB and correlated with strength and power variables. CRF, functional capacity, and muscle strength and power were lower in the OB compared to LN (<0.05). During the 6MST, LN and OB reached ~90% of predicted maximal heart rate and ~80% of the VO2peak obtained during CPX. BMI, age and number of step cycles (NSC) explained 83% of the total variance in VO2peak. Moderate to strong correlations between VO2peak at CPX and VO2peak at 6MST (r = 0.86), VO2peak at CPX and NSC (r = 0.80), as well as between VO2peak, NSC and muscle strength and power variables were found (p<0.05). These findings indicate the 6MST, BMI and age accurately predict VO2peak in both lean and obese young sedentary women. Muscle strength and power were related to measures of aerobic and functional performance. PMID:26717568

  8. Prediction of Cardiorespiratory Fitness by the Six-Minute Step Test and Its Association with Muscle Strength and Power in Sedentary Obese and Lean Young Women: A Cross-Sectional Study.

    PubMed

    Carvalho, Lívia Pinheiro; Di Thommazo-Luporini, Luciana; Aubertin-Leheudre, Mylène; Bonjorno Junior, José Carlos; de Oliveira, Cláudio Ricardo; Luporini, Rafael Luís; Mendes, Renata Gonçalves; Zangrando, Katiany Thais Lopes; Trimer, Renata; Arena, Ross; Borghi-Silva, Audrey

    2015-01-01

    Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO2peak) prediction from the six-minute step test (6MST) has not been established for sedentary females. It is recognized that lower-limb muscle strength and power play a key role during functional activities. The aim of this study was to investigate cardiorespiratory responses during the 6MST and CPX and to develop a predictive equation to estimate VO2peak in both lean and obese subjects. Additionally we aim to investigate how muscle function impacts functional performance. Lean (LN = 13) and obese (OB = 18) women, aged 20-45, underwent a CPX, two 6MSTs, and isokinetic and isometric knee extensor strength and power evaluations. Regression analysis assessed the ability to predict VO2peak from the 6MST, age and body mass index (BMI). CPX and 6MST main outcomes were compared between LN and OB and correlated with strength and power variables. CRF, functional capacity, and muscle strength and power were lower in the OB compared to LN (<0.05). During the 6MST, LN and OB reached ~90% of predicted maximal heart rate and ~80% of the VO2peak obtained during CPX. BMI, age and number of step cycles (NSC) explained 83% of the total variance in VO2peak. Moderate to strong correlations between VO2peak at CPX and VO2peak at 6MST (r = 0.86), VO2peak at CPX and NSC (r = 0.80), as well as between VO2peak, NSC and muscle strength and power variables were found (p<0.05). These findings indicate the 6MST, BMI and age accurately predict VO2peak in both lean and obese young sedentary women. Muscle strength and power were related to measures of aerobic and functional performance.

  9. Controlled Study of Correlation of Biomechanical Profile of Hemiparetic Patients with Distance Travelled in Six Minutes.

    PubMed

    Moura, Laís Moreira; Quintão, Mônica Maria Pena; de Carvalho, Karen Santos R; Carrapatoso, Beatriz Cantanhede; Malfacini, Sabrina Lindenberg L; da Silva, André Custódio; Orsini, Marco; Nascimento, Osvaldo J M; Chermont, Sergio S M C

    2015-09-24

    The six-minute walking test (6MWT) is used to assess exercise tolerance that is associated with motor function of the lower limbs in hemiparetic patients. It is suggested that, for post-stroke subjects, performance in the 6MWT may be limited by biomechanical and cardiovascular factors. Our aim is to determine the correlation between the six-minute walk distance (6MWD) and the biomechanical profile of hemiparetic patients. During this cross-sectional controlled study, 10 hemiparetic patients with heart failure underwent 6MWT (ATS protocol). Tonus (Ashworth Scale) and goniometry of the lower limbs were measured. The average of 6MWD in two tests was 279±8 m. There was a negative correlation between the degree of spasticity for both the sural triceps (r=-0.57, P<0.05), quadriceps (r=-0.58, P<0.05) and the limitation in ankle dorsiflexion and the 6MWD (r=-0.76, P<0.05). Also, there was correlation between hip extension and ankle dorsiflexion limitations with 6MWD (r=0.66, P<0.05), (r=0.77, P<0.05). The negative correlation between the highest spasticity in paretic limb and the 6MWD and the correlation between the lower movement range of paretic hip and ankle suggest association with these factors and gait velocity in 6MWT. Loss percentage represents the percentage calculation between distance traveled and the distance predicted achieved by patients. In this study, the negative correlation between the percentage of loss of 6MWD and the limitation in the ankle dorsiflexion movement suggests that for a minor motion arch of the ankle, there is a higher percentage of walking distance loss foretold.

  10. Controlled Study of Correlation of Biomechanical Profile of Hemiparetic Patients with Distance Travelled in Six Minutes

    PubMed Central

    Moura, Laís Moreira; Quintão, Mônica Maria Pena; de Carvalho, Karen Santos R.; Carrapatoso, Beatriz Cantanhede; Malfacini, Sabrina Lindenberg L.; da Silva, André Custódio; Orsini, Marco; Nascimento, Osvaldo J.M.; Chermont, Sergio S.M.C.

    2015-01-01

    The six-minute walking test (6MWT) is used to assess exercise tolerance that is associated with motor function of the lower limbs in hemiparetic patients. It is suggested that, for post-stroke subjects, performance in the 6MWT may be limited by biomechanical and cardiovascular factors. Our aim is to determine the correlation between the six-minute walk distance (6MWD) and the biomechanical profile of hemiparetic patients. During this cross-sectional controlled study, 10 hemiparetic patients with heart failure underwent 6MWT (ATS protocol). Tonus (Ashworth Scale) and goniometry of the lower limbs were measured. The average of 6MWD in two tests was 279±8 m. There was a negative correlation between the degree of spasticity for both the sural triceps (r=–0.57, P<0.05), quadriceps (r=–0.58, P<0.05) and the limitation in ankle dorsiflexion and the 6MWD (r=–0.76, P<0.05). Also, there was correlation between hip extension and ankle dorsiflexion limitations with 6MWD (r=0.66, P<0.05), (r=0.77, P<0.05). The negative correlation between the highest spasticity in paretic limb and the 6MWD and the correlation between the lower movement range of paretic hip and ankle suggest association with these factors and gait velocity in 6MWT. Loss percentage represents the percentage calculation between distance traveled and the distance predicted achieved by patients. In this study, the negative correlation between the percentage of loss of 6MWD and the limitation in the ankle dorsiflexion movement suggests that for a minor motion arch of the ankle, there is a higher percentage of walking distance loss foretold. PMID:26487924

  11. Feasibility and Reliability of Two Different Walking Tests in People with Severe Intellectual and Sensory Disabilities

    ERIC Educational Resources Information Center

    Waninge, A.; Evenhuis, I. J.; van Wijck, R.; van der Schans, C. P.

    2011-01-01

    Background: The purpose of this study is to describe feasibility and test-retest reliability of the six-minute walking distance test (6MWD) and an adapted shuttle run test (aSRT) in persons with severe intellectual and sensory (multiple) disabilities. Materials and Methods: Forty-seven persons with severe multiple disabilities, with Gross Motor…

  12. Feasibility and Reliability of Two Different Walking Tests in People with Severe Intellectual and Sensory Disabilities

    ERIC Educational Resources Information Center

    Waninge, A.; Evenhuis, I. J.; van Wijck, R.; van der Schans, C. P.

    2011-01-01

    Background: The purpose of this study is to describe feasibility and test-retest reliability of the six-minute walking distance test (6MWD) and an adapted shuttle run test (aSRT) in persons with severe intellectual and sensory (multiple) disabilities. Materials and Methods: Forty-seven persons with severe multiple disabilities, with Gross Motor…

  13. Walking tests during the exercise training: specific use for the cardiac rehabilitation.

    PubMed

    Casillas, J-M; Hannequin, A; Besson, D; Benaïm, S; Krawcow, C; Laurent, Y; Gremeaux, V

    2013-10-01

    Walk tests, principally the six-minute walk test (6mWT), constitute a safe, useful submaximal tool for exercise tolerance testing in cardiac rehabilitation (CR). The 6mWT result reflects functional status, walking autonomy and efficacy of CR on walking endurance, which is more pronounced in patients with low functional capacity (heart failure - cardiac surgery). The 6mWT result is a strong predictor of mortality. However, clinically significant changes and reliability are still subject to debate - probably because of the ambiguity in terms of the target speed (either comfortable or brisk walking). Of the other time-based walk tests, the 2-minute-walk test is the only one applicable during CR, reserved for patients with severe disabilities by its psychometric properties. Fixed-distance tests (principally the 200m fast walk test) and incremental shuttle walking, tests explore higher levels of effort and may represent a safe and inexpensive alternative to laboratory-based tests during CR. These walking tests may be useful for personalizing prescription of training programs. However, the minimum clinically significant difference has not yet been determined. Lastly, walking tests appear to be potential useful tools in promoting physical activity and behavioural changes at home. Thus, validation of other walk tests with better psychometric properties will be necessary.

  14. [Reproducibility of the walking test in patients with cystic fibrosis].

    PubMed

    Jorquera Guillén, M A; Salcedo Posadas, A; Villa Asensi, J R; Girón Moreno, R M; Neira Rodríguez, M A; Sequeiros González, A

    1999-11-01

    The walking test is a useful and objective method for evaluating the tolerance for exercise in patients with chronic bronchopulmonary diseases. Our objective was to check the reproducibility of this test and evaluate whether there are differences between tests of varying duration (2 and 6 minutes) in a group of patients with cystic fibrosis. We utilized the walking test on 29 patients who were in a stable phase and under care in the Cystic Fibrosis Unit of our hospital. Two tests were carried out, one of 2 minutes and the other of 6 minutes duration, both of which were repeated after a 15-minute interval. The reproducibility of the walking test in this type of patient was very good and we found an excellent correlation between the two-minute test and the six-minute test. We did not observe a training effect when the test was repeated. The two minute walking test has a high reproducibility and we propose this test, because it is shorter and more comfortable for pediatric patients with cystic fibrosis, in order to evaluate the evolution, progressive deterioration of the of the patient and the response to different types of treatments.

  15. Walk test and school performance in mouth-breathing children.

    PubMed

    Boas, Ana Paula Dias Vilas; Marson, Fernando Augusto de Lima; Ribeiro, Maria Angela Gonçalves de Oliveira; Sakano, Eulália; Conti, Patricia Blau Margosian; Toro, Adyléia Dalbo Contrera; Ribeiro, José Dirceu

    2013-01-01

    In recent decades, many studies on mouth breathing (MB) have been published; however, little is known about many aspects of this syndrome, including severity, impact on physical and academic performances. Compare the physical performance in a six minutes walk test (6MWT) and the academic performance of MB and nasal-breathing (NB) children and adolescents. This is a descriptive, cross-sectional, and prospective study with MB and NB children submitted to the 6MWT and scholar performance assessment. We included 156 children, 87 girls (60 NB and 27 MB) and 69 boys (44 NB and 25 MB). Variables were analyzed during the 6MWT: heart rate (HR), respiratory rate, oxygen saturation, distance walked in six minutes and modified Borg scale. All the variables studied were statistically different between groups NB and MB, with the exception of school performance and HR in 6MWT. MB affects physical performance and not the academic performance, we noticed a changed pattern in the 6MWT in the MB group. Since the MBs in our study were classified as non-severe, other studies comparing the academic performance variables and 6MWT are needed to better understand the process of physical and academic performances in MB children.

  16. Foot Progression Angle Walking Test

    PubMed Central

    Ranawat, Anil S.; Gaudiani, Michael A.; Slullitel, Pablo A.; Satalich, James; Rebolledo, Brian J.

    2017-01-01

    Background: Determining an accurate clinical diagnosis for nonarthritic hip pain may be challenging, as symptoms related to femoroacetabular impingement (FAI) or hip instability can be difficult to elucidate with current testing methods. In addition, commonly utilized physical examination maneuvers are static and do not include a dynamic or weightbearing assessment to reproduce activity-related symptoms. Therefore, implementing a dynamic assessment for FAI and hip instability could help to improve diagnostic accuracy for routine clinical examinations of patients with nonarthritic hip pain. Purpose: To assess the efficacy of a novel diagnostic foot progression angle walking (FPAW) test for identifying hip pathology related to FAI or hip instability. Study Design: Prospective cohort study; Level of evidence, 3. Methods: This prospective study included 199 consecutive patients who were evaluated for unilateral hip pain and who underwent FPAW testing along with standard physical examination testing. Demographic data, including age, sex and hip laterality, were collected from each patient. FPAW testing was performed with directed internal and external foot progression angles from their baseline measurements, with a positive test reproducing pain and/or discomfort. Comparisons were then made with flexion adduction internal rotation (FADIR) and flexion abduction external rotation (FABER) tests as the designated diagnostic standard examinations for FAI and hip instability, respectively. Sensitivity and specificity, along with the McNemar chi-square test for group comparison, were used to generate summary statistics. In addition, areas under the combined receiver operating characteristic curves (AUC) of test performance were calculated for both FPAW and the designated standard examination tests (FADIR, FABER). Radiographic imaging was used subsequently to confirm the diagnosis. Results: The average age of the study cohort was 35.4 ± 11.8 years, with 114 patients being

  17. Idiopathic Toe Walking: Tests and Family Predisposition.

    PubMed

    Pomarino, David; Ramírez Llamas, Juliana; Pomarino, Andrea

    2016-08-01

    The aim of this study is to provide clinical examination methods that were designed specifically to assess the level of severity among children with idiopathic toe walking (ITW). The idiopathic toe-walking pattern of 836 children was recorded and analyzed during 4 years. Questionnaires and clinical measurements were evaluated, along with differential tests, assessing the occurrence and severity of toe walking. Questions about family history and onset of toe walking were evaluated along with special tests and measurements assessing the occurrence and severity of toe walking. The different measurements apply during this study, ankle dorsiflexion, lumbar lordosis angle, as well as the clinical spin test, walking after spin test, and heel walking test revealed in all cases that children with a positive family predisposition were significantly more affected than children with negative family predisposition. It is concluded that children with ITW and a positive family predisposition were more intensively affected during all performed clinical tests than children with no family predisposition. The tests used during this study have not being used by any other researches, even though they showed significant differences between the children with ITW and children with a normal gait pattern. Diagnostic, Level II: development of diagnostic test with consecutive patients and control patients. © 2016 The Author(s).

  18. How to Summarize a 6,000-Word Paper in a Six-Minute Video Clip

    PubMed Central

    Vachon, Patrick; Daudelin, Genevieve; Hivon, Myriam

    2013-01-01

    As part of our research team's knowledge transfer and exchange (KTE) efforts, we created a six-minute video clip that summarizes, in plain language, a scientific paper that describes why and how three teams of academic entrepreneurs developed new health technologies. Recognizing that video-based KTE strategies can be a valuable tool for health services and policy researchers, this paper explains the constraints and sources of inspiration that shaped our video production process. Aiming to provide practical guidance, we describe the steps and tools that we used to identify, refine and package the key content of the scientific paper into an original video format. PMID:23968634

  19. Is one trial enough for repeated testing? Same-day assessments of walking, mobility and fine hand use in people with myotonic dystrophy type 1.

    PubMed

    Kierkegaard, Marie; Petitclerc, Emilie; Hébert, Luc J; Gagnon, Cynthia

    2017-02-01

    Performance-based assessments of physical function are essential in people with myotonic dystrophy type 1 (DM1) to monitor disease progression and evaluate interventions. Commonly used are the six-minute walk test, the 10 m-walk test, the timed up-and-go test, the timed-stands test, grip strength tests and the nine-hole peg test. The number of trials needed on a same-day test occasion and whether the first, best or average of trials should be reported as result is unknown. Thus, the aim was to describe and explore differences between trials in these measures of walking, mobility and fine hand use in 70 adults with DM1. Three trials were performed for each test except for the six-minute walk test where two trials were allowed. There were statistical significant differences over trials in all tests except for the 10 m-walk test and grip strength tests. Pair-wise comparisons showed that the second and third trials were in general better than the first, although effect sizes were small. At which trial the individuals performed their best differed between individuals and tests. People with severe muscular impairment had difficulties to perform repeated trials. Intraclass correlation coefficients were all high in analyses exploring how to report results. The conclusion and clinical implication is that, for a same-day test occasion, one trial is sufficient for the 10 m-walk test and grip strength tests, and that repeated trials should be allowed in the timed up-and-go test, timed-stands test and nine-hole peg tests. We recommend that two trials are performed for these latter tests as such a protocol could accommodate people with various levels of impairments and physical limitations.

  20. Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland

    PubMed Central

    2013-01-01

    Background The six-minute walk test (6MWT) is a simple, low tech, safe and well established, self-paced assessment tool to quantify functional exercise capacity in adults. The definition of normal 6MWT in children is especially demanding since not only parameters like height, weight and ethnical background influence the measurement, but may be as crucial as age and the developmental stage. The aim of this study is establishing reference values for the 6MWT in healthy children and adolescents in Switzerland and to investigate the influence of age, anthropometrics, heart rate, blood pressure and physical activity on the distance walked. Methods Children and adolescents between 5–17 years performed a 6MWT. Short questionnaire assessments about their health state and physical activities. anthropometrics and vitals were measured before and after a 6-minute walk test and were previously defined as secondary outcomes. Results Age, height, weight and the heart rate after the 6MWT all predicted the distance walked according to different regression models: age was the best single predictor and mostly influenced walk distance in younger age, anthropometrics were more important in adolescents and females. Heart rate after the 6MWT was an important distance predictor in addition to age and outreached anthropometrics in the majority of subgroups assessed. Conclusions The 6MWT in children and adolescents is feasible and practical. The 6MWT distance depends mainly on age; however, heart rate after the 6MWT, height and weight significantly add information and should be taken into account mainly in adolescents. Reference equations allow predicting 6-minute walk test distance and may help to better assess and compare outcomes in young patients with cardiovascular and respiratory diseases and are highly warranted for different populations. PMID:23915140

  1. A six-minute video-clip to ponder the values fostered by health technology.

    PubMed

    Lehoux, Pascale; Williams-Jones, Bryn; Hivon, Myriam; Daudelin, Genevieve; Alice Miller, Fiona

    2012-01-01

    As part of our research team's knowledge transfer and exchange (KTE) initiatives, we developed a six-minute video-clip to enable productive deliberations among technology developers, clinicians and patient representatives. This video-clip summarises in plain language the valuable goals and features that are embedded in health technology and raises questions regarding the direction that should be taken by health care innovations. The use of such video-clips creates unique opportunities for face-to-face deliberations by enabling participants to interact and debate policy issues that are pivotal to the sustainability of health care systems. In our experience, we found that audiovisual-elicitation-based KTE initiatives can fill an important communication gap among key stakeholders: pondering, from a health care system perspective, why and how certain kinds of medical technologies bring a more valuable response to health care needs when compared to others.

  2. Submaximal Exercise Testing Treadmill and Floor Walking.

    DTIC Science & Technology

    1978-05-01

    G., Greyson, J. S., and van der Walt, V. H., "Walk or Jog for Health: II, Iatimating the Maximi Aerobic Capacity for Exercise ,* South &frIca Kedical...Regression Equations versus Determined from Maximal Exercise Test ............ 76 12 Group Means, Percent Errors, and Standard Errors for Maximal Aerobic ...work capacity, expressed as aerobic power, and the associated heart rate with known work i loads have been accomplished through graded exercise tests

  3. [Effects of gender and socioeconomic status of older people on the execution of the 6 minute walk test].

    PubMed

    Medina, Paul G; Mancilla, Eladio S; Muñoz, Rodrigo C; Escobar, Máximo C

    2015-04-01

    The six minute walk test (6MWT) is an important physical performance measure used in older people. To assess the total distance walked and the physiological cost of the 6MWT in non-disabled older people. Fifty six females aged 69 ± 5 years with a body mass index (BMI) of 31 ± 4 kg/m² and sixteen males aged 70 ± 7 years with a BIM of 29 ± 4 kg/m² underwent a 6MWT. The total distance walked was registered and the physiological cost (PC) of the test was calculated as the ratio between the difference of heart rate at work and at rest and the walking speed. The socioeconomic status (SES) of participants was determined using a questionnaire designed in Chile. Among participants of middle-lower and middle-upper SES, the PC was 0.43 ± 0.1 and 0.44 ± 0.09 beats/min, respectively, p = NS. Males of middle-upper SES had a significantly higher PC than their middle-lower SES counterparts. The total distance walked was 493 ± 58 and 501 ± 63 m among participants of upper and lower SES. The plateau in reserve heart rate appeared earlier among participants of upper SES of both genders. Older participants of middle-upper SES had a higher physiological efficiency during the execution of the 6MWT.

  4. The 2-min walk test is sufficient for evaluating walking abilities in sporadic inclusion body myositis.

    PubMed

    Alfano, L N; Lowes, L P; Dvorchik, I; Yin, H; Maus, E G; Flanigan, K M; Mendell, J R

    2014-03-01

    Sporadic inclusion body myositis causes progressive functional loss due to declining muscle strength. Although the underlying cause is unknown, clinical trials are underway to improve strength and function. Selection of appropriate outcome measures is critical for the success of these trials. The 6-min walk test has been the de facto standard for assessing function in neuromuscular disease; however, the optimal walking test has not been determined in this disease. In this study, 67 individuals with sporadic inclusion body myositis completed a battery of quantitative strength and functional tests including timed walking tests, patient-reported outcomes, and other tasks. The 2-min and 6-min walk tests are highly correlated to each other (r=0.97, p<0.001) and to all lower extremity strength, patient-reported, and functional measures in this population. All subjects completed the 2-min walk test, but 7% of subjects were unable to walk the full 6-min of the 6-min walk test due to fatigue. The 2-min walk test demonstrates similar correlation to all outcomes compared to the 6-min walk test, is less fatiguing and better tolerated. Results suggest that the 2-min walk test is a better alternative to tests of longer duration. Further research is needed to determine longitudinal changes on this outcome. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Feasibility of Serial 6-min Walk Tests in Patients with Acute Heart Failure.

    PubMed

    Collins, Sean P; Thorn, Michael; Nowak, Richard M; Levy, Phillip D; Fermann, Gregory J; Hiestand, Brian C; Cowart, Tillman Douglas; Venuti, Robert P; Hiatt, William R; Foo, ShiYin; Pang, Peter S

    2017-09-11

    Functional status assessment is common in many cardiovascular diseases but it has undergone limited study in the setting of acute heart failure (AHF). Accordingly, we performed a pilot study of the feasibility of the six-minute walk test (6MWT) at the emergency department (ED) presentation and through the hospitalization in patients with AHF. From November 2014 to February 2015, we conducted a multicenter, observational study of ED patients, aged 18-85 years, whose primary ED admission diagnosis was AHF. Other criteria for enrollment included a left ventricular ejection fraction ≤40%, systolic blood pressure between 90 and 170 mmHg, and verbal confirmation that the patient was able to walk >30 m at the baseline, prior to ED presentation. Study teams were uniformly trained to administer a 6MWT. Patients underwent a baseline 6MWT within 24 h of ED presentation (Day 1) and follow-up 6MWTs at 24 (Day 2), 48 (Day 3), and 120 h (Day 5). A total of 46 patients (65.2% male, 73.9% African American) had a day one mean walk distance of 137.3 ± 78 m, day 2 of 170.9 ± 100 m, and day 3 of 180.8 ± 98 m. The 6MWT demonstrated good reproducibility, as the distance walked on the first 6MWT on Day 3 was similar to the distance on the repeated 6MWT the same day. Our pilot study demonstrates the feasibility of the 6MWT as a functional status endpoint in AHF patients. A larger study in a more demographically diverse cohort of patients is necessary to confirm its utility and association with 30-day heart failure (HF) events.

  6. Adding Challenge to Performance-Based Tests of Walking: The Walking InCHIANTI Toolkit (WIT)

    PubMed Central

    Bandinelli, Stefania; Pozzi, Martina; Lauretani, Fulvio; Phillips, Caroline; Shumway-Cook, Anne; Guralnik, Jack M.; Ferrucci, Luigi

    2009-01-01

    Bandinelli S, Pozzi M, Lauretani F, Phillips C, Shumway-Cook A, Guralnik JM, Ferrucci L: Adding challenge to performance-based tests of walking: The Walking InCHIANTI Toolkit (WIT). Objective In this report, we provide a detailed description of and reproducibility data on the 14 performance-based tests of lower limb function included in the Walking InCHIANTI Toolkit, which were designed to mimic challenging situations that are encountered while walking in daily life. Design Five women and five men were randomly selected from each of the age strata, 65–74, 75–84, and ≥85 yrs, among those who received a functional evaluation in the Greve site at the second InCHIANTI study follow-up (total n = 30). Walking tests were administered twice at 2-wk intervals. Analyses were aimed at assessing reproducibility of the Walking InCHIANTI Toolkit components and the existence of a learning effect. Results Performance remained stable for eight walking tests and slightly but significantly improved for the 25-cm narrow-path walk, 7-m usual-pace, 7-m obstacle normal light, 7-m holding a package, and 7-m talking while walking tests. Test–retest reliability was in general very high, with 11 of 14 (79%) of the intraclass correlation coefficient values >0.80 and all except one (7-m holding a package) >0.75. Conclusion The walking tests included in the Walking InCHIANTI Toolkit show very good medium-term reproducibility and modest learning effect. Administering components of the Walking InCHIANTI Toolkit may help in the understanding of the effect of challenges encountered in daily life on walking performance. PMID:17033595

  7. Comparison between walking test and treadmill test for intermittent claudication associated with lumbar spinal canal stenosis.

    PubMed

    Tanishima, Shinji; Fukada, Satoru; Ishii, Hiroyuki; Dokai, Toshiyuki; Morio, Yasuo; Nagashima, Hideki

    2015-02-01

    To clarify the priorities of the walking test and the treadmill test for intermittent claudication of lumbar canal stenosis. The study population comprised 45 subjects, with a mean age of 72.6 years. An investigator walked with the subjects during the walking test or watched the subjects walking on the treadmill machine in the treadmill test. The pain scales became significantly worse after the walking test. Ten patients who were diagnosed as root symptom type or cauda equine symptoms were subsequently diagnosed as mixed type by the walking test. The numbers of patients who experienced muscle weakness that was not revealed at rest were eight with the walking test and seven with the treadmill test. The numbers of patients who experienced sensory disturbance that was not observed at rest were seven with the walking test and two with the treadmill test. The walking test detected significantly more symptoms that were not detected at rest than the treadmill test.

  8. Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study.

    PubMed

    Santos, Bruna F A; Souza, Hugo C D; Miranda, Aline P B; Cipriano, Federico G; Gastaldi, Ada C

    2016-01-01

    To assess functional capacity in the preoperative phase of pulmonary surgery by comparing predicted and obtained values for the six-minute walk test (6MWT) in patients with and without postoperative pulmonary complication (PPC) METHOD: Twenty-one patients in the preoperative phase of open thoracotomy were evaluated using the 6MWT, followed by monitoring of the postoperative evolution of each participant who underwent the routine treatment. Participants were then divided into two groups: the group with PPC and the group without PPC. The results were also compared with the predicted values using reference equations for the 6MWT RESULTS: Over half (57.14%) of patients developed PPC. The 6MWT was associated with the odds for PPC (odds ratio=22, p=0.01); the group without PPC in the postoperative period walked 422.38 (SD=72.18) meters during the 6MWT, while the group with PPC walked an average of 340.89 (SD=100.93) meters (p=0.02). The distance traveled by the group without PPC was 80% of the predicted value, whereas the group with PPC averaged less than 70% (p=0.03), with more appropriate predicted values for the reference equations The 6MWT is an easy, safe, and feasible test for routine preoperative evaluation in pulmonary surgery and may indicate patients with a higher chance of developing PPC.

  9. Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study

    PubMed Central

    Santos, Bruna F. A.; Souza, Hugo C. D.; Miranda, Aline P. B.; Cipriano, Federico G.; Gastaldi, Ada C.

    2016-01-01

    OBJECTIVES: To assess functional capacity in the preoperative phase of pulmonary surgery by comparing predicted and obtained values for the six-minute walk test (6MWT) in patients with and without postoperative pulmonary complication (PPC) METHOD: Twenty-one patients in the preoperative phase of open thoracotomy were evaluated using the 6MWT, followed by monitoring of the postoperative evolution of each participant who underwent the routine treatment. Participants were then divided into two groups: the group with PPC and the group without PPC. The results were also compared with the predicted values using reference equations for the 6MWT RESULTS: Over half (57.14%) of patients developed PPC. The 6MWT was associated with the odds for PPC (odds ratio=22, p=0.01); the group without PPC in the postoperative period walked 422.38 (SD=72.18) meters during the 6MWT, while the group with PPC walked an average of 340.89 (SD=100.93) meters (p=0.02). The distance traveled by the group without PPC was 80% of the predicted value, whereas the group with PPC averaged less than 70% (p=0.03), with more appropriate predicted values for the reference equations CONCLUSIONS: The 6MWT is an easy, safe, and feasible test for routine preoperative evaluation in pulmonary surgery and may indicate patients with a higher chance of developing PPC. PMID:26786074

  10. Contribution of ankle dorsiflexor strength to walking endurance in people with spastic hemiplegia after stroke.

    PubMed

    Ng, Shamay S; Hui-Chan, Christina W

    2012-06-01

    (1) To determine the relationships of ankle dorsiflexor strength, ankle plantarflexor strength, and spasticity of the ankle plantarflexors with walking endurance; (2) to determine whether affected ankle dorsiflexor strength makes an independent contribution to walking endurance; and (3) to quantify its relative contribution to the walking endurance of people with spastic hemiplegia after stroke. A cross-sectional study. University-based rehabilitation center. Subjects (N=62) with spastic hemiplegia. Not applicable. Walking endurance was measured by the distance covered in the six-minute walk test (6MWT). Ankle dorsiflexor and plantarflexor strength were measured using a load-cell mounted on a custom-built foot support. Plantarflexor spasticity was measured using the Composite Spasticity Scale. The six-minute walk distances showed stronger positive correlation with affected dorsiflexor strength (r=.793, P≤.000) when compared with affected plantarflexor strength (r=.349, P=.005). Results of the regression model showed that after adjusting for basic demographic and stroke-related impairments, affected ankle dorsiflexor strength remained independently associated with six-minute walk distance, accounting for 48.8% of the variance. This is the first study, to our knowledge, to document the importance of ankle dorsiflexor strength as an independent determinant of walking endurance in stroke survivors with spastic plantarflexors. Our findings suggest that stroke rehabilitation programs aiming to improve walking endurance should include strengthening exercises for the ankle dorsiflexors. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Ultra fast miniaturized real-time PCR: 40 cycles in less than six minutes

    PubMed Central

    Neuzil, Pavel; Zhang, Chunyan; Pipper, Juergen; Oh, Sharon; Zhuo, Lang

    2006-01-01

    We have designed, fabricated and tested a real-time PCR chip capable of conducting one thermal cycle in 8.5 s. This corresponds to 40 cycles of PCR in 5 min and 40 s. The PCR system was made of silicon micromachined into the shape of a cantilever terminated with a disc. The thin film heater and a temperature sensor were placed on the disc perimeter. Due to the system's thermal constant of 0.27 s, we have achieved a heating rate of 175°C s−1 and a cooling rate of −125°C s−1. A PCR sample encapsulated with mineral oil was dispensed onto a glass cover slip placed on the silicon disc. The PCR cycle time was then determined by heat transfer through the glass, which took only 0.5 s. A real-time PCR sample with a volume of 100 nl was tested using a FAM probe. As the single PCR device occupied an area of only a few square millimeters, devices could be combined into a parallel system to increase throughput. PMID:16807313

  12. Association of Chronic Cough and Pulmonary Function with 6-Minute Walk Test Performance in HIV Infection

    PubMed Central

    Campo, Monica; Oursler, Kisann K.; Huang, Laurence; Goetz, Matthew; Rimland, David; Hoo, Guy Soo; Brown, Sheldon; Rodriguez-Barradas, Maria; Au, David; Akgün, Kathleen M.; Shahrir, Shahida; Crothers, Kristina

    2015-01-01

    Objective Chronic lung disease has been associated with greater impairment in self-reported physical function in HIV patients. We sought to study this association using objective measures of physical or pulmonary function. Design Baseline data from the Examinations of HIV Associated Lung Emphysema (EXHALE) study, a multicenter observational cohort of HIV-infected and uninfected Veterans. Methods We assessed the association between clinical, laboratory, and pulmonary function measures on six-minute walk test (6-MWT). Multivariable linear regression models were generated to identify factors associated with 6-MWT performance. Results 340 participants completed 6-MWT (mean age 55 years), with 68% black race, 94% men and 62% current smokers. Overall, 180 (53%) were HIV-infected and 63 (19%) had spirometry-defined COPD. In a multivariable model, age, current smoking, and obesity (BMI>30) were independently associated with lower 6-MWT performance, but HIV infection was not; there was a significant interaction between HIV and chronic cough, such that distance walked among HIV-infected participants with chronic cough was 51.76 meters less (p=0.04) compared to those without cough or HIV. Among HIV-infected participants, the forced expiratory volume in one second (FEV1, % predicted), to a greater extent than total lung capacity or diffusion capacity, attenuated the association with chronic cough; decreased FEV1 was independently associated with lower 6-MWT performance in those with HIV. Conclusion Older age, current smoking and airflow limitation were important determinants of 6-MWT performance in the HIV-infected participants. These findings suggest potential interventions to improve physical function may include early management of respiratory symptoms and airflow limitation. PMID:24346638

  13. Which field walking test should be used to assess functional exercise capacity in lung cancer? An observational study.

    PubMed

    Granger, Catherine L; Denehy, Linda; Parry, Selina M; Martin, Joel; Dimitriadis, Tim; Sorohan, Maeve; Irving, Louis

    2015-08-12

    There is emerging evidence regarding the efficacy of exercise training to improve exercise capacity for individuals with non-small cell lung cancer (NSCLC). Cardiopulmonary exercise testing (CPET) is the gold standard measure of exercise capacity; however this laboratory test has limitations for use in research and clinical practice. Alternative field walking tests are the six-minute walk test (6MWT), incremental-shuttle walk test (ISWT) and endurance-shuttle walk test (ESWT); however there is limited information about their clinimetric properties in NSCLC. In NSCLC to determine the 1) criterion validity of the 6MWT, ISWT and ESWT against CPET; 2) construct validity of the 6MWT, ISWT and ESWT against measures of function, strength, respiratory function and health-related quality of life (HRQoL); and 3) clinical applicability of the tests. Twenty participants (40 % male, mean ± SD age 66.1 ± 6.5 years) with stage I-IIIb NSCLC completed the 6MWT, ISWT, ESWT and CPET within six months of treatment. Testing order was randomised. Additional measures included Eastern Cooperative Oncology Group Performance-Status (ECOG-PS, function), respiratory function, hand-grip dynamometry and HRQoL. Correlations and regression analyses were used to assess relationships. The ISWT demonstrated criterion validity with a moderate relationship between ISWT distance and CPET peak oxygen consumption (r = 0.61, p = 0.007). Relationships between CPET and six minute walk distance (6MWD) (r = 0.24, p = 0.329) or ESWT time (r = 0.02, p = 0.942) were poor. Moderate construct validity existed for the 6MWD and respiratory function (forced vital capacity % predicted r = 0.53, p = 0.019; forced expiratory volume in the first second % predicted r = 0.55, p = 0.015). There were no relationships between the walking tests and measures of function, strength or HRQoL. The ESWT had a ceiling effect with 18 % reaching maximum time. No floor effects were seen

  14. The RANLUX Generator:. Resonances in a Random Walk Test

    NASA Astrophysics Data System (ADS)

    Shchur, Lev N.; Butera, Paolo

    Using a recently proposed directed random walk test, we systematically investigate the popular random number generator RANLUX developed by Lüscher and implemented by James. We confirm the good quality of this generator with the recommended luxury level. At a smaller luxury level (for instance equal to 1) resonances are observed in the random walk test. We also find that the lagged Fibonacci and Subtract-with-Carry recipes exhibit similar failures in the random walk test. A revised analysis of the corresponding dynamical systems leads to the observation of resonances in the eigenvalues of Jacobi matrix.

  15. Heart rate slopes during 6-min walk test in pulmonary arterial hypertension, other lung diseases, and healthy controls.

    PubMed

    Tonelli, Adriano R; Wang, Xiao-Feng; Alkukhun, Laith; Zhang, Qi; Dweik, Raed A; Minai, Omar A

    2014-06-01

    Six-minute walk test (6MWT) continues to be a useful tool to determine the functional capacity in patients with vascular and other lung diseases; nevertheless, it has a limited ability to predict prognosis in this context. We tested whether the heart rate (HR) acceleration and decay slopes during the 6-m walk test are different in patients with pulmonary arterial hypertension (PAH), other lung diseases, and healthy controls. In addition, we assessed whether the HR slopes are associated with clinical worsening. Using a portable, signal-morphology-based, impedance cardiograph (PhysioFlow Enduro, Paris, France) with real-time wireless monitoring via a Bluetooth USB adapter we determined beat-by-beat HR. We included 50 subjects in this pilot study, 20 with PAH (all on PAH-specific treatment), 17 with other lung diseases (obstructive [n = 12, 71%] or restrictive lung diseases [5, 29%]), and 13 healthy controls. The beat-by-beat HR curves were significantly different among all three groups of subjects either during the activity or recovery of the 6MWT. HR curves were less steep in PAH than the other two groups (P < 0.001). HR acceleration rates were slower in patients with PAH or other lung diseases with progression of their disease (P < 0.001). In conclusion, the acceleration and decay slopes during 6MWT are different among patients with PAH, other lung diseases, and healthy controls. The HR slopes during 6MWT were steeper in patients without clinical worsening.

  16. Ecological Validity of Walking Capacity Tests in Multiple Sclerosis

    PubMed Central

    Stellmann, J. P.; Neuhaus, A.; Götze, N.; Briken, S.; Lederer, C.; Schimpl, M.; Heesen, C.; Daumer, M.

    2015-01-01

    Background Ecological validity implicates in how far clinical assessments refer to real life. Short clinical gait tests up to ten meters and 2- or 6-Minutes Walking Tests (2MWT/6MWT) are used as performance-based outcomes in Multiple Sclerosis (MS) studies and considered as moderately associated with real life mobility. Objective To investigate the ecological validity of 10 Meter Walking Test (10mWT), 2MWT and 6MWT. Methods Persons with MS performed 10mWT, 6MWT including 2MWT and 7 recorded days by accelerometry. Ecological validity was assumed if walking tests represented a typical walking sequence in real-life and correlations with accelerometry parameters were strong. Results In this cohort (n=28, medians: age=45, EDSS=3.2, disease duration=9 years), uninterrupted walking of 2 or 6 minutes occurred not frequent in real life (2.61 and 0.35 sequences/day). 10mWT correlated only with slow walking speed quantiles in real life. 2MWT and 6MWT correlated moderately with most real life walking parameters. Conclusion Clinical gait tests over a few meters have a poor ecological validity while validity is moderate for 2MWT and 6MWT. Mobile accelerometry offers the opportunity to control and improve the ecological validity of MS mobility outcomes. PMID:25879750

  17. Predictive validity analysis of six reference equations for the 6-minute walk test in healthy Brazilian men: a cross-sectional study.

    PubMed

    Negreiros, Alexandher; Padula, Rosimeire Simprini; Andrea Bretas Bernardes, Rosane; Moraes, Mônica Vasconcelos de; Pires, Raquel Simoni; Chiavegato, Luciana Dias

    2017-07-04

    The six-minute walk test (6MWT) is an important tool for evaluating functional capacity and exercise tolerance. The reference equations for the 6MWT in healthy subjects were established on the basis of American and European populations, but reference equations have been proposed with different variables for the Brazilian population. To analyze the predictive validity of six reference equations for the six-minute walking distance (6MWD) in healthy adult men. We evaluated 103 individuals in relation to level of physical activity (IPAQ), respiratory symptoms (MRC), handgrip strength, and 6MWD test. The data were submitted to a normality test, then the Bland-Altman agreement test was used to compare individual 6MWD values with that expected for each equation. The subjects were active, with a mean age of 34.12 (SD=8.88) years and no respiratory symptoms. The mean of the 6MWD was 663.43 (SD=93.01)m. The 6MWD's predicted values came closest to the walked distance covered by Britto et al.'s equation (using BMI) of 647.62 (SD=38.62)m. The equation proposed by Britto et al. using body mass index (BMI) was the closest to the 6MWD for the individuals studied and could be widely used as a reference tool during the 6MWT in healthy Brazilian men. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Two-particle quantum walks: Entanglement and graph isomorphism testing

    SciTech Connect

    Berry, Scott D.; Wang, Jingbo B.

    2011-04-15

    We study discrete-time quantum walks on the line and on general undirected graphs with two interacting or noninteracting particles. We introduce two simple interaction schemes and show that they both lead to a diverse range of probability distributions that depend on the correlations and relative phases between the initial coin states of the two particles. We investigate the characteristics of these quantum walks and the time evolution of the entanglement between the two particles from both separable and entangled initial states. We also test the capability of two-particle discrete-time quantum walks to distinguish nonisomorphic graphs. For strongly regular graphs, we show that noninteracting discrete-time quantum walks can distinguish some but not all nonisomorphic graphs with the same family parameters. By incorporating an interaction between the two particles, all nonisomorphic strongly regular graphs tested are successfully distinguished.

  19. A comparison of at-home walking and 10-meter walking test parameters of individuals with post-stroke hemiparesis.

    PubMed

    Nagano, Katsuhito; Hori, Hideaki; Muramatsu, Ken

    2015-02-01

    [Purpose] The purpose of this study was to clarify the difference in gait parameters of at-home walking and the 10-meter walking test results of individuals with hemiparesis. [Subjects] A total of 14 hemiparetic stroke recovery patients participated in this study. Inclusion criteria were: living at home, the ability to walk independently, and demonstrated low extremity on recovery stages III-V on the Brunnstrom Approach. The average age of the subjects was 66 years. [Methods] We used video surveillance and the inked footprint technique to record usual walking speed and maximum speed patterns both in subjects' homes and during the 10-meter walking test. From these methods, walking speed, stride length, and step rate were calculated. [Results] While both usual and maximum walking speeds of the 10-meter walking test correlated with stride length and step rate, at-home walking speeds only significantly correlated with stride length. [Conclusion] Walking patterns of the 10-meter walking test are quantifiably distinct from those demonstrated in patients' homes, and this difference is mainly characterized by stride length. In order to enhance in-home walking ability, exercises that improve length of stride rather than step rate should be recommended.

  20. [Objective evaluation of arterial intermittent claudication by the walking tolerance test. Comparative study of physiological walking and walking on a conveyor belt (author's transl)].

    PubMed

    Bouchet, J Y; Franco, A; Morzol, B; Beani, J C

    1980-01-01

    Two methods are used to evaluate the walking distance: physiological walking along a standard path (0% - 6 mk/h) and walking on a tread mill (10% - 3 km/h). In both tests, four data are checked: -- initial trouble distance, -- cramp or walking-distance, -- localisation of pain, -- recovery time. These tests are dependable for the diagnosis of arterial claudication, reproducible and well tolerated. Their results have been compared: there is no correlation between the initial trouble distance and the cramp distance. However there is a correlation between the cramp distance by physiological walking and on treadmill. Recovery time, if long, is a criteria of gravity. Interests of both methods are discussed.

  1. Validity of the shuttle walk test as a functional assessment of walking ability in individuals with polyneuropathy.

    PubMed

    Erdmann, Peter G; Teunissen, Laurien L; van den Berg, Leonard H; Notermans, Nicolette C; Schröder, Carin D; Bongers, Bart C; van Meeteren, Nico L U

    2017-10-01

    This study assessed the validity of the shuttle walk test (SWT) to evaluate walking ability in patients with polyneuropathy. Forty-one patients with chronic idiopathic axonal polyneuropathy (CIAP) and 49 patients with multifocal motor neuropathy (MMN) performed both the 10-meter walk test (10MWT) and the SWT. Face validity was assessed by evaluating whether patients considered both tests to reflect their walking ability (Likert scale: 1 = not at all, 10 = very well). Concurrent validity was determined by Spearman rank-correlation analyses performed on the outcomes of both tests. Mean (SD) scores for how well the 10MWT and SWT reflected daily walking ability were 6.8 (1.3) and 7.4 (1.6) (p = 0.117) in patients with CIAP and 6.9 (1.2) and 7.9 (1.0) (p = 0.001) in patients with MMN, respectively. Correlation scores between both tests ranged from -0.70 to -0.82, except for 18 patients with MMN with a "normal" walking speed at the 10MWT (-0.21). The SWT seems a valid instrument for assessing walking ability in individuals with CIAP and MMN. Moreover, the SWT seems to be useful for investigating the symptoms elicited by walking long distances and may be more sensitive to changes when compared to the 10MWT. Implications for Rehabilitation Patients with polyneuropathy mainly experience problems when walking long distances. The 10-meter walk test does not possess sufficient psychometrics to diagnose walking abilities in these circumstances. The shuttle walk test is a valid instrument for assessing walking ability in individuals with polyneuropathy and might be the preferred instrument of choice when compared to the 10-meter walk test.

  2. Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke.

    PubMed

    Langhammer, Birgitta; Stanghelle, Johan K

    2010-01-01

    To evaluate spatial and temporal gait characteristics and endurance late after stroke in people who had received two different walking exercises. A secondary aim was to compare the outcomes in relation to length of time exercising and number of exercise occasions between the two. A randomized controlled trial. A private rehabilitation centre. Thirty-nine people with stroke entered the study, and five dropped out. Treadmill training versus walking outdoors. Six-Minute Walk Test, a 10-metre walk test and pulse rates at rest and in activity. There were significant differences in favour of the treadmill group in Six-Minute Walk Test distance (P = 0.04), Six-Minute Walk Test speed (P = 0.03), 10-m walking speed (P = 0.03), bilateral stride length (right leg; P = 0.009, left leg; P = 0.003) and step width (P = 0.01), indicating more symmetrical use of the legs in the treadmill group (1.02-1.10 m versus 0.97-0.92 m). There were no significant differences between groups in cadence (P = 0.78). All participants complied 100% with their respective programmes. Exercise frequency did not differ between the groups but significantly less time was spent exercising on the treadmill compared with walking exercise outdoors (107 versus 316 minutes, P = 0.002). There were no differences in use of assistive aids between the groups on arrival at the clinic or at departure. The results indicate that treadmill walking improves spatial and temporal gait characteristics more effectively than walking outdoors.

  3. Comparison of bioenergetics of walking during a multistage incremental shuttle walk test and a 6-min walk test in active older adults.

    PubMed

    Leone, Mario; Duvergé, Sébastien; Kalinova, Émilia; Bui, Hung Tien; Comtois, Alain S

    2017-04-01

    The goal of the present research was to compare the bioenergetics variability of walking, during the 6-min walk test (6-MWT) and a multistage incremental shuttle walk test (MISWT) in an active older population. Twenty-two healthy physically active older adults with a group mean age of 70.4 ± 5.8 years completed the 6-MWT and the MISWT. Heart rate (HR), walking speed and walking [Formula: see text]O2 were measured throughout each test with a portable metabolic cart. Strong correlations were found for the [Formula: see text]O2 peak and the walking speed (r = 0.91 and r = 0.89 respectively for 6-MWT and MISWT). Differences in [Formula: see text]O2 peak values were analysed with a paired Student's t test. Repeated measures ANOVA were conducted to detect differences between tests. The Bland and Altman plot indicates that the average difference between both tests was 2.5 ml kg(-1) min(-1). MISWT [Formula: see text]O2 peak means were significantly greater than the 6-MWT [Formula: see text]O2 peak mean values (21.6 ± 5.3 vs. 18.9 ± 4.5 ml kg(-1) min(-1)) which indicate bioenergetics differences between the two walking tests. Thus, the MISWT and 6-MWT elicited different walking [Formula: see text]O2 peak and HR suggesting that the MISWT field test challenge the participants to a higher level of cardiovascular and respiratory stress. The walking [Formula: see text]O2 peak recorded for the MISWT was significantly greater than the 6-MWT. Consequently, both tests seem to measure different facets of the aerobic capacity. MISWT seems to be a better indicator of maximal aerobic power whereas the 6-MWT provides more relevant information regarding aerobic endurance in aging population.

  4. 76 FR 21579 - Energy Conservation Program: Test Procedures for Walk-In Coolers and Walk-In Freezers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ...On January 4, 2010, the U.S. Department of Energy (DOE) issued a notice of proposed rulemaking (January 2010 NOPR) to establish new test procedures for walk-in coolers and walk-in freezers (WICF or walk- ins). On September 9, 2010, DOE issued a supplemental notice of proposed rulemaking (September 2010 SNOPR) to propose changes to the test procedures that it proposed in the NOPR. Those proposed rulemakings serve as the basis for today's action. DOE is issuing a final rule that establishes new test procedures for measuring the energy efficiency of certain walk-in cooler and walk-in freezer components including panels, doors, and refrigeration systems. These test procedures will be mandatory for product testing to demonstrate compliance with energy standards that DOE is establishing in a separate, but concurrent rulemaking, and for representations starting 180 days after publication. This final rule incorporates by reference industry test procedures that, along with calculations established in the rule, can be used to measure the energy consumption or performance characteristics of certain components of walk-in coolers and walk-in freezers. Additionally, the final rule clarifies the definitions of ``Display door,'' ``Display panel,'' ``Door,'' ``Envelope,'' ``K- factor,'' ``Panel,'' ``Refrigerated,'' ``Refrigeration system,'' ``U- factor,'' ``Automatic door opener/closer,'' ``Core region,'' ``Edge region,'' ``Surface area,'' ``Rating condition,'' and ``Percent time off'' as applicable to walk-in coolers and walk-in freezers.

  5. Tests of walking balance for screening vestibular disorders.

    PubMed

    Cohen, Helen S; Mulavara, Ajitkumar P; Peters, Brian T; Sangi-Haghpeykar, Haleh; Bloomberg, Jacob J

    2012-01-01

    Few reliable tests are available for screening people rapidly for vestibular disorders although such tests would be useful for a variety of testing situations. Balance testing is widely performed but of unknown value for screening. The goal of this study was to determine the value of tests of walking balance for screening people with vestibular impairments. We tested three groups of patients with known vestibular impairments: benign paroxysmal positional vertigo, unilateral vestibular weakness, and post-acoustic neuroma resection. We compared them to normal subjects. All subjects were independently ambulatory without gait aids. Subjects were tested on tandem walking (TW) with eyes open and eyes closed for 10 steps, walking with no additional head motions and with augmented head rotations in yaw for 7 m (WwHT), and an obstacle avoidance task, the Functional Mobility Test (FMT). Subjects wore a 3-D motion sensor centered at mid-torso to capture kinematic measures. Patients and normals differed significantly on some behavioral measures, such as the number of steps to perform TW, and on some but not all kinematic measures. ROC analyses, however, were at best only moderate, and failed to find strong differences and cut-points that would differentiate the groups. These findings suggest that although patients and normals differ in performance of these tests in some interesting ways the groups are not sufficiently different on these tests for easy use as screening tests to differentiate the populations.

  6. Reproducibility for Heart Rate Variability Analysis during 6-Min Walk Test in Patients with Heart Failure and Agreement between Devices.

    PubMed

    Braga, Lays Magalhães; Prado, Gustavo Faibischew; Umeda, Iracema Ioco Kikuchi; Kawauchi, Tatiana Satie; Taboada, Adriana Marques Fróes; Azevedo, Raymundo Soares; Pereira Filho, Horacio Gomes; Grupi, César José; Souza, Hayala Cristina Cavenague; Moreira, Dalmo Antônio Ribeiro; Nakagawa, Naomi Kondo

    2016-01-01

    Heart rate variability (HRV) analysis is a useful method to assess abnormal functioning in the autonomic nervous system and to predict cardiac events in patients with heart failure (HF). HRV measurements with heart rate monitors have been validated with an electrocardiograph in healthy subjects but not in patients with HF. We explored the reproducibility of HRV in two consecutive six-minute walk tests (6MW), 60-minute apart, using a heart rate monitor (PolarS810i) and a portable electrocardiograph (called Holter) in 50 HF patients (mean age 59 years, NYHA II, left ventricular ejection fraction ~35%). The reproducibility for each device was analysed using a paired t-test or the Wilcoxon signed-rank test. Additionally, we assessed the agreement between the two devices based on the HRV indices at rest, during the 6MW and during recovery using concordance correlation coefficients (CCC), 95% confidence intervals and Bland-Altman plots. The test-retest for the HRV analyses was reproducible using Holter and PolarS810i at rest but not during recovery. In the second 6MW, patients showed significant increases in rMSSD and walking distance. The PolarS810i measurements had remarkably high concordance correlation [0.86

  7. Reproducibility for Heart Rate Variability Analysis during 6-Min Walk Test in Patients with Heart Failure and Agreement between Devices

    PubMed Central

    Braga, Lays Magalhães; Prado, Gustavo Faibischew; Umeda, Iracema Ioco Kikuchi; Kawauchi, Tatiana Satie; Taboada, Adriana Marques Fróes; Azevedo, Raymundo Soares; Pereira Filho, Horacio Gomes; Grupi, César José; Souza, Hayala Cristina Cavenague; Moreira, Dalmo Antônio Ribeiro

    2016-01-01

    Heart rate variability (HRV) analysis is a useful method to assess abnormal functioning in the autonomic nervous system and to predict cardiac events in patients with heart failure (HF). HRV measurements with heart rate monitors have been validated with an electrocardiograph in healthy subjects but not in patients with HF. We explored the reproducibility of HRV in two consecutive six-minute walk tests (6MW), 60-minute apart, using a heart rate monitor (PolarS810i) and a portable electrocardiograph (called Holter) in 50 HF patients (mean age 59 years, NYHA II, left ventricular ejection fraction ~35%). The reproducibility for each device was analysed using a paired t-test or the Wilcoxon signed-rank test. Additionally, we assessed the agreement between the two devices based on the HRV indices at rest, during the 6MW and during recovery using concordance correlation coefficients (CCC), 95% confidence intervals and Bland-Altman plots. The test-retest for the HRV analyses was reproducible using Holter and PolarS810i at rest but not during recovery. In the second 6MW, patients showed significant increases in rMSSD and walking distance. The PolarS810i measurements had remarkably high concordance correlation [0.86

  8. 75 FR 186 - Energy Conservation Program: Test Procedures for Walk-In Coolers and Walk-In Freezers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-04

    ...Pursuant to the Energy Policy and Conservation Act, as amended, the U.S. Department of Energy (DOE) is proposing test procedures for measuring the energy consumption of walk-in coolers and walk-in freezers (collectively ``walk-in equipment'' or ``walk- in(s)''), definitions to delineate the products covered by the test procedures, and provisions (including a sampling plan) for manufacturers to implement the test procedures. The notice also addresses enforcement issues as they relate to walk-in equipment. Concurrently, DOE is undertaking an energy conservation standards rulemaking for this equipment. Any data gathered through the use of the test procedure adopted by DOE will be used in evaluating any potential standards for this equipment. Once these standards are promulgated, the adopted test procedures will be used to determine equipment efficiency and compliance with the standards.

  9. 10 CFR 431.304 - Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... consumption of walk-in coolers and walk-in freezers. 431.304 Section 431.304 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY EFFICIENCY PROGRAM FOR CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Walk-in Coolers and Walk-in Freezers Test Procedures § 431.304 Uniform test method for the measurement of...

  10. 10 CFR 431.304 - Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... consumption of walk-in coolers and walk-in freezers. 431.304 Section 431.304 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY EFFICIENCY PROGRAM FOR CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Walk-in Coolers and Walk-in Freezers Test Procedures § 431.304 Uniform test method for the measurement of...

  11. 10 CFR 431.304 - Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in freezers. 431.304 Section 431.304 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY EFFICIENCY PROGRAM FOR CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Walk-in Coolers and Walk-in Freezers Test Procedures...

  12. Can simple clinical tests predict walking ability after prosthetic rehabilitation?

    PubMed

    Sansam, Kate; O'Connor, Rory J; Neumann, Vera; Bhakta, Bipin

    2012-11-01

    To investigate whether simple clinical measures can predict walking ability after lower limb prosthetic rehabilitation. Prospective observational study. Ninety five adults who were assessed as suitable for lower limb prosthetic rehabilitation by the multidisciplinary team. Information regarding baseline clinical factors (amputation details, comorbidities, physical ability, mood and cognitive ability) was collected prior to provision of the prosthesis. Backward step linear regression was used to identify factors predictive of performance on the Timed Up and Go test following rehabilitation. Seventy one participants were able to complete this walking test and were included in the final analysis. The backward step regression model had an adjusted R2 of 0.588 and comprised 6 factors: age (p = 0.002), gender (p = 0.027), level of amputation (p = 0.000), presence of contracture (p = 0.088), ability to stand on one leg (p = 0.062) and Trail Making Tests A + B (p = 0.047), a test of cognitive flexibility. Cause of amputation (dysvascular or non-dysvascular) was not an independent predictor of walking outcome. These results indicate that simple clinical assessments completed prior to prosthetic provision can be used to predict mobility outcome. These findings need to be validated in a larger population across other amputee rehabilitation services and if confirmed could easily be incorporated into routine clinical practice.

  13. Test-Retest Reliability of the 10-Metre Fast Walk Test and 6-Minute Walk Test in Ambulatory School-Aged Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Thompson, Patricia; Beath, Tricia; Bell, Jacqueline; Jacobson, Gabrielle; Phair, Tegan; Salbach, Nancy M.; Wright, F. Virginia

    2008-01-01

    Short-term test-retest reliability of the 10-metre fast walk test (10mFWT) and 6-minute walk test (6MWT) was evaluated in 31 ambulatory children with cerebral palsy (CP), with subgroup analyses in Gross Motor Function Classification System (GMFCS) Levels I (n=9), II (n=8), and III (n=14). Sixteen females and 15 males participated, mean age 9 years…

  14. Test-Retest Reliability of the 10-Metre Fast Walk Test and 6-Minute Walk Test in Ambulatory School-Aged Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Thompson, Patricia; Beath, Tricia; Bell, Jacqueline; Jacobson, Gabrielle; Phair, Tegan; Salbach, Nancy M.; Wright, F. Virginia

    2008-01-01

    Short-term test-retest reliability of the 10-metre fast walk test (10mFWT) and 6-minute walk test (6MWT) was evaluated in 31 ambulatory children with cerebral palsy (CP), with subgroup analyses in Gross Motor Function Classification System (GMFCS) Levels I (n=9), II (n=8), and III (n=14). Sixteen females and 15 males participated, mean age 9 years…

  15. Correlation of 6-min walk test with left ventricular function and quality of life in heart failure due to Chagas disease.

    PubMed

    Chambela, Mayara C; Mediano, Mauro F F; Ferreira, Roberto R; Japiassú, André M; Waghabi, Mariana C; da Silva, Gilberto M S; Saraiva, Roberto M

    2017-10-01

    To evaluate the correlation of the total distance walked during the six-minute walk test (6MWT) with left ventricular function and quality of life in patients with Chagas Disease (ChD) complicated by heart failure. This is a cross-sectional study of adult patients with ChD and heart failure diagnosed based on Framingham criteria. 6MWT was performed following international guidelines. New York Heart Association functional class, brain natriuretic peptide (BNP) serum levels, echocardiographic parameters and quality of life (SF-36 and MLHFQ questionnaires) were determined and their correlation with the distance covered at the 6MWT was tested. Forty adult patients (19 male; 60 ± 12 years old) with ChD and heart failure were included in this study. The mean left ventricular ejection fraction was 35 ± 12%. Only two patients (5%) ceased walking before 6 min had elapsed. There were no cardiac events during the test. The average distance covered was 337 ± 105 metres. The distance covered presented a negative correlation with BNP (r = -0.37; P = 0.02), MLHFQ quality-of-life score (r = -0.54; P = 0.002), pulmonary artery systolic pressure (r = -0.42; P = 0.02) and the degree of diastolic dysfunction (r = -0.36; P = 0.03) and mitral regurgitation (r = -0.53; P = 0.0006) and positive correlation with several domains of the SF-36 questionnaire. The distance walked during the 6MWT correlates with BNP, quality of life and parameters of left ventricular diastolic function in ChD patients with heart failure. We propose this test to be adopted in endemic areas with limited resources to aid in the identification of patients who need referral for tertiary centres for further evaluation and treatment. © 2017 John Wiley & Sons Ltd.

  16. Comparison of walking parameters and cardiorespiratory changes during the 6-minute walk test in healthy sexagenarians and septuagenarians.

    PubMed

    Hovington, Cindy L; Nadeau, Sylvie; Leroux, Alain

    2009-01-01

    The 6-minute walk test (6-MWT) is commonly used in research, with a focus on walking distance parameters rather than the physiological parameters. Even though it has been reported that the distance walked during the 6-MWT decreases with age, the adaptation of cardiorespiratory functions in healthy older adults remains to be studied. The primary objective of this study was to compare the changes in walking distance and cardiorespiratory parameters during the 6-MWT in healthy sexagenarians and septuagenarians. A secondary objective was to determine the cardiorespiratory parameters and functional performance variables that best predict the distance covered during the 6-MWT. Ten healthy sexagenarians (G60, mean age 63.6 +/- 3.3 years) and 10 septuagenarians (G70, mean age 76.0 +/- 3.3 years) performed the 6-MWT while the distance, heart rate and oxygen uptake (VO(2)) were recorded. The subjects also completed the Timed-Up-and-Go, the Berg Balance Scale and the Human Activity Profile to establish their functional level. Results showed that G60 reached significantly greater (p < 0.05) distance and VO(2) values during the 6-MWT than G70. In contrast, the energy cost of walking (O(2) cost) and heart rate did not differ between the 2 groups. Correlational analyses of the combined groups revealed that VO(2) was the variable that showed the strongest correlation with walking distance during the 6-MWT. Results revealed that, while G60 achieved a greater level of walking performance than G70, the 2 groups maintained the same level of walking efficiency (O(2) cost) during the walk. Both groups adjusted their walking speed to have an oxygen consumption rate at a level sufficient to meet the energy demands of the task and prevent early exhaustion. Therefore, the 6-MWT appears to be a simple tool that can be used to assess cardiorespiratory parameters in older adults and be sensitive enough to detect differences between sexagenarians and septuagenarians.

  17. 75 FR 55067 - Energy Conservation Program: Test Procedures for Walk-In Coolers and Walk-In Freezers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ...The U.S. Department of Energy (DOE) previously published a notice of proposed rulemaking to adopt test procedures for measuring the energy consumption of walk-in coolers and walk-in freezers, pursuant to the Energy Policy and Conservation Act (EPCA), as amended. DOE is continuing to consider those proposals, but is now soliciting comments on several alternative proposed options. Once any final test procedure is effective, any representation as to the energy use of walk-in equipment must reflect the results of testing that equipment using the test procedure. Concurrently, DOE is undertaking an energy conservation standards rulemaking for this equipment. If DOE receives data in this test procedure rulemaking that are pertinent to the development of standards, it will use that data in evaluating potential standards for this equipment. Once these standards are promulgated, the adopted test procedures will be used to determine compliance with the standards.

  18. Optimizing the 6-Min Walk Test as a Measure of Exercise Capacity in COPD

    PubMed Central

    Chandra, Divay; Wise, Robert A.; Kulkarni, Hrishikesh S.; Benzo, Roberto P.; Criner, Gerard; Make, Barry; Slivka, William A.; Ries, Andrew L.; Reilly, John J.; Martinez, Fernando J.

    2012-01-01

    Background: It is uncertain whether the effort and expense of performing a second walk for the 6-min walk test improves test performance. Hence, we attempted to quantify the improvement in 6-min walk distance if an additional walk were to be performed. Methods: We studied patients consecutively enrolled into the National Emphysema Treatment Trial who prior to randomization and after 6 to 10 weeks of pulmonary rehabilitation performed two 6-min walks on consecutive days (N = 396). Patients also performed two 6-min walks at 6-month follow-up after randomization to lung volume reduction surgery (n = 74) or optimal medical therapy (n = 64). We compared change in the first walk distance to change in the second, average-of-two, and best-of-two walk distances. Results: Compared with the change in the first walk distance, change in the average-of-two and best-of-two walk distances had better validity and precision. Specifically, 6 months after randomization to lung volume reduction surgery, changes in the average-of-two (r = 0.66 vs r = 0.58, P = .01) and best-of-two walk distances (r = 0.67 vs r = 0.58, P = .04) better correlated with the change in maximal exercise capacity (ie, better validity). Additionally, the variance of change was 14% to 25% less for the average-of-two walk distances and 14% to 33% less for the best-of-two walk distances than the variance of change in the single walk distance, indicating better precision. Conclusions: Adding a second walk to the 6-min walk test significantly improves its performance in measuring response to a therapeutic intervention, improves the validity of COPD clinical trials, and would result in a 14% to 33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in patients with COPD. PMID:23364913

  19. Optimizing the 6-min walk test as a measure of exercise capacity in COPD.

    PubMed

    Chandra, Divay; Wise, Robert A; Kulkarni, Hrishikesh S; Benzo, Roberto P; Criner, Gerard; Make, Barry; Slivka, William A; Ries, Andrew L; Reilly, John J; Martinez, Fernando J; Sciurba, Frank C

    2012-12-01

    It is uncertain whether the effort and expense of performing a second walk for the 6-min walk test improves test performance. Hence, we attempted to quantify the improvement in 6-min walk distance if an additional walk were to be performed. We studied patients consecutively enrolled into the National Emphysema Treatment Trial who prior to randomization and after 6 to 10 weeks of pulmonary rehabilitation performed two 6-min walks on consecutive days (N = 396). Patients also performed two 6-min walks at 6-month follow-up after randomization to lung volume reduction surgery (n = 74) or optimal medical therapy (n = 64). We compared change in the first walk distance to change in the second, average-of-two, and best-of-two walk distances. Compared with the change in the first walk distance, change in the average-of-two and best-of-two walk distances had better validity and precision. Specifically, 6 months after randomization to lung volume reduction surgery, changes in the average-of-two (r = 0.66 vs r = 0.58, P = .01) and best-of-two walk distances (r = 0.67 vs r = 0.58, P = .04) better correlated with the change in maximal exercise capacity (ie, better validity). Additionally, the variance of change was 14% to 25% less for the average-of-two walk distances and 14% to 33% less for the best-of-two walk distances than the variance of change in the single walk distance, indicating better precision. Adding a second walk to the 6-min walk test significantly improves its performance in measuring response to a therapeutic intervention, improves the validity of COPD clinical trials, and would result in a 14% to 33% reduction in sample size requirements. Hence, it should be strongly considered by clinicians and researchers as an outcome measure for therapeutic interventions in patients with COPD.

  20. Validation of a single-stage submaximal treadmill walking test.

    PubMed

    Waddoups, Lindsey; Wagner, Dale; Fallon, Jennifer; Heath, Edward

    2008-03-01

    The single-stage treadmill walking test of Ebbeling et al. is commonly used to predict maximal oxygen consumption (.VO(2max)) from a submaximal effort between 50% and 70% of the participant's age-predicted maximum heart rate. The purpose of this study was to determine if this submaximal test correctly predicts .VO(2max) at the low (50% of maximum heart rate) and high (70% of maximum heart rate) ends of the specified heart rate range for males and females aged 18 - 55 years. Each of the 34 participants completed one low-intensity and one high-intensity trial. The two trials resulted in significantly different estimates of .VO(2max) (low-intensity trial: mean 40.5 ml . kg(-1) . min(-1), s = 9.3; high-intensity trial: 47.5 ml . kg(-1) . min(-1), s = 8.8; P < 0.01). A subset of 22 participants concluded their second trial with a .VO(2max) test (mean 47.9 ml . kg(-1) . min(-1), s = 8.9). The low-intensity trial underestimated (mean difference = -3.5 ml . kg(-1) . min(-1); 95% CI = -6.4 to -0.6 ml . kg(-1) . min(-1); P = 0.02) and the high-intensity trial overestimated (mean difference = 3.5 ml . kg(-1) . min(-1); 95% CI = 1.1 to 6.0 ml . kg(-1) . min(-1); P = 0.01) the measured .VO(2max). The predictive validity of Ebbeling and colleagues' single-stage submaximal treadmill walking test is diminished when performed at the extremes of the specified heart rate range.

  1. Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test

    PubMed Central

    Brach, Jennifer S.; Piva, Sara R.; VanSwearingen, Jessie M.

    2010-01-01

    Background The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life. Objective The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure. Design Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study. Methods The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed. Results Figure-of-8 Walk Test time correlated with gait (gait speed, r=−.570; GARS-M, r=.281), physical function (LLFDI function, r=−.469; SAFFE restriction subscale, r=.370; PPT, r=−.353), confidence in walking (GES, r=−.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=−.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=−.339) and was related to fear of falling (t=−2.50). All correlations were significant (P<.05). Limitations This pilot study had a small sample size, and further research is needed. Conclusions The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed

  2. Effect of the 6-minute walk test on plantar loading and capability to produce ankle plantar flexion forces.

    PubMed

    Vie, Bruno; Griffon, Patricia; Bijoux, Audrey; Cadiere, Julie; Weber, Jean Paul; Jammes, Yves

    2016-09-01

    The six-minute walk test (6MWT) is used to evaluate the ambulatory capacity of patients suffering from respiratory disorders, obesity or neuromuscular diseases. Our primary aim was to evaluate the effects of the 6MWT on the postural sway and the ankle plantar flexion forces in healthy subjects. We measured the ankle plantar flexion forces and the plantar contact area before and after a 6MWT in normal weight and overweight subjects with no history of respiratory, cardiac, and neuromuscular disorders. A post-6MWT sensation of bodily fatigue was evaluated by Multidimensional Fatigue Inventory (MFI) and Pichot fatigue scales. A computerized pedobarographic platform was used to collect the mean plantar contact area, the changes of the center of pressure (CoP) surface and its medial and lateral deviations. In a limited number of subjects, the reproducibility of all the measurements was explored. In both groups, the 6MWT elicited a sensation of bodily fatigue. It also significantly reduced the ankle plantar flexion forces, and increased both the mean plantar contact area and the CoP surface, the changes being not apparent after 10min. The post-6MWT lateral CoP deviations were accentuated in normal weight subjects, while an increase in medial CoP deviations occurred in overweight ones. The 6MWT-induced changes in the plantar flexion force and pedobarographic variables were reproducible. Because this study clearly showed some post-6MWT alterations of the subjects' posture sway of our subjects, we questioned the possible mechanisms occurring that could explain the altered muscle force and the transient destabilization of posture after the 6MWT.

  3. Physical activity, functional capacity, and step variability during walking in people with lower-limb amputation.

    PubMed

    Lin, Suh-Jen; Winston, Katie D; Mitchell, Jill; Girlinghouse, Jacob; Crochet, Karleigh

    2014-01-01

    Physical activity is important for general health. For an individual with amputation to sustain physical activity, certain functional capacity might be needed. Gait variability is related to the incidence of falls. This study explored the relationship between physical activity and a few common performance measures (six-minute walk test, step length variability, step width variability, and comfortable walking speed) in individuals with unilateral lower-limb amputation. Twenty individuals completed the study (age: 50±11yrs). Twelve of them had transtibial amputation, seven had transfemoral amputation, and one had through-knee amputation. Gait data was collected by the GaitRite instrumented walkway while participants performed a 3-min comfortable walking trial followed by a six-minute walk test. Physical activity was indicated by the mean of 7-day step counts via a pedometer. Gait variability was calculated by the coefficient of variation. Pearson correlation analysis was conducted between physical activity level and the 4 performance measures. Significance level was set at 0.05. Physical activity correlates strongly to comfortable walking speed (r=0.76), six-minute walk distance (r=0.67), and correlates fairly to step width variability (r=0.44). On the contrary, physical activity is inversely related to step length variability of the prosthetic leg (r=-0.46) and of the sound leg (r=-0.47). Having better functional capacity and lateral stability might enable an individual with lower-limb amputation to engage in a higher physical activity level, or vise versa. However, our conclusions are only preliminary as limited by the small sample size.

  4. Walking capacity of children with clubfeet in primary school: something to worry about?

    PubMed

    Lohle-Akkersdijk, Jacqueline J; Rameckers, Eugene A A; Andriesse, Hanneke; de Reus, Ingeborg; van Erve, Ruud H G P

    2015-01-01

    Although the main aim of clubfoot correction is to create a foot without limitations in daily activities and sport, studies on the walking capacity of children with corrected clubfeet are rare. In this cross-sectional study, the outcome of the six-minute walking test in 44 children with clubfeet (16 unilateral and 28 bilateral, mean age 8.57±2.45 years) was compared with the reference values of Geiger, clinical status measured with the Clubfoot Assessment Protocol (CAP), and regression analysis used to calculate which CAP subgroup predicts walking capacity. The mean walking capacity was decreased to 79% (P<0.001) and was not influenced by unilaterality or bilaterality (P=0.437). The subgroup CAP morphology was a significant predictor (R=0.103; P=0.034). Knowing that walking capacity is only slightly decreased can help adjust expectations and set goals for training.

  5. Effect of intensive aerobic exercise on respiratory capacity and walking ability with chronic stroke patients: a randomized controlled pilot trial

    PubMed Central

    Bang, Dae-Hyouk; Son, Young-Lan

    2016-01-01

    [Purpose] To investigate the effects of intensive aerobic exercise on respiratory capacity and walking ability in chronic stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received intensive aerobic exercise for 30 minutes and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. The comparison of the two groups after the intervention revealed that the experimental group showed more significant improvements in the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. There was no significant difference in saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] The results of this study suggest that intensive aerobic exercise has a positive effect on respiratory capacity and walking endurance in patients with chronic stroke. PMID:27630438

  6. Sideways walk test: Reliability and association with lower limb motor function after stroke.

    PubMed

    Ng, Shamay S M; Lau, Bobby K C; Law, Gilbert T C; Wom, Choco W K; Liu, Tai-Wa; Tam, Eric W C; Tse, Mimi M Y; Fong, Shirley S M

    2016-10-05

    To investigate (i) the intra-rater, inter-rater and test-retest reliability of sideways walk test times and counts in individuals with stroke; (ii) their correlations with stroke-specific measures of impairment; (iii) the cut-off sideways walk test times and counts between stroke survivors and healthy controls; and (iv) the minimum detectable changes in the sideways walk test times and counts. Cross-sectional study. University-based rehabilitation centre. Twenty-nine older adults with stroke and 32 healthy controls. The sideways walk test was conducted together with Fugl-Meyer motor assessments of the lower extremities, lower limb muscle strength tests, the Five-Times-Sit-To-Stand test, Berg Balance Scale, Timed Up-and-Go test, and Activity-based Confidence and Community Integration Measure questionnaires. The sideways walk test times and counts demonstrated good to excellent intra-rater, inter-rater, and test-retest reliabilities. The sideways walk test times and counts were significantly correlated with motor control and ankle dorsiflexor and plantarflexor strength of the affected leg, balance performance and functional mobility. The cut-off sideways walk test time and count that best discriminated between individuals with stroke and controls were 10.74 s and 8.83 steps, respectively. The minimal detectable change in the sideways walk test time in that situation was 1.85 s, and the count minimum detectable change was 1.12 steps. The sideways walk test is a reliable and easy-to-administer clinical test for assessing sideways walking ability of individuals with chronic stroke.

  7. Sharpening the Tandem Walking Test for Screening Peripheral Neuropathy

    PubMed Central

    Cohen, Helen S.; Mulavara, Ajitkumar P.; Peters, Brian T.; Sangi-Haghpeykar, Haleh; Kung, Doris H.; Mosier, Dennis R.; Bloomberg, Jacob J.

    2013-01-01

    Objective Few tests of functional motor behavior are useful for rapidly screening people for lower extremity peripheral neuropathy. The goal of this study was to improve the widely used Tandem Walking test (TW). Methods We tested adult normals and ambulatory peripheral neuropathy patients (PN) with eyes open and eyes closed, while they performed TW on industrial carpeting, in sock-covered feet. Each subject wore a torso-mounted inertial motion unit to measure kinematic data. PN subjects’ data were also compared to historical data on patients with vestibular impairments (VI). Results The normal and PN groups differed significantly on TW on the number of steps completed. PN and VI data also differed significantly on both visual conditions. Kinematic data showed that PN patients were more unstable than normals. For the number of steps taken during the eyes open condition receiver operating characteristic (ROC) values were only 0.81. For the number of steps taken during the eyes closed condition, however, ROC=0.88. Although not optimal, this ROC value is better. Sensitivity and specificity at a cut-off of 2 steps were 0.81 and 0.92, respectively, and at a cut-off of 3 steps was 0.86 and 0.75, respectively. ROC values for kinematic data were all < 0.8 and, when combined with the ROC value for the number of steps, the total ROC value did not improve appreciably. Conclusions Although not ideal for screening patients who may have peripheral neuropathy, counting the number of steps during TW is a quick and useful clinical test. TW is most sensitive to peripheral neuropathy patients when they are tested with eyes closed. PMID:24096950

  8. Sharpening the tandem walking test for screening peripheral neuropathy.

    PubMed

    Cohen, Helen S; Mulavara, Ajitkumar P; Peters, Brian T; Sangi-Haghpeykar, Haleh; Kung, Doris H; Mosier, Dennis R; Bloomberg, Jacob J

    2013-10-01

    Few tests of functional motor behavior are useful for rapidly screening people for lower extremity peripheral neuropathy. The goal of this study was to improve the widely used tandem walking (TW) test. We tested "normal" (control) adult and ambulatory patients with peripheral neuropathy (PN) with their eyes open and eyes closed while they performed TW on industrial carpeting in sock-covered feet. Each subject wore a torso-mounted inertial motion unit to measure kinematic data. The data of subjects with PN also were compared with historical data on patients with vestibular impairments. The normal and PN groups differed significantly on TW and on the number of steps completed. PN and vestibular impairments data also differed significantly on both visual conditions. Kinematic data showed that patients with PN were more unstable than normal patients in the group. For the number of steps taken during the eyes open condition, receiver operating characteristic (ROC) values were only 0.81 and for the number of steps taken during the eyes closed condition, ROC values were 0.88. Although not optimal, this ROC value is better. Sensitivity and specificity at a cutoff of two steps were 0.81 and 0.92, respectively, and at a cutoff of three steps were 0.86 and 0.75, respectively. ROC values for kinematic data were <0.8, and when combined with the ROC value for the number of steps, the total ROC value did not improve appreciably. Although not ideal for screening patients who may have PN, counting the number of steps during TW is a quick and useful clinical test. TW is most sensitive to patients with PN when they are tested with eyes closed.

  9. Prevalence of Walking-Related Motor Fatigue in Persons With Multiple Sclerosis: Decline in Walking Distance Induced by the 6-Minute Walk Test.

    PubMed

    Leone, Carmela; Severijns, Deborah; Doležalová, Vendula; Baert, Ilse; Dalgas, Ulrik; Romberg, Anders; Bethoux, Francois; Gebara, Benoit; Santoyo Medina, Carmen; Maamâgi, Heigo; Rasova, Kamila; Maertens de Noordhout, Benoît; Knuts, Kathy; Skjerbaek, Anders; Jensen, Ellen; Wagner, Joanne M; Feys, Peter

    2016-05-01

    To investigate the individual occurrence of walking-related motor fatigue in persons with multiple sclerosis (PwMS), according to disability level and disease phenotype.Study design This was a cross-sectional, multinational study.Participants They were 208 PwMS from 11 centers with Expanded Disability Status Scale (EDSS) scores up to 6.5. The percentage change in distance walked (distance walked index, DWI) was calculated between minute 6 and 1 (DWI(6-1)) of the 6-Minute Walk Test (6MWT). Its magnitude was used to classify participants into 4 subgroups: (1) DWI(6-1)[≥5%], (2) DWI(6-1)[5%; -5%], (3) DWI(6-1)[-5%; > -15%], and (4) DWI(6-1)[≤-15%]. The latter group was labeled as having walking-related motor fatigue. PwMS were stratified into 5 subgroups based on the EDSS (0-2.5, 3-4, 4.5-5.5, 6, 6.5) and 3 subgroups based on MS phenotype (relapsing remitting [RR], primary progressive [PP], and secondary progressive [SP]). The DWI6-1was ≥5% in 16 PwMS (7.7%), between 5% and -5% in 70 PwMS (33.6%), between -5% and -15% in 58 PwMS (24%), and ≤-15% in 64 PwMS (30.8%). The prevalence of walking-related motor fatigue (DWI(6-1)[≤-15%]) was significantly higher among the progressive phenotype (PP = 50% and SP = 39%; RR = 15.6%) and PwMS with higher disability level (EDSS 4.5-5.5 = 48.3%, 6 = 46.3% and 6.5 = 51.5%, compared with EDSS 0-2.5 = 7.8% and 3-4 = 16.7%;P< .05). Stepwise multiple regression analysis indicated that EDSS, but not MS phenotype, explained a significant part of the variance in DWI(6-1)(R(2)= 0.086;P< .001). More than one-third of PwMS showed walking-related motor fatigue during the 6MWT, with its prevalence greatest in more disabled persons (up to 51%) and in those with progressive MS phenotype (up to 50%). Identification of walking-related motor fatigue may lead to better-tailored interventions. © The Author(s) 2015.

  10. Multidirectional walk test in individuals with Parkinson's disease: a validity study.

    PubMed

    Bryant, Mon S; Workman, Craig D; Jackson, George R

    2015-03-01

    Gait parameters of forward, backward, and sideways walk were studied when the participants walked overground in four directions at their self-selected speed and were compared with walking in the four directions on an instrumented GAITRite walkway. Intraclass correlation coefficients between the overground walk test measures and the instrumented walkway measures of gait speed, cadence, and stride length for the forward walk were 0.85, 0.88, and 0.87, respectively. For the backward walk, the coefficients were 0.91 for gait speed, 0.75 for cadence, and 0.93 for stride length. For the sideways walk, the coefficients were 0.92 for gait speed, 0.93 for cadence, and 0.94 for stride length. Gait parameters of forward, backward, and sideways walk obtained by the overground walk test had excellent agreement with those obtained by the instrumented walkway. The quick timed test provided quantitative data for gait evaluation and was valid for clinical use.

  11. Psychometric properties of 2-minute walk test: a systematic review.

    PubMed

    Pin, Tamis W

    2014-09-01

    To systematically review the psychometric evidence on the 2-minute walk test (2MWT). Electronic searches of databases including MEDLINE, CINAHL, Academic Search Premier, SPORTDiscus, PsycINFO, EMBASE, the Cochrane Library, and DARE were done until February 2014 using a combination of subject headings and free texts. Studies were included if psychometric properties of the 2MWT were (1) evaluated; (2) written as full reports; and (3) published in English language peer-reviewed journals. A modified consensus-based standard for the selection of health measurement instruments checklist was used to rate the methodological quality of the included studies. A quality assessment for statistical outcomes was used to assess the measurement properties of the 2MWT. Best-evidence synthesis was collated from 25 studies of 14 patient groups. Only 1 study was found that examined the 2MWT in the pediatric population. The testing procedures of the 2MWT varied across the included studies. Reliability, validity (construct and criterion), and responsiveness of the 2MWT also varied across different patient groups. Moderate to strong evidence was found for reliability, convergent validity, discriminative validity, and responsiveness of the 2MWT in frail elderly patients. Moderate to strong evidence for reliability, convergent validity, and responsiveness was found in adults with lower limb amputations. Moderate to strong evidence for validity (convergent and discriminative) was found in adults who received rehabilitation after hip fractures or cardiac surgery. Limited evidence for the psychometric properties of the 2MWT was found in other population groups because of methodological flaws. There is inadequate breadth and depth of psychometric evidence of the 2MWT for clinical and research purposes-specifically, minimal clinically important changes and responsiveness. More good-quality studies are needed, especially in the pediatric population. Consensus on standardized testing procedures of

  12. Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy.

    PubMed

    Kane, Kyra J; Lanovaz, Joel; Bisaro, Derek; Oates, Alison; Musselman, Kristin E

    2016-01-01

    Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function-the Obstacles and Curb tests-relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy. A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test-retest reliability. At fast speeds, all tests showed discriminative validity (p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81-0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73-0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test-retest reliability for tests performed at fast speeds rather than self-selected speeds. The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test-retest reliability for children with spina bifida/cerebral palsy.

  13. Effect of inspiratory muscle training on respiratory capacity and walking ability with subacute stroke patients: a randomized controlled pilot trial

    PubMed Central

    Jung, Kyeong-Man; Bang, Dae-Hyouk

    2017-01-01

    [Purpose] To investigate the effects of inspiratory muscle training on respiratory capacity and walking ability in subacute stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received inspiratory muscle training for 30 minutes (six sets of five-minutes) and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. There were significant between-group differences for the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. No statistically significant differences were observed for measures of saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] These findings gave some indications that inspiratory muscle training may benefit in patients with subacute stroke, and it is feasible to be included in rehabilitation program with this population. PMID:28265169

  14. Effect of inspiratory muscle training on respiratory capacity and walking ability with subacute stroke patients: a randomized controlled pilot trial.

    PubMed

    Jung, Kyeong-Man; Bang, Dae-Hyouk

    2017-02-01

    [Purpose] To investigate the effects of inspiratory muscle training on respiratory capacity and walking ability in subacute stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received inspiratory muscle training for 30 minutes (six sets of five-minutes) and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. There were significant between-group differences for the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. No statistically significant differences were observed for measures of saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] These findings gave some indications that inspiratory muscle training may benefit in patients with subacute stroke, and it is feasible to be included in rehabilitation program with this population.

  15. Knuckle-walking anteater: a convergence test of adaptation for purported knuckle-walking features of African Hominidae.

    PubMed

    Orr, Caley M

    2005-11-01

    Appeals to synapomorphic features of the wrist and hand in African apes, early hominins, and modern humans as evidence of knuckle-walking ancestry for the hominin lineage rely on accurate interpretations of those features as adaptations to knuckle-walking locomotion. Because Gorilla, Pan, and Homo share a relatively close common ancestor, the interpretation of such features is confounded somewhat by phylogeny. The study presented here examines the evolution of a similar locomotor regime in New World anteaters (order Xenarthra, family Myrmecophagidae) and uses the terrestrial giant anteater (Myrmecophaga tridactyla) as a convergence test of adaptation for purported knuckle-walking features of the Hominidae. During the stance phase of locomotion, Myrmecophaga transmits loads through flexed digits and a vertical manus, with hyperextension occurring at the metacarpophalangeal joints of the weight-bearing rays. This differs from the locomotion of smaller, arboreal anteaters of outgroup genera Tamandua and Cyclopes that employ extended wrist postures during above-branch quadrupedality. A number of features shared by Myrmecophaga and Pan and Gorilla facilitate load transmission or limit extension, thereby stabilizing the wrist and hand during knuckle-walking, and distinguish these taxa from their respective outgroups. These traits are a distally extended dorsal ridge of the distal radius, proximal expansion of the nonarticular surface of the dorsal capitate, a pronounced articular ridge on the dorsal aspects of the load-bearing metacarpal heads, and metacarpal heads that are wider dorsally than volarly. Only the proximal expansion of the nonarticular area of the dorsal capitate distinguishes knuckle-walkers from digitigrade cercopithecids, but features shared with digitigrade primates might be adaptive to the use of a vertical manus of some sort in the stance phase of terrestrial locomotion. The appearance of capitate nonarticular expansion and the dorsal ridge of the

  16. Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy

    PubMed Central

    Kane, Kyra J; Lanovaz, Joel; Bisaro, Derek; Oates, Alison; Musselman, Kristin E

    2016-01-01

    Objective: Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function—the Obstacles and Curb tests—relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy. Methods: A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test–retest reliability. Results: At fast speeds, all tests showed discriminative validity (p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81–0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73–0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test–retest reliability for tests performed at fast speeds rather than self-selected speeds. Conclusion: The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test–retest reliability for children with spina bifida/cerebral palsy. PMID:27493754

  17. Which walking capacity tests to use in multiple sclerosis? A multicentre study providing the basis for a core set.

    PubMed

    Gijbels, Domien; Dalgas, Ulrik; Romberg, Anders; de Groot, Vincent; Bethoux, Francois; Vaney, Claude; Gebara, Benoit; Medina, Carme Santoyo; Maamâgi, Heigo; Rasova, Kamila; de Noordhout, Benoit Maertens; Knuts, Kathy; Feys, Peter

    2012-03-01

    Many different walking capacity test formats are being used. It is unclear whether walking speed, obtained from short tests, and walking distance, obtained from long tests, provide different clinical information. To determine the differential effect of various short and long walk test formats on gait velocity, and the actual relationship between walking speed and walking distance in multiple sclerosis (MS) patients with diverse ambulation status. A cross-sectional multicentre study design was applied. Ambulatory MS patients (Expanded Disability Status Scale (EDSS) 0-6.5; n = 189) were tested at 11 sites. Short tests consisted of the Timed 25-Foot Walk (static start, fastest speed) and 10-Metre Walk Test (dynamic start, usual and fastest speed). Long tests consisted of the 2- and 6-Minute Walk Tests (fastest speed). Subjects were divided into mild (EDSS 0-4; n = 99) or moderate (EDSS 4.5-6.5; n = 79) disability subgroups. In both subgroups, the start protocol, instructed pace and length of test led to significantly different gait velocities. Fastest walking speed and 6-Minute walking distance showed the strongest correlation (R (2) = 0.78 in mild and R (2) = 0.81 in moderate MS; p < 0.01). Short tests' relative estimation errors for 6-Minute walking distance were 8-12% in mildly and 15-16% in moderately affected subjects. Based on the 2-Minute Walk Test, estimation errors significantly reduced to approximately 5% in both subgroups. A single short test format at fastest speed accurately describes an MS patient's general walking capacity. For intervention studies, a long test is to be considered. We propose the Timed 25-Foot Walk and 2-Minute Walk Test as standards. Further research on responsiveness is needed.

  18. A Straightforward Random Walk Model for Fast Push-Pull Tracer Test Evaluation.

    PubMed

    Klotzsch, Stephan; Binder, Martin; Händel, Falk

    2017-01-01

    In this article, we present a straightforward random walk model for fast evaluation of push-pull tracer tests. By developing an adaptive algorithm, we overcome the problem of manually defining how many particles have to be used to simulate the transport problem. Beside this, we validate the random walk model by evaluating a push-pull tracer test with drift phase and confirm the results with MT3DMS. The random walk model took less than 1% of computational time of MT3DMS, thus allowing a remarkable faster evaluation of push-pull tracer tests. © 2016, National Ground Water Association.

  19. Test-retest reliability and sensitivity of the 20-meter walk test among patients with knee osteoarthritis.

    PubMed

    Motyl, Jillian M; Driban, Jeffrey B; McAdams, Erica; Price, Lori Lyn; McAlindon, Timothy E

    2013-05-10

    The 20-meter walk test is a physical function measure commonly used in clinical research studies and rehabilitation clinics to measure gait speed and monitor changes in patients' physical function over time. Unfortunately, the reliability and sensitivity of this walk test are not well defined and, therefore, limit our ability to evaluate real changes in gait speed not attributable to normal variability. The aim of this study was to assess the test-restest reliability and sensitivity of the 20-meter walk test, at a self-selected pace, among patients with mild to moderate knee osteoarthritis (OA) and to suggest a standardized protocol for future test administration. This was a measurement reliability study. Fifteen consecutive people enrolled in a randomized-controlled trial of intra-articular corticosteroid injections for knee OA participated in this study. All participants completed 4 trials on 2 separate days, 7 to 21 days apart (8 trials total). Each day was divided into 2 sessions, which each involved 2 walking trials. We compared walk times between trials with Wilcoxon signed-rank tests. Similar analyses compared average walk times between sessions. To confirm these analyses, we also calculated Spearman correlation coefficients to assess the relationship between sessions. Finally, smallest detectable differences (SDD) were calculated to estimate the sensitivity of the 20-meter walk test. Wilcoxon signed-rank tests between trials within the same session demonstrated that trials in session 1 were significantly different and in the subsequent 3 sessions, the median differences between trials were not significantly different. Therefore, the first session of each day was considered a practice session, and the SDD between the second session of each day were calculated. SDD was -1.59 seconds (walking slower) and 0.15 seconds (walking faster). Practice trials and a standardized protocol should be used in administration of the 20-meter walk test. Changes in walk time

  20. Self-reported walking ability in persons with chronic stroke and the relationship with gait performance tests.

    PubMed

    Brogårdh, Christina; Flansbjer, Ulla-Britt; Lexell, Jan

    2012-10-01

    To assess self-reported walking ability in individuals with chronic stroke and to determine the relationship with gait performance tests. Descriptive analysis of a convenience sample. A university hospital rehabilitation medicine clinic. Fifty ambulatory community-dwelling poststroke individuals (mean age, 64 years [range, 44-74 years] and mean time since stroke onset 42 months [range, 6-101 months]). The Walking Impact Scale (the Walk-12) to assess self-reported walking ability, and the Timed "Up & Go" test, 10-m Comfortable Gait Speed and Fast Gait Speed tests, and 6-Minute Walk Test to assess gait performance. A majority of the participants (94%) reported limitations in their walking ability. The most common limitations were related to standing or walking, walking speed and distance, effort, and gait quality aspects. The ability to run was reported as most affected, whereas the need for support indoors or outdoors was least affected. Significant correlations (P < .01) were found between the Walk-12 and the 4 gait performance tests (ρ = -0.60 to 0.60). Persons with chronic stroke perceive limitations in their walking ability. The relationship between the Walk-12 and the 4 gait performance tests indicates that self-reports and quantitative assessments are associated. Because the Walk-12 reflects broader dimensions than the gait performance tests, it can be a complementary tool when walking ability in persons with chronic stroke is evaluated. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  1. [Efficiency as a new parameter of physical fitness of patients in 6-minute-walk-test].

    PubMed

    Marek, E M; Friz, Y; Pohl, W; Vogel, P; Mückenhoff, K; Kotschy-Lang, N; Marek, W

    2011-04-01

    AIMS OF THE INVESTIGATION: The 6-minute-walk-test (6-MWT) is an effective tool for measuring physical fitness in elderly patients. The increased walking distance is taken as a parameter for improved physical conditions. Frequently an unaltered walking distance is found after participation in a rehabilitation measure, but heart rate is significantly lower in the second challenge, indicating an improved physical fitness. This positive effect is not recognized when only the walking distance is considered. We therefore carried out a retrospective analysis of the 6-MWT tests performed by 303 male patients (69.2 ± 8.7 years) before and after 3-4 weeks of clinical rehabilitation. Instrumented by a mobile pulse oximeter for recording oxygen saturation and heart rate, patients were instructed at the outset and at the end of their rehabilitation stay to walk as fast as they could during 6 min. Measurements were performed every 30 s and printed. A new parameter, efficiency (E = S/6/f (C)) was introduced: the ratio of the walking distance, S, divided by 6 min and divided by the mean heart frequency, f (C) (beats/minute). The patients group walked 351 ± 79 m at 106.2 ± 12.7 beats/min in the initial 6-MWT and 362 ± 76.0 m at a heart rate of 104.0 ± 12.2 beats/min in the final test. Along with the increase in walking distance, efficiency E increased from 0.56 ± 0.13 m/beat to 0.59 ± 0.12 m/beat. Efficiency significantly correlates with the walking distance (p < 0.01). 54 patients (18%) had an increased efficiency in the final test at the end of rehabilitation although they walked a shorter distance compared to the initial test value: they walked with a lower heart frequency. The patient's performance of the second walk test with an unchanged distance at a lower heart frequency reveals an improved physical fitness. This is solely described by an increase of the parameter of efficiency, E. Calculation of this parameter delivers a quantification of the effect of exercise

  2. The 6-Minute Walk Test and Person-Reported Outcomes in Boys with Duchenne Muscular Dystrophy and Typically Developing Controls: Longitudinal Comparisons and Clinically-Meaningful Changes Over One Year

    PubMed Central

    Henricson, Erik; Abresch, Richard; Han, Jay J.; Nicorici, Alina; Goude Keller, Erica; de Bie, Evan; McDonald, Craig M.

    2013-01-01

    Introduction: Data is currently lacking anchoring a 30-meter longitudinal change in walking ability by 6-minute walk test (6MWT) in Duchenne muscular dystrophy as a minimal clinically important difference and “clinically meaningful” person-reported outcomes (PROs) at differing levels of ambulatory ability. Methods: We describe correlation between measures, 1-year change in measures, and correlation of 1-year changes between measures for the six-minute walk test (6MWT), 10-meter run/walk velocity, PedsQL and POSNA Pediatric Outcomes Data Collection Instrument (PODCI) in 24 4-12 year old. ambulatory DMD and 36 typical controls, and determine if minimal clinically important differences (MCID) of PROs contribute to different estimates of 6-minute walk distance (6MWD) change at differing levels of ability. Results: PedsQL total and physical function and PODCI global, transfer/mobility and sports/physical function PROs demonstrated significant differences between DMD and controls (p<0.00001). In DMD, 6MWD and 10-meter run/walk velocity were correlated with PODCI domain scores, with the transfer/mobility scale showing the strongest relationship (r=0.79 and r=0.76). In DMD, 6MWD distance and 10-meter run/walk velocity weakly correlated with PedsQL domain scores. In DMD, 6MWD, 10-meter run/walk velocity, and PODCI global and transfer and basic mobility demonstrated significant one-year change and exceeded the amount of change representing MCID. In DMD, 6MWD change highly correlated with change in PODCI global and PODCI transfer/mobility scores (r=0.76 and r=0.93). PODCI global and PODCI transfer/mobility scales provided the best estimates of 6MWT performance. A “meaningful” 4.5 point change in a low PODCI transfer / basic mobility score of 30 to 34.5 was associated with a 5.6m 6MWD change from 150.3 to 155.9m. At PODCI levels closer to normative levels for healthy controls, the change in 6MWD distance associated with a “meaningful” change in PODCI scores was

  3. Exploring adaptations to the modified shuttle walking test

    PubMed Central

    Woolf-May, Kate; Meadows, Steve

    2013-01-01

    Objective The 10 m modified shuttle walking test (MSWT) is recommended to determine the functional capacity in older individuals and for patients entering cardiac rehabilitation. Participants are required to negotiate around cones set 1 m from the end markers. However, consistent comments indicate that for some individuals manoeuvring around the cones can be quite difficult. Therefore, the objective of this study was to explore differences within and between non-cardiac and postmyocardial infarction (MI) males during MSWT with and without the cones. Design Comparative study. Participants 20 post-MI (64.8±6.6, range 51–74 years) and 20 non-cardiac male controls (64.1±5.7, range 52–74 years) participated. Methods Participants performed MSWT with and without cones. Throughout, the participants expired air, and the heart rate (bpm) (HR) and ratings of perceived exertion (RPE) were measured. Participant protocol preference was recorded verbatim. Results One-way analysis of variance found no significant difference in VO2 peak (cones 20.4±5.1 vs no-cones 21.9±4.8 ml/kg/min, p=0.197) or distance ambulated (cones 631.8±132.9 m vs no-cones 662.4±164.1 m, p=0.371) between protocols or groups. Analysis comparing lines of regression showed a significant trajectory difference in VO2 (ml/kg/min) (p<0.01) between protocols with higher HR (p<0.01) and respiratory exchange ratio (RER, p<0.001) values during cones. RPEs were higher for post-MIs versus controls during both protocols (p<0.05). Post-MIs taking β-blockers produce significantly lower HR values. The χ2 analysis found no significant difference in protocol preference (no-cones: all n=25, 63%; post-MIs n=13, 65%; and controls n=12, 60%). Conclusions Post-MIs found both protocols subjectively harder than controls with no significant difference in the VO2 peak. However, both groups worked at a lesser percentage of their anaerobic threshold during no-cones protocol as indicated by lower RER values

  4. Reference values for the incremental shuttle walk test in healthy subjects: from the walk distance to physiological responses *,**

    PubMed Central

    Dourado, Victor Zuniga; Guerra, Ricardo Luís Fernandes; Tanni, Suzana Erico; Antunes, Letícia Cláudia de Oliveira; Godoy, Irma

    2013-01-01

    OBJECTIVE: To determine reference values for incremental shuttle walk distance (ISWD) and peak physiological responses during the incremental shuttle walk test (ISWT), as well as to develop a series of predictive equations for those variables in healthy adults. METHODS: We evaluated 103 healthy participants ≥ 40 years of age (54 women and 49 men). We fitted each participant with a gas analysis system for use during the ISWT. Oxygen consumption (VO2), carbon dioxide production, minute ventilation, heart rate (HR), ISWD, and maximal walking velocity (MWV) were obtained as primary outcomes. We also assessed hand grip strength (HGS) and lean body mass (LBM). RESULTS: The regression analysis models, including physiological variables, ISWD, and MWV (adjusted for age, body mass, height, and sex), produced R2 values ranging from 0.40 to 0.65 (for HR and peak VO2, respectively). Using the models including LBM or HGS, we obtained no significant increase in the R2 values for predicting peak VO2, although the use of those models did result in slight increases in the R2 values for ISWD and MWV (of 8% and 12%, respectively). The variables ISWD, MWV, and ISWD × body mass, respectively, explained 76.7%, 73.3%, and 81.2% of peak VO2 variability. CONCLUSIONS: Our results provide reference values for ISWD and physiological responses to the ISWT, which can be properly estimated by determining simple demographic and anthropometric characteristics in healthy adults ≥ 40 years of age. The ISWT could be used in assessing physical fitness in the general adult population and in designing individualized walking programs. PMID:23670504

  5. Effects of home-based pulmonary rehabilitation with a metronome-guided walking pace in chronic obstructive pulmonary disease.

    PubMed

    Lee, Sung-soon; Kim, Changhwan; Jin, Young-Soo; Oh, Yeon-Mok; Lee, Sang-Do; Yang, Yun Jun; Park, Yong Bum

    2013-05-01

    Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P < 0.001) over the six-month follow-up period after rehabilitation. There were no significant differences in pulmonary function and peak exercise parameters. We developed an effective home-based PR program with a metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.

  6. The Walking Trail-Making Test is an early detection tool for mild cognitive impairment

    PubMed Central

    Perrochon, Anaick; Kemoun, Gilles

    2014-01-01

    Background Executive function impairment (in particular, mental flexibility) in the elderly, and in patients with mild cognitive impairment (MCI), is strongly correlated with difficulties in performing complex walking tasks. The aim of this study was to determine if the adaptation of a neuropsychological test (the Trail-Making Test), to evaluate executive functions during walking, can be an early detection tool for cognitive impairment. Methods Fifty subjects (15 young, 20 older, presumably healthy, and 15 MCI) were first evaluated for cognitive functions (Mini-Mental State Examination, Frontal Assessment Battery, and Trail-Making Test) and motor functions (10-meter walking test). All subjects then performed a spatial navigation, or a complex walking test (the Walking Trail-Making Test: [WTMT]), and their spatiotemporal walking variables were analyzed using cluster analysis. Results Following evaluation of WTMT locomotor performance, cluster analysis revealed three groups that were distinctly different in age and cognitive abilities: a group of young subjects, a group of healthy older subjects, MCI subjects with amnestic impairment, and a group of MCI subjects with executive function impairment. The WTMT enabled early detection, (ie, borderline MCI) of dysexecutive impairment, with 78% sensitivity and 90% specificity. Conclusion The WTMT is of interest in that it can help provide early detection of dysexecutive cognitive impairment. PMID:24426778

  7. 10 CFR 431.304 - Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in freezers. 431.304 Section 431.304 Energy DEPARTMENT OF ENERGY... measuring, pursuant to EPCA, the energy consumption of refrigerated bottled or canned beverage vending...

  8. Early cycling test as a predictor of walking performance in stroke patients.

    PubMed

    Michal, Katz-Leurer; Shochina, Mara

    2005-01-01

    To assess the relative contribution and the predictive value of an early cycling test to walking performance three months after stroke. This follow-up study included subjects who were inpatients after afirst stroke (n=44). A cycling test was performed at the beginning of rehabilitation, followed by three-months' post-stroke evaluation of walking performance. The independent variables were the ability to cycle at constant rhythm of 50 rpm, without and with resistance, lower extremity motor strength and walking function, scored by the Scandinavian Stroke Scale. Dependent variables were gait velocity, distance and stair-climbing three months after stroke. Multiple linear regression analysis demonstrated that rhythmic, constant cycling is the best predictor of walking velocity (r2 = 0.4), gait distance (r2 = 0.2) and number of stairs climbed (r2 = 0.26). Lower extremity motor strength and walking function had no additional separate contribution to the prediction of study outcomes. The inability to cycle at a constant rhythm for one minute, two weeks after stroke is a more significant predictor than lower extremity motor strength or walking function of walking performance at three months post-stroke.

  9. Daily intermittent hypoxia enhances walking after chronic spinal cord injury

    PubMed Central

    Hayes, Heather B.; Jayaraman, Arun; Herrmann, Megan; Mitchell, Gordon S.; Rymer, William Z.

    2014-01-01

    Objectives: To test the hypothesis that daily acute intermittent hypoxia (dAIH) and dAIH combined with overground walking improve walking speed and endurance in persons with chronic incomplete spinal cord injury (iSCI). Methods: Nineteen subjects completed the randomized, double-blind, placebo-controlled, crossover study. Participants received 15, 90-second hypoxic exposures (dAIH, fraction of inspired oxygen [Fio2] = 0.09) or daily normoxia (dSHAM, Fio2 = 0.21) at 60-second normoxic intervals on 5 consecutive days; dAIH was given alone or combined with 30 minutes of overground walking 1 hour later. Walking speed and endurance were quantified using 10-Meter and 6-Minute Walk Tests. The trial is registered at ClinicalTrials.gov (NCT01272349). Results: dAIH improved walking speed and endurance. Ten-Meter Walk time improved with dAIH vs dSHAM after 1 day (mean difference [MD] 3.8 seconds, 95% confidence interval [CI] 1.1–6.5 seconds, p = 0.006) and 2 weeks (MD 3.8 seconds, 95% CI 0.9–6.7 seconds, p = 0.010). Six-Minute Walk distance increased with combined dAIH + walking vs dSHAM + walking after 5 days (MD 94.4 m, 95% CI 17.5–171.3 m, p = 0.017) and 1-week follow-up (MD 97.0 m, 95% CI 20.1–173.9 m, p = 0.014). dAIH + walking increased walking distance more than dAIH after 1 day (MD 67.7 m, 95% CI 1.3–134.1 m, p = 0.046), 5 days (MD 107.0 m, 95% CI 40.6–173.4 m, p = 0.002), and 1-week follow-up (MD 136.0 m, 95% CI 65.3–206.6 m, p < 0.001). Conclusions: dAIH ± walking improved walking speed and distance in persons with chronic iSCI. The impact of dAIH is enhanced by combination with walking, demonstrating that combinatorial therapies may promote greater functional benefits in persons with iSCI. Classification of evidence: This study provides Class I evidence that transient hypoxia (through measured breathing treatments), along with overground walking training, improves walking speed and endurance after iSCI. PMID:24285617

  10. Development of a clinical measure of dual-task performance in walking: reliability and preliminary validity of the Walking and Remembering Test.

    PubMed

    McCulloch, Karen L; Mercer, Vicki; Giuliani, Carol; Marshall, Steve

    2009-01-01

    (1) To examine the reliability of a new clinical measure of simultaneous walking with performance of a working memory task, the Walking and Remembering Test (WART). (2) To compare older adult to younger adult WART performance to illustrate preliminary validity. Convenience sample of 25 young adults (ages 22-35) and 25 older adults (ages 65-86) performed the WART twice. Subjects walked 6.1 meters at their fastest safe speed along a path requiring a narrowed base of support in both single and dual-task (with simultaneous digit span task) conditions. Reductions in walking and cognitive performance were examined in the dual-task condition for older adults as compared to younger adults. Walking time, step accuracy, digit span memory accuracy, and dual-task costs for walking and cognitive tasks. Inter-rater reliability ICC (2,1) values were > or = .97 for walking time and digit span accuracy. Rater agreement of steps off the path was excellent (93%) for young adults and good (76%) for older adults. Test-retest reliability ICC (2,1) values for walking time were > or = .79. Older adults were slower and remembered shorter digit spans, and demonstrated greater dual-task costs for digit span accuracy and steps off the path than younger adults, but relative dual-task costs for walking time were not significantly different between groups. The WART is a reliable clinical measure of dual-task memory and walking that can be administered safely with community-dwelling older adults. Expected greater dual-task costs for older adults were observed, but not as strongly as anticipated in this group of very active subjects. The WART provides information that may be useful in targeting patients for intervention to reduce risk of falls in dual-task conditions, but needs validation with older adults across a greater range of walking ability.

  11. Walking speed and distance in different environments of subjects in the later stage post-stroke.

    PubMed

    Carvalho, Cristiane; Sunnerhagen, Katharina S; Willén, Carin

    2010-11-01

    The purpose of this study is to assess short- and long-distance walking performance in indoor and outdoor environments of slow and fast walkers' subjects living in the community in the later stage post-stroke. Thirty-six subjects with at least 6 months post-stroke were included and divided into two groups based on their walking speed in the clinical setting. Thirty-meter walk tests (30 mWT) at self-selected and maximum speeds were assessed in three environments: (1) clinical setting; (2) basement setting; and (3) outdoor setting. Six-minute walk test (6 MWT) distance was assessed in the clinical and outdoor settings. The differences between the 30 mWT and the 6 MWT, as measured by the actual distance obtained in the 6 MWT and the predicted distance calculated for the 30 mWT, were also investigated. There was no difference in walking speed when subjects performed short-distance walking in different environments. However, a difference was found in performance of long-distance walking. Subjects who walked 0.8 m/s or faster also walked further in the outdoor setting. The findings of our study demonstrate that in those who scored below 0.8 m/s, performance of short- and long-distance walking evaluated in an indoor environment reflects the results obtained in an outdoor environment. However, for subjects post-stroke who score 0.8 m/s or faster, distance was increased in the outdoor environments during long-distance walking. Walking speed obtained over a short distance seemed to overestimate long-distance walking capacity for the slow walkers, despite the environment.

  12. Tests of the random walk hypothesis for financial data

    NASA Astrophysics Data System (ADS)

    Nakamura, Tomomichi; Small, Michael

    2007-04-01

    We propose a method from the viewpoint of deterministic dynamical systems to investigate whether observed data follow a random walk (RW) and apply the method to several financial data. Our method is based on the previously proposed small-shuffle surrogate method. Hence, our method does not depend on the specific data distribution, although previously proposed methods depend on properties of the data distribution. The data we use are stock market (Standard & Poor's 500 in US market and Nikkei225 in Japanese market), exchange rate (British Pound/US dollar and Japanese Yen/US dollar), and commodity market (gold price and crude oil price). We found that these financial data are RW whose first differences are independently distributed random variables or time-varying random variables.

  13. Heart rate recovery after the 6-min walk test is related to 6-min walk distance and percutaneous oxygen saturation recovery in patients with COPD.

    PubMed

    Shiroishi, Ryota; Kitagawa, Chika; Miyamoto, Naomi; Kakuno, Nao; Koyanagi, Harumi; Rikitomi, Naoto; Senjyu, Hideaki

    2015-05-01

    Heart rate recovery (HRR) after maximal load exercise affects mortality in chronic obstructive pulmonary disease (COPD). However, the associations of clinical characteristics with HRR after the 6-min walk test (6MWT), which is defined as a submaximal load test, remain unclear. We showed that HRR in patients with COPD after 6MWT was related to 6-min walk distance and percutaneous oxygen saturation recovery. HRR after the 6MWT may be useful to assess exercise capacity in COPD.

  14. Test-retest reliability of trunk accelerometry during standing and walking.

    PubMed

    Moe-Nilssen, R

    1998-11-01

    To investigate repeatability of acceleration measured by a portable, triaxial accelerometer over the lumbar spine as a measure of balance during standing and walking. Acceleration was measured along three axes and transformed to a horizontal-vertical coordinate system. Standing was tested on two feet, vision unobstructed and obstructed, and on one foot, vision unobstructed. Walking was tested in five different self-selected speeds on even and uneven ground. Retest was performed after 2 days. A flat floor with a 7m uneven mat. Nineteen healthy students. Standing: Acceleration root mean square (RMS). Walking: Point estimate of acceleration RMS for a reference walking speed (1.2m/sec). All tests: Within-subject standard deviation (sw), intraclass correlation coefficients (ICCs). The sw indicated high absolute test-retest repeatability for standing on two feet. Because of restricted ranges of value, relative reliability was low, however, with ICC(3,1) < .56. For standing on one foot, absolute and relative reliability were highest in the mediolateral direction, with ICC(3,1) = .84. For the walking tests, ICC(3,1) ranged from .79 to .94 for the three axes. Reliability was on the same level for even and uneven ground. The results indicate that accelerometry without need for stationary instrumentation is a reliable method that may be useful for studying standing balance and gait in the clinic.

  15. Reliability and concurrent validity of standardized walking obstacle course test in people with stroke.

    PubMed

    Ng, Shamay S M; Chan, Sunny C L; Chan, Alexis K Y; Chung, Hephzibah H Y; Lee, Navis K W; Ngan, Anson T S; Tse, Mimi M Y

    2017-09-01

    To investigate: (i) the intra-rater, inter-rater and test-retest reliabilities of completion times and step counts on the Standardized Walking Obstacle Course test (SWOC); (ii) correlations between SWOC scores and stroke-specific impairments; (iii) the cut-off SWOC completion times and step counts for distinguishing differences in obstacle negotiation ability in people with chronic stroke and healthy older adults. Cross-sectional study. University-based rehabilitation centre. Twenty-nine people with stroke and 30 healthy older adults. SWOC completion times and step counts were measured under 3 conditions: (i) normal walking; (ii) walking with a tray; and (iii) walking with dark-glasses. The Fugl-Meyer Assessment of lower extremity, the Five-Times-Sit-to-Stand Test, the Berg Balance Scale, the Timed Up and Go Test (TUG), and the Community Integration Measure questionnaire, were also administered. SWOC completion times and step counts showed very satisfactory to excellent reliabilities (intraclass correlation coefficient; ICC = 0.851-0.993). TUG times correlated significantly with SWOC completion times and step counts under the 3 conditions (r = 0.586-0.815, p < 0.001). SWOC completion times of 14.73-16.00 s and step counts of 23.06-24.13, depending on different walking conditions, were able to discriminate between stroke survivors and healthy older adults. The SWOC is a reliable clinical tool for assessing obstacle negotiation ability in people with stroke.

  16. Oxygen cost of walking in persons with multiple sclerosis: disability matters, but why?

    PubMed

    Sandroff, Brian M; Klaren, Rachel E; Pilutti, Lara A; Motl, Robert W

    2014-01-01

    Background. The oxygen cost (O2 cost) of walking is elevated in persons with MS, particularly as a function of increasing disability status. Objective. The current study examined symptomatic (i.e., fatigue, pain, anxiety, and depression) and gait (i.e., velocity, cadence, and step length) variables that might explain why disability status is associated with O2 cost of walking in persons with MS. Materials and Methods. 82 participants completed the Patient-Determined Disease Steps, Fatigue Severity Scale, McGill Pain Questionnaire, and Hospital Anxiety and Depression Scale and undertook 2 trials of walking on a GAITRite electronic walkway. Participants then completed a six-minute walk test with concurrent assessment of expired gases for quantifying oxygen consumption and O2 cost of walking. Results. Disability (r = 0.55) as well as fatigue (r = 0.22), gait velocity (r = -0.62), cadence (r = -0.73), and step length (r = -0.53) were associated with the O2 cost of walking. Cadence (β = -0.67), but not step length (β = -0.14) or fatigue (β = -0.10), explained the association between disability and the O2 cost of walking. Conclusions. These results highlight cadence as a target of rehabilitation for increasing metabolic efficiency during walking among those with MS, particularly as a function of worsening disability.

  17. Oxygen Cost of Walking in Persons with Multiple Sclerosis: Disability Matters, but Why?

    PubMed Central

    Sandroff, Brian M.; Klaren, Rachel E.; Pilutti, Lara A.; Motl, Robert W.

    2014-01-01

    Background. The oxygen cost (O2 cost) of walking is elevated in persons with MS, particularly as a function of increasing disability status. Objective. The current study examined symptomatic (i.e., fatigue, pain, anxiety, and depression) and gait (i.e., velocity, cadence, and step length) variables that might explain why disability status is associated with O2 cost of walking in persons with MS. Materials and Methods. 82 participants completed the Patient-Determined Disease Steps, Fatigue Severity Scale, McGill Pain Questionnaire, and Hospital Anxiety and Depression Scale and undertook 2 trials of walking on a GAITRite electronic walkway. Participants then completed a six-minute walk test with concurrent assessment of expired gases for quantifying oxygen consumption and O2 cost of walking. Results. Disability (r = 0.55) as well as fatigue (r = 0.22), gait velocity (r = −0.62), cadence (r = −0.73), and step length (r = −0.53) were associated with the O2 cost of walking. Cadence (β = −0.67), but not step length (β = −0.14) or fatigue (β = −0.10), explained the association between disability and the O2 cost of walking. Conclusions. These results highlight cadence as a target of rehabilitation for increasing metabolic efficiency during walking among those with MS, particularly as a function of worsening disability. PMID:24734181

  18. Utility of Walk Tests in Evaluating Functional Status Among Participants in an Outpatient Cardiac Rehabilitation Program.

    PubMed

    Harris, Kristie M; Anderson, Derek R; Landers, Jacob D; Emery, Charles F

    2017-09-01

    Although walk tests are frequently used in cardiac rehabilitation (CR), no prior study has evaluated the capacity of these measures to predict peak oxygen uptake during exercise testing ((Equation is included in full-text article.)O2peak). This study evaluated the interrelationship of objective measures of exercise performance (walk and exercise testing) among patients entering CR as well as a novel measure of functional status assessment for use in CR. Forty-nine patients (33 males) referred to an outpatient CR program were evaluated with objective measures of ambulatory functional status (peak oxygen uptake [(Equation is included in full-text article.)O2peak], 6-minute walk test [6MWT], and 60-ft walk test [60ftWT]). All measures of functional status were moderately to highly intercorrelated (r values from 0.50 to 0.88; P values < .05). The relationship among measures differed by sex, but not by age or diagnosis. Among men, results were generally consistent with the full sample. Among women, the magnitude of correlations was generally lower and there was no relationship between (Equation is included in full-text article.)O2peak and other measures. Measures of functional status, including (Equation is included in full-text article.)O2peak, 6MWT, and 60ftWT, were highly correlated among CR patients, suggesting the plausibility of using them interchangeably to fit the needs of the patient and testing environment. Among women, walk tests may not be appropriate substitutes for (Equation is included in full-text article.)O2peak. Because of the brevity of the 60ftWT, it may be particularly useful for measuring functional status in patients with greater symptoms and those with comorbidities limiting walking.

  19. Comparison of the distances covered during 3 and 6 min walking test.

    PubMed

    Iriberri, Milagros; Gáldiz, Juan Bta; Gorostiza, Amaia; Ansola, Pedro; Jaca, Carmen

    2002-10-01

    To determine the reproducibility of the distance covered in 3 min and its correlation with the 6 min walking test, as well as compare the distances covered at different time intervals. Secondly, to evaluate the relationship between the distances covered during these time periods and the maximum oxygen intake obtained during a bicycle ergometer test. Forty-five Chronic Obstructive Pulmonary Disesase patients were included in the study. Subjects who were either physically limited or familiar with the test, or those with acute exacerbation in the month prior to the study, were excluded. Three walking tests were carried out each day. In 30 patients for three consecutive days, and the distances covered in periods of 3 and 6 min were measured with 20 min rest between each walk. No incentive was given and the patients knew that the distances covered in 3 and 6 min would be quantified. Oxygen saturation, heart rate and degree of breathlessness (modified Borg scale) were registered at baseline. After 3 min, the distance covered and degree of breathlessness were also measured. After 6 min, oxygen saturation, heart rate, degree of breathlessness and distance covered in meters were registered. Spirometry was performed daily on each patient, and those with an FEV1 variation of less than 10% were considered clinically and functionally stable. An exercise test using bicycle ergometer was carried out to determine maximum oxygen intake. A 3 min walking test was performed in 15 patients, independently on the same day, which was followed after 20 min rest with a 6 min walking test. A significant increase was observed in the distance covered over 3 and 6 min in the first 5 walks, with the greatest increase seen in the first 3 walks. The correlation between the distance covered in 3 and 6 min was 0.98. The correlation between the distance covered in 3 min and oxygen intake was 0.64. No significant differences were observed between the distances covered in the 0-3 and 3 to 6 min periods

  20. Incremental shuttle walk test in the assessment of patients with obstructive sleep apnea-hypopnea syndrome.

    PubMed

    Billings, Catherine G; Aung, Thida; Renshaw, Stephen A; Bianchi, Stephen M

    2013-08-01

    Obstructive sleep apnea-hypopnea syndrome is associated independently with an increase in cardiovascular risk factors and is associated with self-reported lack of exercise. We aimed to investigate the utility of the incremental shuttle walk test in routine clinical practice to monitor physical capacity of patients with obstructive sleep apnea-hypopnea syndrome and explore whether continuous positive airway pressure therapy alters exercise capacity. Participants with symptomatic moderate/severe obstructive sleep apnea-hypopnea syndrome attending for a trial of continuous positive airway pressure therapy completed questionnaires assessing sleepiness and physical activity and underwent an incremental shuttle walk test. Subjects compliant or partially compliant with continuous positive airway pressure therapy underwent reassessment at 2 weeks, 3 months and 6 months post-initiation of therapy. Participants unable to tolerate continuous positive airway pressure therapy completed a single reassessment 6 months after their initial visit. Continuous positive airway pressure therapy resulted in an increased distance walked during the incremental shuttle walk test. Improvements in cardiovascular responses to exercise were identified. Compliant patients reported increased daily activity. The incremental shuttle walk test is a simple, reproducible and safe test that is responsive to continuous positive airway pressure treatment. Our findings support the use of the incremental shuttle walk test for monitoring the effects of continuous positive airway pressure treatment and may suggest its use in rehabilitation programmes designed to reduce obesity and cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome. © 2013 European Sleep Research Society.

  1. A smartphone approach for the 2 and 6-minute walk test.

    PubMed

    Capela, Nicole A; Lemaire, Edward D; Baddour, Natalie C

    2014-01-01

    The 2 and 6-minute walk tests (2-6MWT) are used by rehabilitation professionals as a measure of exercise capacity. Our research has produced a new 2-6MWT BlackBerry smartphone application (app) that can be used to run the 2-6MWT and also provide new information about how the person moves during the test. The smartphone is worn on a belt at the lower back to record phone sensor data while walking. This data is used to identify foot strikes, calculate the total distance walked and step timing, and analyze pelvis accelerations. Information on symmetry, walking changes over time, and poor walking patterns is not available from a typical 2-6MWT and could help with clinical decision-making. The 2-6MWT app was evaluated in a pilot test using data from five able-bodied participants. Foot strike time was within 0.07 seconds when compared to gold standard video recordings. The total distance calculated by the app was within 1m of the measured distance.

  2. The weighted walking test as an alternative method of assessing aerobic power.

    PubMed

    Klimek, Andrzej T; Klimek, Adam

    2007-01-15

    The aim of the present study was to determine maximal oxygen uptake (VO2max) directly during uphill walking exercise and to compare these values with those achieved during running and cycling exercise. Forty untrained students (20 males and 20 females) took part in three exercise tests. The running test was performed on a horizontal treadmill and the speed was gradually increased by 0.3 m . s(-1) every 3 min. The walking test was conducted on a treadmill inclined at 12% (speed of 1.8 m . s(-1)). The load was further increased every 3 min by the addition of a mass of one-twentieth of the body mass of the participant (plastic containers filled with water and added to a backpack carried by the participant). During the bicycle ergometry test, the workload was increased by 20 W every 2 min. All tests were performed until volitional exhaustion. During all tests, oxygen uptake, minute ventilation, tidal volume, respiratory frequency, heart rate, hydrogen ion concentration, base excess, and blood lactate concentration were analysed. The Pearson correlation coefficients between the weighted walking test and the commonly applied running and bicycle ergometry tests indicate a strong association with the new test in evaluating maximal oxygen uptake. The negligible differences in VO2max between the three tests for the male participants (running: 61.0 ml . kg(-1) . min(-1); walking: 60.4 ml . kg(-1) . min(-1); cycling: 60.2 ml . kg(-1) . min(-1)), and the fact that the females achieved better results on the walking test than the cycle ergometer test (running: 45.0 ml . kg(-1) . min(-1); walking: 42.6 ml . kg(-1) . min(-1); cycling: 40.1 ml . kg(-1) . min(-1)), confirm the suitability of the new method for evaluating aerobic power. The weighted walking test could be useful in the assessment of aerobic power in individuals for whom running is not advised or is difficult. In addition, the new test allows for determination of VO2max on small treadmills with a limited speed regulator

  3. Influence of step length on 6-minute walk test performance in patients with chronic heart failure.

    PubMed

    Pepera, Garyfallia K; Sandercock, Gavin R; Sloan, Rebecca; Cleland, John J F; Ingle, Lee; Clark, Andrew L

    2012-12-01

    To investigate the influence of gait parameters including step length and walking speed during performance of the 6-minute walking test (6MWT) in patients with chronic heart failure (CHF). Observational study. Specialist heart failure clinic. Patients with CHF and aged-matched, apparently healthy controls. Each patient and control performed a 6MWT following a standardised protocol in a 15m corridor. The number of steps (defined as step from left foot to right foot) taken every 15m was counted, and reported as minute-by-minute changes in 6MWT performance. In addition, minute-by-minute changes in time taken to complete 15m and mean walking speed throughout the test were calculated. Walking speed and step length. Thirty patients with CHF {87% males; mean age 75 [standard deviation (SD) 8] years} and 10 healthy controls [80% males; mean age 77 (SD 11) years] undertook the 6MWT. For the CHF group, the mean distance walked was 309 (SD 48)m and the peak Borg score was 12 (SD 1). For the controls, the mean distance walked was 334 (SD 138)m and the peak Borg score was 12 (SD 1). Patients with CHF showed no significant minute-by-minute changes in step length or walking speed over the course of the 6MWT. In the first 5minutes, healthy controls had a longer step length and faster walking speed than patients with CHF [step length: mean difference in the first minute was 0.03m, 95% confidence interval (CI) of the difference 0.01 to 0.05m; P=0.02; walking speed: mean difference in the first minute 0.04m/second, 95% CI of the difference 0.02 to 0.07m/second; P=0.01]. A multiple linear regression analysis demonstrated that body mass index (P=0.02) was the most important predictor of 6MWT performance. Patients with CHF have a shorter step length and walk more slowly than controls during the 6MWT. Altered gait mechanics may contribute to limited exercise capacity in patients with CHF. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  4. Influence of a visual-verbal Stroop test on standing and walking performance of older adults.

    PubMed

    Wollesen, B; Voelcker-Rehage, C; Regenbrecht, T; Mattes, K

    2016-03-24

    The dual task (DT) paradigm has been used to investigate decrements in balance performance while walking and standing in fall prevention studies with older adults. However, there are inconsistent findings whether balance performance decreases or increases in DT situations. Following different theoretical models (e.g. limited resource hypothesis or cross domain competition model), these inconsistent findings can be explained by task settings and task complexity. We compared DT performance in an executive control task (Stroop test) while standing and walking to analyze which theoretical model would fit our data best. Twenty-eight persons (>65 years) were examined under single task (ST) and DT conditions for standing (sway length and sway velocity) and walking (step length, step width (SW), peak forces of the heel, mid- and forefoot). SW increased from ST to DT conditions, and step length decreased significantly. Maximum forces of the forefoot were reduced whereas the maximum forces of the midfoot increased. Additionally, correct answers of the Stroop test decreased from the ST baseline condition to DT walking. No correlations were found between DT costs (performance decrements) of standing and walking. For both conditions (standing and walking), the limited resources hypothesis fits best. Moreover, not all modified gait variables could be defined as negative DT costs. Increased SW and decreased step length might be used to compensate influences on lateral stability while demands on motor-cognitive resources increase. Further, drawing conclusions from a standing task for walking conditions might lead to misinterpretations. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Clinical utility of the 6-min walk test for patients with moderate Parkinson's disease.

    PubMed

    Kobayashi, Eiji; Himuro, Nobuaki; Takahashi, Mitsuhiko

    2017-03-01

    The aim of this study was to test the clinical utility of the 6-min walk test (6MWT) for patients with moderate Parkinson's disease (PD) through a determination of factors related to this test. This was a descriptive, observational study carried out at a General Hospital, in-patients. Twenty-four patients with moderate PD were studied. We used Hoehn and Yahr stage ratings (HY stage), Unified Parkinson Disease Rating Scales (UPDRS) motor examination score, 6MWT, Berg Balance scale, Timed 'Up & Go' test (TUG), 10-m walk test (10-m walk speed, 10-m walk steps and cadence), and the energy cost of walking (Ec). The average HY stage was 3.1±0.5 and 6MWT was 340.8±110.9 m. TUG (r=-0.68, P<0.01) and Ec (r=-0.65, P<0.01) were correlated significantly with 6MWT. Multiple regression analysis with age, HY stage, TUG, cadence, and Ec as variables indicated a significant degree of variability in the 6MWT results (R=0.77, P<0.001). The TUG (β=-0.47, P<0.01) and Ec (β=-0.4, P<0.01) were correlated independently with the 6MWT results. In contrast, age, HY stage, and cadence were not independently correlated. The 6MWT is a simple tool for assessing walking capacity for patients with PD. In this study, we confirmed the convergent validity and clinical utility of the 6MWT for patients with moderate PD. The 6MWT is useful for clinical assessment to guide the planning of rehabilitation treatment for patients with moderate PD.

  6. Walk on Floor Eyes Closed Test: A Unique Test of Spaceflight Induced Ataxia

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Fisher, E. A.; Kofman, I. S.; Cerisano, J. M.; Harm, D. L.; Bloomberg, J. J.

    2011-01-01

    Measurement and quantification of posture and locomotion following spaceflight is an evolving process. Based on the data obtained from the current investigation we believe that the walk on the floor line test with the eyes closed (WOFEC) provides a unique procedure for quantifying postflight ataxia. As a part of an ongoing investigation designed to look at functional changes in astronauts returning from spaceflight seven astronauts (5 short duration with flights of 12-16 days; 2 long duration crewmembers with flights of 6 months) were tested twice before flight, on landing day (short duration only), and 1, 6, and 30 days after flight. The WOFEC consisted of walking for 10 steps (repeated twice) with the feet heel to toe in tandem, arms folded across the chest and the eyes closed. The performance metric (scored by three examiners from video) was the percentage of correct steps completed over the three trials. A step was not counted as correct if the crewmember side-stepped, opened their eyes, or paused for more than three seconds between steps. The data reveled a significant decrease in percentage of correct steps on landing day (short duration crew) and on the first day following landing (long duration) with partial recovery the following day, and full recovery beginning on day sixth after flight. Both short and long duration fliers appeared to be unaware of foot position relative to their bodies or the floor. Postflight, deviation from a straight path was common, and seemed to be determined by the angle of foot placement relative to their body. While deviation from a straight line could be either left or right, primary deviations were observed to occur to the right. Furthermore, the test for two crewmembers elicited motion sickness symptoms. These data clearly demonstrate the sensorimotor challenges facing crewmembers after returning from spaceflight. The WOFEC test has value providing the investigator or crew surgeon with a simple method to quantify vestibular

  7. Plasma ammonia response to incremental cycling and walking tests in COPD.

    PubMed

    Calvert, L D; Steiner, M C; Morgan, M D; Singh, S J

    2010-05-01

    It is well documented that plasma ammonia accumulates during exercise under conditions of metabolic stress. Metabolic stress (when skeletal muscle ATP supply fails to meet demand) occurs at low work rates during cycling in patients with COPD, but not been described during walking. Walking is an important activity for many patients with COPD and is commonly prescribed in pragmatic outpatient pulmonary rehabilitation programmes. In this study we explored whether metabolic stress occurs during incremental walking at the low work rates these patients achieve. Twenty-nine subjects with stable COPD [mean(SD) age 68(7)years, FEV(1) 50(19)% predicted] performed maximal cardiopulmonary exercise tests on a cycle ergometer and treadmill. Plasma ammonia concentration was measured at rest, 1 and 2min of exercise, peak exercise and 2min recovery. Subjects achieved mean(SD) cycle work rate of 57(20)W with VO(2max) 15.5(4.6)ml/min per kg, and treadmill distance 284(175)m with VO(2peak) 16.8(4.2)ml/min per kg. Plasma ammonia concentration rose significantly (p<0.001) with walking [mean(SEM) change 24.7(3.8)micromol/l] and cycling [mean(SEM) change 35.2(4.3)micromol/l], but peak exercise ammonia was lower in walking (p<0.01). In a subgroup of subjects (n=7) plasma ammonia did not rise during either cycling or walking despite similar lactate rise and peak exercise indices. Our data indicate that failure of muscle ATP re-synthesis to meet demand and development of metabolic stress can occur during walking in COPD patients at the low work rates these patients achieve. This may therefore be a factor contributing to exercise limitation independent of ventilatory limitation.

  8. Within-day variability on short and long walking tests in persons with multiple sclerosis.

    PubMed

    Feys, Peter; Bibby, Bo; Romberg, Anders; Santoyo, Carme; Gebara, Benoit; de Noordhout, Benoit Maertens; Knuts, Kathy; Bethoux, Francois; Skjerbæk, Anders; Jensen, Ellen; Baert, Ilse; Vaney, Claude; de Groot, Vincent; Dalgas, Ulrik

    2014-03-15

    To compare within-day variability of short (10 m walking test at usual and fastest speed; 10MWT) and long (2 and 6-minute walking test; 2MWT/6MWT) tests in persons with multiple sclerosis. Observational study. MS rehabilitation and research centers in Europe and US within RIMS (European network for best practice and research in MS rehabilitation). Ambulatory persons with MS (Expanded Disability Status Scale 0-6.5). Subjects of different centers performed walking tests at 3 time points during a single day. 10MWT, 2MWT and 6MWT at fastest speed and 10MWT at usual speed. Ninety-five percent limits of agreement were computed using a random effects model with individual pwMS as random effect. Following this model, retest scores are with 95% certainty within these limits of baseline scores. In 102 subjects, within-day variability was constant in absolute units for the 10MWT, 2MWT and 6MWT at fastest speed (+/-0.26, 0.16 and 0.15m/s respectively, corresponding to +/-19.2m and +/-54 m for the 2MWT and 6MWT) independent on the severity of ambulatory dysfunction. This implies a greater relative variability with increasing disability level, often above 20% depending on the applied test. The relative within-day variability of the 10MWT at usual speed was +/-31% independent of ambulatory function. Absolute values of within-day variability on walking tests at fastest speed were independent of disability level and greater with short compared to long walking tests. Relative within-day variability remained overall constant when measured at usual speed. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  9. Development and Psychometric Testing of the Dogs and WalkinG Survey (DAWGS)

    ERIC Educational Resources Information Center

    Richards, Elizabeth A.; McDonough, Meghan H.; Edwards, Nancy E.; Lyle, Roseann M.; Troped, Philip J.

    2013-01-01

    Purpose: Dog owners represent 40% of the population, a promising audience to increase population levels of physical activity. The purpose of this study was to develop and test the psychometric properties of a new instrument to assess social-cognitive theory constructs related to dog walking. Method: Dog owners ("N" = 431) completed the…

  10. Development and Psychometric Testing of the Dogs and WalkinG Survey (DAWGS)

    ERIC Educational Resources Information Center

    Richards, Elizabeth A.; McDonough, Meghan H.; Edwards, Nancy E.; Lyle, Roseann M.; Troped, Philip J.

    2013-01-01

    Purpose: Dog owners represent 40% of the population, a promising audience to increase population levels of physical activity. The purpose of this study was to develop and test the psychometric properties of a new instrument to assess social-cognitive theory constructs related to dog walking. Method: Dog owners ("N" = 431) completed the…

  11. Validation of the Rockport Fitness Walking Test in College Males and Females.

    ERIC Educational Resources Information Center

    Dolgener, Forrest A.; And Others

    1994-01-01

    This study attempted to validate the Rockport Fitness Walking Test (RFWT) in college students and develop prediction equations if the RFWT proved invalid. Researchers compared measured maximal oxygen uptake (VO2max) and VO2max predicted from previous equations. The original RFWT overpredicted VO2max in college students and thus is invalid for that…

  12. How to carry out a field walking test in chronic respiratory disease.

    PubMed

    Holland, Anne E; Spruit, Martijn A; Singh, Sally J

    2015-06-01

    To provide recommendations for conducting field walking tests in people with chronic respiratory disease, from the new European Respiratory Society/American Thoracic Society Technical StandardTo provide information to assist in selecting a field walking test in people with chronic respiratory disease. The 6MWT, ISWT and ESWT are valid and reliable tests of functional exercise capacity in people with COPD. The 6MWT is also widely used in other chronic respiratory disorders.There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded.The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be held constant when the test is repeated.The 6MWT, ISWT and ESWT are strenuous tests, with cardiorespiratory responses that are similar to those during a maximal incremental exercise test. As a result, the contraindications and precautions for these field walking tests should be the same as for a laboratory-based incremental exercise test. The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT). The Technical Standard shows that all three tests are valid and reliable measures of functional exercise capacity in people with chronic respiratory disease and makes recommendations for standardising their performance. Key findings and recommendations of the Technical Standard include: The 6MWT, ISWT and ESWT are strenuous tests which elicit cardiorespiratory responses that are similar to those observed during a maximal incremental exercise test. As a result, the contraindications and precautions for field

  13. How to carry out a field walking test in chronic respiratory disease

    PubMed Central

    Spruit, Martijn A.; Singh, Sally J.

    2015-01-01

    Educational Aims To provide recommendations for conducting field walking tests in people with chronic respiratory disease, from the new European Respiratory Society/American Thoracic Society Technical Standard To provide information to assist in selecting a field walking test in people with chronic respiratory disease. Key points The 6MWT, ISWT and ESWT are valid and reliable tests of functional exercise capacity in people with COPD. The 6MWT is also widely used in other chronic respiratory disorders. There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded. The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be held constant when the test is repeated. The 6MWT, ISWT and ESWT are strenuous tests, with cardiorespiratory responses that are similar to those during a maximal incremental exercise test. As a result, the contraindications and precautions for these field walking tests should be the same as for a laboratory-based incremental exercise test. Summary The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT). The Technical Standard shows that all three tests are valid and reliable measures of functional exercise capacity in people with chronic respiratory disease and makes recommendations for standardising their performance. Key findings and recommendations of the Technical Standard include: The 6MWT, ISWT and ESWT are strenuous tests which elicit cardiorespiratory responses that are similar to those observed during a maximal incremental exercise test. As a result, the

  14. Effects of two exercise training techniques on walking function in adult patients with stroke.

    PubMed

    Olawale, O A; Jaja, S I; Anigbogu, C N; Appiah-Kubi, K O; Jones-Okai, D

    2009-01-01

    Patients with stroke usually demonstrate activity limitations manifested by reduced ability to perform daily functions. The purpose of this study was to examine the effects of treadmill walking and overground walking exercise training on walking function in adult patients with stroke. Participants were forty (40) patients with stroke comprising 22 males and 18 females. Inclusion criteria included absence of any co-morbidity that could affect rehabilitation. They were randomly assigned to 2 exercise training groups (20 in each group). All study subjects received conventional physiotherapy rehabilitation for 12 weeks. During the same period, subjects in Group A had treadmill walking exercise training (TWET) while those in Group B had overground walking exercise training (OWET) in addition to the conventional physiotherapy. Outcomes were measured as (i) Ten-metre walk time and (ii) Six-minute walk distance. They were evaluated at entry into the study and at the end of every 4 weeks. Results at weeks 0, 4, 8 and 12 were used for analysis. For each of the 2 groups, paired t-tests were used to evaluate the significance of the differences between the pre-intervention (week 0) mean scores on both tests and the mean scores at weeks 4, 8 and 12. With 12 weeks of exercise training, both TWET and OWET produced significant improvement in walking function (P < 0.05). However, OWET resulted in significantly greater reduction (26.8%) in mean walking time over 10 metres than TWET (22.6%); and significantly greater increase (45.2%) in mean walking distance over 6 minutes than TWET (31.0%). Exercise training, especially overground walking, could be integrated into the traditional rehabilitation care given to adult patients with stroke.

  15. 78 FR 20695 - Walk-Through Metal Detectors and Hand-Held Metal Detectors Test Method Validation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... Office of Justice Programs Walk-Through Metal Detectors and Hand-Held Metal Detectors Test Method... has recently developed updated versions of its minimum performance standards for walk-through metal detectors and hand-held metal detectors. In order to ensure that the test methods in the standards...

  16. Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study.

    PubMed

    Kim, Kyoung; Lee, Hye-Young; Lee, Do-Youn; Nam, Chan-Woo

    2015-08-01

    [Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after the Rockport 1 mile walking test in males, and significant improvements in forced vital capacity, forced expiratory volume at 1 s, maximal inspiratory pressure, and maximal expiratory pressure were observed after the Rockport 1 mile walking test in females. However, the maximal oxygen uptake was not significantly different. [Conclusion] Our findings indicate that the Rockport 1 mile walking test changes cardiopulmonary function in males and females, and that it may improve cardiopulmonary function in middle-aged and older adults and provide basic data on cardiopulmonary endurance.

  17. Predictors of shuttle walking test performance in patients with cardiovascular disease.

    PubMed

    Pepera, G; Cardoso, F; Taylor, M J D; Peristeropoulos, A; Sandercock, G R H

    2013-12-01

    The incremental shuttle walking test (ISWT) is used to estimate cardiorespiratory fitness, but data from healthy individuals suggest that demographic and anthropometric measures account for much of the variance in test performance. The aim of this study was to determine whether anthropometric, demographic and selected gait measures also predict ISWT performance (i.e. distance walked) in patients with cardiovascular disease. Observational study. A community-based cardiac rehabilitation centre (Cohort 1) and a hospital outpatient cardiac rehabilitation programme (Cohort 2). Sixteen patients with clinically stable cardiovascular disease (Cohort 1) and 113 patients undergoing cardiac rehabilitation (Cohort 2). Patients in Cohort 1 performed the ISWT on two occasions. Anthropometric data and walking and turning variables were collected. Linear regression analyses were used to identify the predictors of test performance. The authors subsequently attempted to validate the equation created by comparing predicted and actual ISWT values in a larger (n=113) validation sample (Cohort 2). Distance walked during ISWT, step length and height. No gait or turning measures were significantly associated with ISWT performance. Distance walked correlated most strongly with step length (r=0.83, P<0.05) and height (r=0.74, P<0.05). Given the similarity of these correlations and the rarity of step length assessment in clinical practice, ISWT performance was predicted using patient's height; this explained 55% of the variance in ISWT performance. Height was also the best predictor in Cohort 2, explaining 17% of test variance (P<0.01). Body mass index explained an additional 3% of variance (P<0.05) in ISWT performance. Routine clinical measures, particularly patient's height, are predictive of ISWT performance. The findings of the present study are in partial agreement with similar studies performed in healthy individuals, and it remains unclear whether the ISWT performance of patients with

  18. Synthesis of two-dimensional human walking: a test of the lambda-model.

    PubMed

    Günther, Michael; Ruder, Hanns

    2003-08-01

    To test the lambda-model version of the equilibrium point hypothesis both for feasibility and validity with respect to the control of terrestrial locomotion, we developed a two-dimensional, eleven-segment musculoskeletal model of the human body including 14 muscle-tendon complexes per leg, three-segment feet, and a physiologically based model of foot-ground interaction. Human walking was synthesized by numerical integration of the coupled muscle-tendon and rigid body dynamics. To this end a control algorithm based on the lambda-model was implemented in the model providing muscle stimulation patterns that guaranteed dynamically stable walking including a balanced trunk. Thus, the timing of the movement is not preset by a central pattern generator but emerges from the interaction of the musculoskeletal system with the control algorithm. The control parameters were found in a trial-and-error approach. The feedforward part of the control scheme consists of just two target configurations each of which is composed of a set of one nominal length per muscle (lambda-model). Variation of gravity reveals that (1) the synthesized walking patterns are close to ballistic walking and (2) this muscularly induced natural walking can only be initiated and maintained in the range between about a tenth and three times earth-bound gravity. Our walking patterns are robust both against parameter variations and shuffling of the swing leg. We discuss our model with respect to gravity scaling, speed control, feedback delay, and the terms "equilibrium point hypothesis" and "central pattern generator."

  19. Utilization of the walking oximetry test to allow safe ambulation after pulmonary resection.

    PubMed

    Kageyama, Y; Urabe, N; Chiba, A

    2001-01-01

    Supplemental oxygen therapy after pulmonary resection can generally be tapered according to arterial blood gases at rest or pulse oximetry (SpO2). However, detecting exercise-induced oxygen desaturation can be difficult. We developed the walking oximetry test (WOT) so that thoracotomy patients could be rehabilitated without the risk of undetected ambulatory hypoxemia. The subjects were 58 patients who had undergone pulmonary resection and could walk at the bedside, with oxygen at 3 l/min via a nasal cannula. Patients with a value of more than 100 torr were allowed to walk with assistance for 6 min in the corridor. The oxygen flow rate was kept at 3 l/min and the walking pace was less than 50 m/min. SpO2 was determined using a wristwatch pulse oximeter. The test was stopped if the SpO2 fell below 90% or there was a score of 5 or more on the Borg scale (range 1-10). Oxygen desaturation occurred in six patients (10%) during the WOT. These patients underwent ambulatory training with sufficient oxygen supplementation and were then tested again. Patients whose SpO2 values remained higher than 90% and who showed no more than 5% desaturation were permitted to walk in the corridor with oxygen at 3 l/min via a nasal cannula. All these patients had a Borg score of 4 or lower. The WOT is a reliable, nonvasive method for detecting exercise-induced oxygen desaturation during ambulation after pulmonary resection.

  20. Value of impedance cardiography during 6-minute walk test in pulmonary hypertension.

    PubMed

    Tonelli, Adriano R; Alkukhun, Laith; Arelli, Vineesha; Ramos, José; Newman, Jennie; McCarthy, Kevin; Pichurko, Bohdan; Minai, Omar A; Dweik, Raed A

    2013-12-01

    Methods that predict prognosis and response to therapy in pulmonary hypertension (PH) are lacking. We tested whether the noninvasive estimation of hemodynamic parameters during 6-minute walk test (6MWT) in PH patients provides information that can improve the value of the test. We estimated hemodynamic parameters during the 6MWT using a portable, signal-morphology-based, impedance cardiograph (PhysioFlow Enduro) with real-time wireless monitoring via a bluetooth USB adapter. We recruited 48 subjects in the study (30 with PH and 18 healthy controls). PH patients had significantly lower maximum stroke volume (SV) and CI and slower cardiac output (CO) acceleration and decelerations slopes during the test when compared with healthy controls. In PH patients, CI change was associated with total distance walked (R = 0.62; P < 0.001) and percentage of predicted (R = 0.4, P = 0.03), HR recovery at 1 minute (0.57, P < 0.001), 2 minutes (0.65, P < 0.001), and 3 minutes (0.66, P < 0.001). Interestingly, in PH patients CO change during the test was predominantly related to an increase in SV instead of HR. Estimation of hemodynamic parameters such as cardiac index during 6-minute walk test is feasible and may provide useful information in patients with PH. Clin Trans Sci 2013; Volume #: 1-7. © 2013 Wiley Periodicals, Inc.

  1. Value of Impedance Cardiography during 6‐Minute Walk Test in Pulmonary Hypertension

    PubMed Central

    Alkukhun, Laith; Arelli, Vineesha; Ramos, José; Newman, Jennie; McCarthy, Kevin; Pichurko, Bohdan; Minai, Omar A.; Dweik, Raed A.

    2013-01-01

    Abstract Background Methods that predict prognosis and response to therapy in pulmonary hypertension (PH) are lacking. We tested whether the noninvasive estimation of hemodynamic parameters during 6‐minute walk test (6MWT) in PH patients provides information that can improve the value of the test. Methods We estimated hemodynamic parameters during the 6MWT using a portable, signal‐morphology‐based, impedance cardiograph (PhysioFlow Enduro) with real‐time wireless monitoring via a bluetooth USB adapter. Results We recruited 48 subjects in the study (30 with PH and 18 healthy controls). PH patients had significantly lower maximum stroke volume (SV) and CI and slower cardiac output (CO) acceleration and decelerations slopes during the test when compared with healthy controls. In PH patients, CI change was associated with total distance walked (R = 0.62; P < 0.001) and percentage of predicted (R = 0.4, P = 0.03), HR recovery at 1 minute (0.57, P < 0.001), 2 minutes (0.65, P < 0.001), and 3 minutes (0.66, P < 0.001). Interestingly, in PH patients CO change during the test was predominantly related to an increase in SV instead of HR. Conclusions Estimation of hemodynamic parameters such as cardiac index during 6‐minute walk test is feasible and may provide useful information in patients with PH. Clin Trans Sci 2013; Volume #: 1–7 PMID:24330692

  2. The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy.

    PubMed

    McDonald, Craig M; Henricson, Erik K; Han, Jay J; Abresch, R Ted; Nicorici, Alina; Elfring, Gary L; Atkinson, Leone; Reha, Allen; Hirawat, Samit; Miller, Langdon L

    2010-04-01

    Walking abnormalities are prominent in Duchenne muscular dystrophy (DMD). We modified the 6-minute walk test (6MWT) for use as an outcome measure in patients with DMD and evaluated its performance in 21 ambulatory boys with DMD and 34 healthy boys, ages 4 to 12 years. Boys with DMD were tested twice, approximately 1 week apart; controls were tested once. The groups had similar age, height, and weight. All tests were completed. Boys who fell recovered rapidly from falls without injury. Mean +/- SD [range] 6-minute walk distance (6MWD) was lower in boys with DMD than in controls (366 +/- 83 [125-481] m vs. 621 +/- 68 [479-754] m; P < 0.0001; unpaired t-test). Test-retest correlation for boys with DMD was high (r = 0.91). Stride length (R(2) = 0.89; P < 0.0001) was the major determinant of 6MWD for both boys with DMD and controls. A modified 6MWT is feasible and safe, documents disease-related limitations on ambulation, is reproducible, and offers a new outcome measure for DMD natural history and therapeutic trials.

  3. Strong correlation between the 6-minute walk test and accelerometry functional outcomes in boys with Duchenne muscular dystrophy.

    PubMed

    Davidson, Zoe E; Ryan, Monique M; Kornberg, Andrew J; Walker, Karen Z; Truby, Helen

    2015-03-01

    Accelerometry provides information on habitual physical capability that may be of value in the assessment of function in Duchenne muscular dystrophy. This preliminary investigation describes the relationship between community ambulation measured by the StepWatch activity monitor and the current standard of functional assessment, the 6-minute walk test, in ambulatory boys with Duchenne muscular dystrophy (n = 16) and healthy controls (n = 13). All participants completed a 6-minute walk test and wore the StepWatch™ monitor for 5 consecutive days. Both the 6-minute walk test and StepWatch accelerometry identified a decreased capacity for ambulation in boys with Duchenne compared to healthy controls. There were strong, significant correlations between 6-minute walk distance and all StepWatch parameters in affected boys only (r = 0.701-0.804). These data proffer intriguing observations that warrant further exploration. Specifically, accelerometry outcomes may compliment the 6-minute walk test in assessment of therapeutic interventions for Duchenne muscular dystrophy.

  4. Instrumented balance and walking assessments in persons with multiple sclerosis show strong test-retest reliability.

    PubMed

    Craig, Jordan J; Bruetsch, Adam P; Lynch, Sharon G; Horak, Fay B; Huisinga, Jessie M

    2017-05-22

    There is a need for objective movement assessment for clinical research trials aimed at improving gait and balance in persons with multiple sclerosis (PwMS). Wireless inertial sensors can accurately measure numerous walking and balance parameters but these measures require evaluation of reliability in PwMS. The current study determined the test-retest reliability of wireless inertial sensor measures obtained during an instrumented standing balance test and an instrumented Timed Up and Go test in PwMS. Fifteen PwMS and 15 healthy control subjects (HC) performed an instrumented standing balance and instrumented Timed Up and Go (TUG) test on two separate days. Ten instrumented standing balance measures and 18 instrumented TUG measures were computed from the wireless sensor data. Intraclass correlation coefficients (ICC) were calculated to determine test-retest reliability of all instrumented standing balance and instrumented TUG measures. Correlations were evaluated between the instrumented standing balance and instrumented TUG measures and self-reported walking and balance performance, fall history, and clinical disability. For both groups, ICCs for instrumented standing balance measures were best for spatio-temporal measures, while frequency measures were less reliable. All instrumented TUG measures exhibited good to excellent (ICCs > 0.60) test-retest reliability in PwMS and in HC. There were no correlations between self-report walking and balance scores and instrumented TUG or instrumented standing balance metrics, but there were correlations between instrumented TUG and instrumented standing balance metrics and fall history and clinical disability status. Measures from the instrumented standing balance and instrumented TUG tests exhibit good to excellent reliability, demonstrating their potential as objective assessments for clinical trials. A subset of the most reliable measures is recommended for measuring walking and balance in clinical settings.

  5. Assessing Walking Ability in People with HTLV-1-Associated Myelopathy Using the 10 Meter Timed Walk and the 6 Minute Walk Test

    PubMed Central

    Adonis, Adine; Taylor, Graham P.

    2016-01-01

    Background Five to ten million persons, are infected by HTLV-1 of which 3% will develop HTLV-1-associated myelopathy (HAM) a chronic, disabling inflammation of the spinal cord. Walking, a fundamental, complex, multi-functional task is demanding of multiple body systems. Restricted walking ability compromises activity and participation levels in people with HAM (pwHAM). Therapy aims to improve mobility but validated measures are required to assess change. Study Design Prospective observational study. Objectives To explore walking capacity in pwHAM, walking endurance using the 6 minute walk (6MW), and gait speed, using the timed 10m walk (10mTW). Setting Out-patient setting in an inner London Teaching hospital. Methods Prospective documentation of 10mTW and 6MW distance; walking aid usage and pain scores measured twice, a median of 18 months apart. Results Data analysis was completed for twenty-six pwHAM, (8♂; 18♀; median age: 57.8 years; median disease duration: 8 years). Median time at baseline to: complete 10m was 17.5 seconds, versus 21.4 seconds at follow up; 23% completed the 6MW compared to 42% at follow up and a median distance of 55m was covered compared to 71m at follow up. Using the 10mTW velocity to predict the 6MW distance, overestimated the distance walked in 6 minutes (p<0.01). Functional decline over time was captured using the functional ambulation categories. Conclusions The 10mTW velocity underestimated the degree of disability. Gait speed usefully predicts functional domains, shows direction of functional change and comparison with published healthy age matched controls show that these patients have significantly slower gait speeds. The measured differences over 18 months were sufficient to reliably detect change and therefore these assessments can be useful to detect improvement or deterioration within broader disability grades. Walking capacity in pwHAM should be measured using the 10mTW for gait speed and the 6MW for endurance. PMID

  6. Heart rate recovery post 6-minute walking test in obstructive sleep apnea: cycle ergometry versus 6-minute walking test in OSA patients.

    PubMed

    Cholidou, Kyriaki G; Manali, Effrosyni D; Kapsimalis, Fotis; Kostakis, Ioannis D; Vougas, Konstantinos; Simoes, Davina; Markozannes, Evaggelos; Vogiatzis, Ioannis; Bakakos, Petros; Koulouris, Nikolaos; Alchanatis, Manos

    2014-10-01

    To examine the clinical usefulness of heart rate recovery (HRR) post 6-minute walking test (6MWT) as a simple marker of cardiovascular risk in obstructive sleep apnea (OSA) patients in comparison to HRR post cycle ergometry, the validated and more sophisticated protocol. Seventy-four participants underwent full overnight polysomnography, cycle ergometry and 6MWT. The HRR at 1, 2 and 3 min (HRR-1, HRR-2 and HRR-3) 6MWT was compared to HRR at 1, 2, and 3 min post cycle ergometry in normal subjects and in moderate and severe OSA patients before and after 6-month CPAP treatment. The HRR-1, HRR-2 and HRR-3 in 6MWT were significantly different between normal, moderate and severe OSA patients with higher rates achieved in normal. The higher the severity of OSA the lower the HRR was. There were also no differences found between work rate and distance walked during cycle ergometry or 6MWT, respectively, concerning normal, moderate and severe OSA patients. Heart rate recovery was further associated with minimum saturation of oxygen during sleep independently of the duration of apnea episodes of BMI and ESS. The treatment with CPAP had a beneficial effect on HRR both post-6MWT and post cycle ergometry. Autonomic nervous system dysfunction in OSA can be found even with submaximal exertion. Heart rate recovery post-6MWT, such as HRR post cycle ergometry, was significantly impaired in OSA patients in comparison to normals and was favorably influenced from CPAP treatment. Furthermore, it was found to be more sensitive compared with distance walked in 6MWT in discriminating severity of OSA. The HRR post-6MWT was found to be an easily measured and reliable marker of OSA severity both before and after CPAP treatment.

  7. Usefulness of a 50-meter round walking test for fall prediction in the elderly requiring long-term care.

    PubMed

    Hachiya, Mizuki; Murata, Shin; Otao, Hiroshi; Ihara, Takehiko; Mizota, Katsuhiko; Asami, Toyoko

    2015-12-01

    [Purpose] This study aimed to verify the usefulness of a 50-m round walking test developed as an assessment method for walking ability in the elderly. [Subjects] The subjects were 166 elderly requiring long-term care individuals (mean age, 80.5 years). [Methods] In order to evaluate the factors that had affected falls in the subjects in the previous year, we performed the 50-m round walking test, functional reach test, one-leg standing test, and 5-m walking test and measured grip strength and quadriceps strength. [Results] The 50-m round walking test was selected as a variable indicating fall risk based on the results of multiple logistic regression analysis. The cutoff value of the 50-m round walking test for determining fall risk was 0.66 m/sec. The area under the receiver operating characteristic curve was 0.64. The sensitivity of the cutoff value was 65.7%, the specificity was 63.6%, the positive predictive value was 55.0%, the negative predictive value was 73.3%, and the accuracy was 64.5%. [Conclusion] These results suggest that the 50-m round walking test is a potentially useful parameter for the determination of fall risk in the elderly requiring long-term care.

  8. Plantarflexor weakness negatively impacts walking in persons with multiple sclerosis more than plantarflexor spasticity

    PubMed Central

    Wagner, Joanne M.; Kremer, Theodore R.; Van Dillen, Linda R.; Naismith, Robert T.

    2014-01-01

    Objective To determine if plantarflexor (PF) spasticity or ankle strength best predicts variance in walking capacity or self-perceived limitations in walking in persons with multiple sclerosis (pwMS), and if pwMS with PF spasticity are weaker and have greater walking dysfunction than pwMS without PF spasticity. Design Cross-sectional study. Setting University research laboratory. Participants Forty-two pwMS (age: 42.9 ± 10.1 years; Expanded Disability Status Scale (EDSS): median = 3.0, range = 0–6) and 14 adults without disability (WD) (age: 41.9 ± 10.1 years). Intervention Not applicable. Main Outcome Measures PF spasticity and dorsiflexion (DF) and PF maximum voluntary isometric torque (MVIT) were assessed using the Modified Ashworth Scale (MAS) and a computerized dynamometer, respectively. The Timed 25-Foot Walk Test (T25FWT) was the primary outcome measure of walking capacity. Secondary measures included the Six Minute Walk Test (6MWT) and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Results PF strength was the most consistent predictor of the variance in walking capacity (T25FWT: R2 change = 0.23 to 0.29, p ≤ 0.001; 6MWT: R2 change = 0.12 to 0.29, p ≤ 0.012), and self-perceived limitations of walking (MSWS-12: R2 change = 0.04 to 0.14, p < 0.18). There were no significant differences (p > 0.05) between the pwMS with PF spasticity and pwMS without PF spasticity for any of the outcome measures. Conclusions Our study suggests a unique contribution of PF weakness to walking dysfunction in pwMS, and highlights the importance of evaluating PF strength in this clinical population. PMID:24582617

  9. Factors associated with the 6-minute walk test in nursing home residents and community-dwelling older adults

    PubMed Central

    Caballer, Vicent-Benavent; Lisón, Juan Francisco; Rosado-Calatayud, Pedro; Amer-Cuenca, Juan José; Segura-Orti, Eva

    2015-01-01

    [Purpose] The main objective of this study was to determine the contributions and extent to which certain physical measurements explain performance in the 6-minute walk test in healthy older adults living in a geriatric nursing home and for older adults dwelling in the community. [Subjects] The subjects were 122 adults aged 65 and older with no cognitive impairment who were independent in their daily activities. [Methods] The 6-minute walk test, age, body mass index, walking speed, chair stand test, Berg Balance Scale, Timed Up-and-Go test, rectus femoris cross-sectional area, Short Physical Performance Battery, and hand-grip strength were examined. [Results] Strong significant associations were found between mobility, lower-limb function, balance, and the 6-minute walk test. A stepwise multiple regression on the entire sample showed that lower-limb function was a significant and independent predictor for the 6-minute walk test. Additionally, lower-limb function was a strong predictor for the 6-minute walk test in our nursing home group, whereas mobility was found to be the best predictor in our community-dwelling group. [Conclusion] Better lower-limb function, balance, and mobility result in a higher distance covered by healthy older adults. Lower-limb function and mobility appeared to best determine walking performance in the nursing home and community-dwelling groups, respectively. PMID:26696740

  10. Changes in the endurance shuttle walk test in COPD patients with chronic respiratory failure after pulmonary rehabilitation: the minimal important difference obtained with anchor- and distribution-based method.

    PubMed

    Altenburg, Wytske A; Duiverman, Marieke L; Ten Hacken, Nick H T; Kerstjens, Huib A M; de Greef, Mathieu H G; Wijkstra, Peter J; Wempe, Johan B

    2015-02-19

    Although the endurance shuttle walk test (ESWT) has proven to be responsive to change in exercise capacity after pulmonary rehabilitation (PR) for COPD, the minimally important difference (MID) has not yet been established. We aimed to establish the MID of the ESWT in patients with severe COPD and chronic hypercapnic respiratory failure following PR. Data were derived from a randomized controlled trial, investigating the value of noninvasive positive pressure ventilation added to PR. Fifty-five patients with stable COPD, GOLD stage IV, with chronic respiratory failure were included (mean (SD) FEV1 31.1 (12.0) % pred, age 62 (9) y). MID estimates of the ESWT in seconds, percentage and meters change were calculated with anchor based and distribution based methods. Six minute walking distance (6MWD), peak work rate on bicycle ergometry (Wpeak) and Chronic Respiratory Questionnaire (CRQ) were used as anchors and Cohen's effect size was used as distribution based method. The estimated MID of the ESWT with the different anchors ranged from 186-199 s, 76-82% and 154-164 m. Using the distribution based method the MID was 144 s, 61% and 137 m. Estimates of the MID for the ESWT after PR showed only small differences using different anchors in patients with COPD and chronic respiratory failure. Therefore we recommend using a range of 186-199 s, 76-82% or 154-164 m as MID of the ESWT in COPD patients with chronic respiratory failure. Further research in larger populations should elucidate whether this cut-off value is also valid in other COPD populations and with other interventions. ClinicalTrials.Gov (ID NCT00135538).

  11. The Use of Videotape Technology to Train Administrators of Walk-Through Performance Testing.

    DTIC Science & Technology

    1988-07-01

    1985 at the annual meeting of the American Psychological Association in Los Angeles, California. PmZ 0 TABLE OF CONTENTS Page I. INTRODUCTION...The methodology of Walk-Through Performance Testing. Paper presented at the annual meeting of the American Psychological Association , Toronto. Jones...Paper presented at the annual meeting of the American Psychological Association , Toronto. Lord, R. G. (1985). Accuracy in behavioral measurement: An

  12. Incremental shuttle walk test: Reference values and predictive equation for healthy Indian adults

    PubMed Central

    Agarwal, Bela; Shah, Monal; Andhare, Nilesh; Mullerpatan, Rajani

    2016-01-01

    Purpose: Physical inactivity in Indians is leading to an increase in noncommunicable disorders at an early age in life. Early identification and quantification of the lack of physical activity using simple and reliable exercise testing is the need of the hour. The incremental shuttle walk test (ISWT) is an externally paced walk test widely used for the evaluation of exercise capacity. Currently the normative values available for clinical reference are generated from Western populations. Hence, the study was conducted to find normative values for the ISWT in healthy Indian adults (17-75 years). Materials and Methods: A convenience sample of 862 subjects was recruited after ethical approval was obtained. All subjects were divided into groups as per age and gender. For age, the grouping was as follows: Group 1: Young adulthood (17-40 years), group 2: Middle adulthood (40-65 years), and group 3: Old adulthood (>65 years). The ISWT was performed as per standard protocol by Sally Singh. Results: The average distance walked were 709.2m,556.4m and 441.3m in females and 807.9 m, 639.6 m and 478.2 m in males in the three respective age groups. Stepwise regression analysis revealed age and gender as key variables correlating with incremental shuttle walk distance (ISWD). The derived predictive equations for males and females may be given as follows: 740.351 - (5.676 × age) + (99.007 × gender). Conclusion: Reference values were generated for healthy Indian adults. Physiological response to the ISWT was shown to be affected by gender and increasing age. Easily measurable variables explained 68% of the variance seen in the test, making the reference equation a relevant part of the evaluation of the ISWT. PMID:26933305

  13. Are the average gait speeds during the 10meter and 6minute walk tests redundant in Parkinson disease?

    PubMed

    Duncan, Ryan P; Combs-Miller, Stephanie A; McNeely, Marie E; Leddy, Abigail L; Cavanaugh, James T; Dibble, Leland E; Ellis, Terry D; Ford, Matthew P; Foreman, K Bo; Earhart, Gammon M

    2017-02-01

    We investigated the relationships between average gait speed collected with the 10Meter Walk Test (Comfortable and Fast) and 6Minute Walk Test (6MWT) in 346 people with Parkinson disease (PD) and how the relationships change with increasing disease severity. Pearson correlation and linear regression analyses determined relationships between 10Meter Walk Test and 6MWT gait speed values for the entire sample and for sub-samples stratified by Hoehn & Yahr (H&Y) stage I (n=53), II (n=141), III (n=135) and IV (n=17). We hypothesized that redundant tests would be highly and significantly correlated (i.e. r>0.70, p<0.05) and would have a linear regression model slope of 1 and intercept of 0. For the entire sample, 6MWT gait speed was significantly (p<0.001) related to the Comfortable 10 Meter Walk Test (r=0.75) and Fast 10Meter Walk Test (r=0.79) gait speed, with 56% and 62% of the variance in 6MWT gait speed explained, respectively. The regression model of 6MWT gait speed predicted by Comfortable 10 Meter Walk gait speed produced slope and intercept values near 1 and 0, respectively, especially for participants in H&Y stages II-IV. In contrast, slope and intercept values were further from 1 and 0, respectively, for the Fast 10Meter Walk Test. Comfortable 10 Meter Walk Test and 6MWT gait speeds appeared to be redundant in people with moderate to severe PD, suggesting the Comfortable 10 Meter Walk Test can be used to estimate 6MWT distance in this population.

  14. Exercise training improves walking function in an African group of stroke survivors: a randomized controlled trial.

    PubMed

    Olawale, O A; Jaja, S I; Anigbogu, C N; Appiah-Kubi, K O; Jones-Okai, D

    2011-05-01

    To evaluate the effects of treadmill walking and overground walking exercise training on recovery of walking function in an African group of stroke survivors. Prospective, randomized controlled study. Outpatient stroke rehabilitation unit in a tertiary hospital. Sixty patients with chronic stroke (≥3 months). All subjects received individual outpatient conventional physiotherapy rehabilitation for 12 weeks. In addition, subjects in Group A (n = 20) received treadmill walking exercise training (TWET) while those in Group B (n = 20) received overground walking exercise training (OWET). Those in Group C (control) (n = 20) received conventional physiotherapy rehabilitation only. Outcome measures were (i) 10-metre walk time (10MWT) test and (ii) six-minute walk distance (6MWD) test. These were evaluated at entry into the study and at the end of every four weeks. Paired t-tests were used to evaluate the significance of the difference between pre-training and post-training scores on the two measures (P < 0.05). Subjects in the TWET group recorded 22.6 ± 1.5% decrease in 10MWT and 31.0 ± 4.3% increase in 6MWD; those in the OWET group made 26.8 ± 1.3% and 45.2 ± 4.6% improvement in 10MWT and 6MWD respectively. Subjects in the control group made 2.2 ± 0.7% and 2.9 ± 0.8% improvement in the two functions. These changes were significant for the TWET and OWET groups (P < 0.05). This study indicated that treadmill and overground walking exercise training programmes, combined with conventional rehabilitation, improved walking function in an African group of adult stroke survivors. Therefore, professionals who conduct stroke rehabilitation programmes should utilize exercise training to optimize patient outcomes.

  15. The 6-Minute Walk Test as a Predictor of Summit Success on Denali.

    PubMed

    Shea, Katherine M; Ladd, Eric R; Lipman, Grant S; Bagley, Patrick; Pirrotta, Elizabeth A; Vongsachang, Hurnan; Wang, N Ewen; Auerbach, Paul S

    2016-03-01

    To test whether the 6-minute walk test (6MWT), including postexercise vital sign measurements and distance walked, predicts summit success on Denali, AK. This was a prospective observational study of healthy volunteers between the ages of 18 and 65 years who had been at 4267 m for less than 24 hours on Denali. Physiologic measurements were made after the 6MWT. Subjects then attempted to summit at their own pace and, at the time of descent, completed a Lake Louise Acute Mountain Sickness Questionnaire and reported maximum elevation reached. One hundred twenty-one participants enrolled in the study. Data were collected on 111 subjects (92% response rate), of whom 60% summited. On univariate analysis, there was no association between any postexercise vital sign and summit success. Specifically, there was no significant difference in the mean postexercise peripheral oxygen saturation (Spo2) between summiters (75%) and nonsummiters (74%; 95% CI, -3 to 1; P = .37). The distance a subject walked in 6 minutes (6MWTD) was longer in summiters (617 m) compared with nonsummiters (560 m; 95% CI, 7.6 to 106; P = .02). However, this significance was not maintained on a multivariate analysis performed to control for age, sex, and guide status (P = .08), leading to the conclusion that 6MWTD was not a robust predictor of summit success. This study did not show a correlation between postexercise oxygen saturation or 6MWTD and summit success on Denali. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  16. Reliability of the Shuttle Walk Test With Controlled Incremental Velocity in Patients With Difficult-to-Control Asthma.

    PubMed

    Costa, Ivan Peres; Dal Corso, Simone; Borghi-Silva, Audrey; Peixoto, Fabiana; Stirbulov, Roberto; Arena, Ross; Cahalin, Lawrence P; Malosá Sampaio, Luciana Maria

    2017-09-06

    Asthma is a chronic inflammatory condition characterized by bronchial hypersensitivity to endogenous or exogenous agents and variable airflow limitation, which is reversible either spontaneously or with the use of medication. The evaluation of functional capacity in these patients is commonly performed using field tests to gauge activity of daily living. However, the reliability of the symptom-controlled shuttle walk test has not yet been determined for individuals with difficult-to-control asthma. The aim of the present study was to determine the reliability of the shuttle walk test in patients with severe, difficult-to-control asthma. Forty-five patients were evaluated including lung function tests, the International Physical Activity Questionnaire (IPAQ), and the Asthma Control Questionnaire. The participants performed a shuttle walk test twice, with a 20-min rest period between tests. The mean distance walked for this cohort was 330.5 m (range, 50-570 m) on the first walk test and 336.3 m (range, 60-571 m) on the second test. There was no statistical difference between the mean distances walked. The Bland-Altman plots of the 2 tests revealed a mean difference of -12.7 m, with a 95% CI of 37.9 to -63.2 m. Significant correlations were found between the distance walked in meters and the IPAQ (r = 0.36, P < .01) and distance in meters and muscle mass (r = 0.39, P < .009). The shuttle walk test is reliable for individuals with difficult-to-control asthma and can be used in the evaluation of functional capacity.

  17. Shuttle walking versus maximal cycle testing: clinical correlates in patients with kyphoscoliosis.

    PubMed

    López-Campos, José Luis; Cejudo, Pilar; Ortega, Francisco; López-Márquez, Isabel; Márquez-Martín, Eduardo; Capote, Francisco; Echevarría, Miriam; Montemayor, Teodoro; Barrot, Emilia

    2008-02-29

    A cross-sectional prospective design was used to compare the effectiveness of the shuttle walking test (SWT) and the maximal cycle ergometry test (CET) to assess the functional capacity of patients with chronic hypercapnic respiratory failure due to severe kyphoscoliosis. Twenty-four patients completed both the SWT and CET. Heart rate, blood pressure, leg fatigue, chest pain and dyspnea (Borg's scale) were measured immediately after each test. Correlation coefficients and Bland-Altman analysis were used to compare the two methods. Borg's dyspnea, leg and chest pain after exercise were not significantly different between tests. Only heart rate (SWT 130[20.7] versus CET 116[28.75]; p = 0.048) and diastolic blood pressure (SWT: 85.5[13.75] versus CET 95[17.5]; p = 0.021) were slightly but significantly different between the two protocols. There was a good positive correlation between the distance walked in SWT and maximal oxygen consumption (r = 0.675; p < 0.001). SWT and CET testing elicited similar clinical and hemodynamic responses. SWT is a feasible measure of functional capacity in this patient group.

  18. Do field walking tests produce similar cardiopulmonary demands to an incremental treadmill test in obese individuals with treated OSA?

    PubMed

    Evans, Rachael A; Dolmage, Thomas E; Robles, Priscila G; Goldstein, Roger S; Brooks, Dina

    2014-07-01

    Cardiorespiratory fitness, assessed during cardiopulmonary exercise tests by peak oxygen uptake (Vo2pk), is an independent predictor of mortality in obesity. We investigated whether Vo2pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test (ITMT) in obese individuals with treated OSA. Individuals with treated OSA and a BMI > 30 kg/m2 were recruited. Participants completed an ITMT, two 6-min walk tests (6MWTs), and two incremental shuttle walk tests (ISWTs) on three separate days in a randomized order. Expired gas analysis was performed during all tests. The study was completed by 16 patients (nine men) (mean [SD] age, 58 [12] y; BMI, 36.1 [7.6] kg/m2). There was no difference (P = .27) in Vo2pk assessed by the ITMT and the ISWT (2,266 [478] and 2,017 [561] mL/min, respectively). The Vo2pk measured by the 6MWT (1,778 [360] mL/min) was lower than that measured by the ITMT (P < .01). The limits of agreement for Vo2pk between the ISWT and the ITM were ± 730 mL/min. Cardiorespiratory responses during the ISWT and the ITMT reflected a graded response to a peak, whereas the 6MWT demonstrated a rapid rise to a plateau. The ISWT can be used instead of an ITMT and in preference to the 6MWT to assess cardiorespiratory fitness for a cohort of obese people with treated OSA. However, the imprecision of the agreement in Vo2pk between the ITMT and ISWT means they cannot be used interchangeably in an individual. ClinicalTrials.gov; No.: NCT01930513; www.clinicaltrials.gov.

  19. Reliability and validity of a twelve-minute walking test for coronary heart disease patients.

    PubMed

    de Greef, Mathieu H G; Sprenger, Siska R; Elzenga, Corrie T A; Popkema, Dorien Y; Bennekers, Johan H; Niemeijer, Menco G; Middel, Berry; Mook, Gerrit A

    2005-04-01

    This study examined the reliability and validity of a 12-min. walking test for coronary heart disease patients. CHD patients (28 men, 18 women) were recruited out of 86 CHD patients of the Martini Hospital Groningen, The Netherlands. 46 CHD patients (age M=66.0 yr., SD=6.8) participated in the reliability study and 24 (age M=62.0 yr., SD=9.2) in the validity study. A test-retest analysis showed a satisfactory Bland-Altman plot and an intraclass coefficient of .98. The Pearson correlation between the score on the test and the VO2 peak was .77. This test gives a reliable and valid assessment of cardiorespiratory fitness of CHD patients.

  20. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease.

    PubMed

    Holland, Anne E; Spruit, Martijn A; Troosters, Thierry; Puhan, Milo A; Pepin, Véronique; Saey, Didier; McCormack, Meredith C; Carlin, Brian W; Sciurba, Frank C; Pitta, Fabio; Wanger, Jack; MacIntyre, Neil; Kaminsky, David A; Culver, Bruce H; Revill, Susan M; Hernandes, Nidia A; Andrianopoulos, Vasileios; Camillo, Carlos Augusto; Mitchell, Katy E; Lee, Annemarie L; Hill, Catherine J; Singh, Sally J

    2014-12-01

    Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers. The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease. Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT. This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results. ©ERS 2014.

  1. The 6 minute walk test and performance of upper limb in ambulant duchenne muscular dystrophy boys.

    PubMed

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Fanelli, Lavinia; De Sanctis, Roberto; D'Amico, Adele; Messina, Sonia; Battini, Roberta; Bianco, Flaviana; Scutifero, Marianna; Petillo, Roberta; Frosini, Silvia; Scalise, Roberta; Vita, Gian Luca; Bruno, Claudio; Pedemonte, Marina; Mongini, Tiziana; Pegoraro, Elena; Brustia, Francesca; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Busato, Fabio; Bonfiglio, Serena; Rolle, Enrica; Colia, Giulia; Bonetti, Annamaria; Palermo, Concetta; Graziano, Alessandra; D'Angelo, Grazia; Pini, Antonella; Corlatti, Alice; Gorni, Ksenija; Baranello, Giovanni; Antonaci, Laura; Bertini, Enrico; Politano, Luisa; Mercuri, Eugenio

    2014-10-07

    The Performance of Upper Limb (PUL) test was specifically developed for the assessment of upper limbs in Duchenne muscular dystrophy (DMD). The first published data have shown that early signs of involvement can also be found in ambulant DMD boys. The aim of this longitudinal Italian multicentric study was to evaluate the correlation between the 6 Minute Walk Test (6MWT) and the PUL in ambulant DMD boys. Both 6MWT and PUL were administered to 164 ambulant DMD boys of age between 5.0 and 16.17 years (mean 8.82). The 6 minute walk distance (6MWD) ranged between 118 and 557 (mean: 376.38, SD: 90.59). The PUL total scores ranged between 52 and 74 (mean: 70.74, SD: 4.66). The correlation between the two measures was 0.499. The scores on the PUL largely reflect the overall impairment observed on the 6MWT but the correlation was not linear. The use of the PUL appeared to be less relevant in the very strong patients with 6MWD above 400 meters, who, with few exceptions had near full scores. In patients with lower 6MWD the severity of upper limb involvement was more variable and could not always be predicted by the 6MWD value or by the use of steroids. Our results confirm that upper limb involvement can already be found in DMD boys even in the ambulant phase.

  2. The 6 Minute Walk Test and Performance of Upper Limb in Ambulant Duchenne Muscular Dystrophy Boys

    PubMed Central

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Fanelli, Lavinia; De Sanctis, Roberto; D’Amico, Adele; Messina, Sonia; Battini, Roberta; Bianco, Flaviana; Scutifero, Marianna; Petillo, Roberta; Frosini, Silvia; Scalise, Roberta; Vita, Gian Luca; Bruno, Claudio; Pedemonte, Marina; Mongini, Tiziana; Pegoraro, Elena; Brustia, Francesca; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Busato, Fabio; Bonfiglio, Serena; Rolle, Enrica; Colia, Giulia; Bonetti, Annamaria; Palermo, Concetta; Graziano, Alessandra; D’Angelo, Grazia; Pini, Antonella; Corlatti, Alice; Gorni, Ksenija; Baranello, Giovanni; Antonaci, Laura; Bertini, Enrico; Politano, Luisa; Mercuri, Eugenio

    2014-01-01

    The Performance of Upper Limb (PUL) test was specifically developed for the assessment of upper limbs in Duchenne muscular dystrophy (DMD). The first published data have shown that early signs of involvement can also be found in ambulant DMD boys. The aim of this longitudinal Italian multicentric study was to evaluate the correlation between the 6 Minute Walk Test (6MWT) and the PUL in ambulant DMD boys. Both 6MWT and PUL were administered to 164 ambulant DMD boys of age between 5.0 and 16.17 years (mean 8.82). The 6 minute walk distance (6MWD) ranged between 118 and 557 (mean: 376.38, SD: 90.59). The PUL total scores ranged between 52 and 74 (mean: 70.74, SD: 4.66). The correlation between the two measures was 0.499. The scores on the PUL largely reflect the overall impairment observed on the 6MWT but the correlation was not linear. The use of the PUL appeared to be less relevant in the very strong patients with 6MWD above 400 meters, who, with few exceptions had near full scores. In patients with lower 6MWD the severity of upper limb involvement was more variable and could not always be predicted by the 6MWD value or by the use of steroids. Our results confirm that upper limb involvement can already be found in DMD boys even in the ambulant phase. PMID:25642376

  3. Walk on Floor Eyes Closed Test as a Measure of Postflight Ataxia

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Fisher, E. A.; Kofman, I. S.; Cerisano, J. M.; Harm, D.L.; Peters, B. T.; Bloomberg, J. J.

    2010-01-01

    INTRODUCTION: Astronauts returning from space flight universally exhibit impaired posture and locomotion. Measurement of this impairment is an evolving process. The walk on the floor line test with the eyes closed (WOFEC) provides a unique procedure for quantifying postflight ataxia. Data from a modified WOFEC were obtained as part of an ongoing NASA interdisciplinary pre- and postflight study (Functional Task Test, FTT) designed to evaluate astronaut postflight functional performance. METHODS: Seven astronauts (5 short duration with flights of 12-16 days; 2 long duration crewmembers with flights of 6 months) were tested twice before flight, on landing day (short duration only), and 1, 6, and 30 days after flight. The WOFEC consisted of walking for 10 steps (repeated twice) with the feet heel to toe in tandem, arms folded across the chest and the eyes closed. The performance metric (scored by three examiners from video) was the percentage of correct steps completed over the three trials. A step was not counted as correct if the crewmember sidestepped, opened their eyes, or paused for more than three seconds between steps. RESULTS/ CONCLUSIONS: There was a significant decrease in percentage of correct steps on landing day (short duration crew) and on first day following landing (long duration) with partial recovery the following day, and full recovery beginning on day sixth after flight. Both short and long duration fliers appeared to be unaware of foot position relative to their bodies or the floor. Postflight, deviation from a straight path was common, and the test for two crewmembers elicited motion sickness symptoms. These data clearly demonstrate the sensorimotor challenges facing crewmembers after returning from spaceflight. The WOFEC test has value providing the investigator or crew surgeon with a simple method to quantify vestibular ataxia, as well as providing instant feedback of postural ataxia without the use of complex test equipment.

  4. Minimal important difference in field walking tests in non-cystic fibrosis bronchiectasis following exercise training.

    PubMed

    Lee, A L; Hill, C J; Cecins, N; Jenkins, S; McDonald, C F; Burge, A T; Rautela, L; Stirling, R G; Thompson, P J; Holland, A E

    2014-09-01

    The 6-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) are clinically meaningful measures of exercise capacity in people with non-cystic fibrosis (CF) bronchiectasis, but the change in walking distance which constitutes clinical benefit is undefined. This study aimed to determine the minimal important difference for the 6MWD and ISWD in non-CF bronchiectasis. Thirty-seven participants with mean FEV1 70% predicted completed both field walking tests before and after an 8-week exercise program. The minimal important difference was calculated using a distribution-based and anchor-based method, with the global rating of change scale used. The mean change in 6MWD in participants who reported themselves to be unchanged was 10 m, compared to 36 m (small change) and 45 m (substantial change) (p = 0.01). For the ISWD, the mean change in participants who reported themselves to be unchanged was 33 m, compared to 54 m (small change) and 73 m (substantial change) (p = 0.04). The anchor-based method defined the minimal important difference for 6MWD as 24.5 m (AUC 0.76, 95% CI 0.61-0.91) and for ISWD as 35 m (AUC 0.88, 95% CI 0.73-0.99), based on participant's global rating of change. The distribution-based method indicated a value of 22.3 m for the 6MWD and 37 m for the ISWD. There was excellent agreement between the two methods for the 6MWD (kappa = 0.91) and the ISWD (kappa = 0.92). Small changes in 6MWD and ISWD may represent clinically important benefits in people with non-CF bronchiectasis. These data are likely to assist in the interpretation of change in exercise capacity following intervention. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Estimated V(O2)max from the rockport walk test on a nonmotorized curved treadmill.

    PubMed

    Seneli, Rhiannon M; Ebersole, Kyle T; OʼConnor, Kristian M; Snyder, Ann C

    2013-12-01

    The Rockport Walk Test (RWT) is a 1-mile walk used to estimate the maximal volume of oxygen uptake (V(O2)max). The purpose of this study was to validate the RWT on a nonmotorized curved treadmill (CT). Twenty-three healthy adults (10 females; 19-44 years old) participated. One trial of the RWT was performed on a measured indoor track (RWTO) and another on the CT (RWTC) on different days in randomized order. Heart rate (HR) and completion time were used to calculate V(O2)max using 6 different general and gender specific equations from previous research. Subjects also performed a treadmill graded exercise test (GXT), which was used as the criterion measure for V(O2)max. Completion times and HR between the 2 RWT were compared using dependent t-tests. Estimated V(O2)max values were compared between the RWTC, RWTO, and GXT through repeated measures analysis of variance, Pearson's correlations (r), and Bland-Altman's plots. There was no difference between completion times for the RWTO and RWTC but HRs were significantly higher with RWTC. When the same equation was applied to the RWTO and RWTC, there were no similar results. All V(O2)max estimations were different from observed V(O2)max except for the estimation from the relative general Kline et al. equation on the RWTO. Despite high correlations (r = 0.75-0.91), the RWTC underestimated V(O2)max. The RWTC underestimates V(O2)max but may be beneficial if a new equation were created specifically for the CT. With appropriate equations for the CT, the RWTC would provide an alternate form of V(O2)max testing.

  6. Reproducibility of the incremental shuttle walk test for women with morbid obesity.

    PubMed

    Peixoto-Souza, Fabiana Sobral; Sampaio, Luciana Maria Malosa; de Campos, Elaine Cristina; Cangussu Barbalho-Moulim, Marcela; Nascimento de Araujo, Poliane; Laurino Neto, Rafael Melillo; Arena, Ross; Costa, Dirceu

    2015-01-01

    The incremental shuttle walk test (ISWT) is a valuable tool for the assessment of functional capacity. However, few studies have used the ISWT in individuals with obesity or have determined its reproducibility in this population. The aim of the present study was to evaluate the reproducibility of the ISWT in women with morbid obesity. Twenty-three women with a body mass index >40 kg/m(2) (mean age: 39.1 ± 7.7) performed the ISWT twice on the same day. The mean distance traveled was 313.3 ± 100.2 m on the first test and 322.5 ± 98.9 on the second test, with no significant difference between tests. The intraclass correlation coefficient (0.91) indicated excellent reproducibility. Reliability determined through Bland-Altman analysis revealed a small mean difference between tests (-9.2 m). The practice of repeating the ISWT appears to be unnecessary for women with morbid obesity, as demonstrated by the excellent reproducibility of the test.

  7. Novel algorithm for a smartphone-based 6-minute walk test application: algorithm, application development, and evaluation.

    PubMed

    Capela, Nicole A; Lemaire, Edward D; Baddour, Natalie

    2015-02-20

    The 6-minute walk test (6MWT: the maximum distance walked in 6 minutes) is used by rehabilitation professionals as a measure of exercise capacity. Today's smartphones contain hardware that can be used for wearable sensor applications and mobile data analysis. A smartphone application can run the 6MWT and provide typically unavailable biomechanical information about how the person moves during the test. A new algorithm for a calibration-free 6MWT smartphone application was developed that uses the test's inherent conditions and smartphone accelerometer-gyroscope data to report the total distance walked, step timing, gait symmetry, and walking changes over time. This information is not available with a standard 6MWT and could help with clinical decision-making. The 6MWT application was evaluated with 15 able-bodied participants. A BlackBerry Z10 smartphone was worn on a belt at the mid lower back. Audio from the phone instructed the person to start and stop walking. Digital video was independently recorded during the trial as a gold-standard comparator. The average difference between smartphone and gold standard foot strike timing was 0.014 ± 0.015 s. The total distance calculated by the application was within 1 m of the measured distance for all but one participant, which was more accurate than other smartphone-based studies. These results demonstrated that clinically relevant 6MWT results can be achieved with typical smartphone hardware and a novel algorithm.

  8. Note: Network random walk model of two-state protein folding: Test of the theory

    NASA Astrophysics Data System (ADS)

    Berezhkovskii, Alexander M.; Murphy, Ronan D.; Buchete, Nicolae-Viorel

    2013-01-01

    We study two-state protein folding in the framework of a toy model of protein dynamics. This model has an important advantage: it allows for an analytical solution for the sum of folding and unfolding rate constants [A. M. Berezhkovskii, F. Tofoleanu, and N.-V. Buchete, J. Chem. Theory Comput. 7, 2370 (2011), 10.1021/ct200281d] and hence for the reactive flux at equilibrium. We use the model to test the Kramers-type formula for the reactive flux, which was derived assuming that the protein dynamics is described by a Markov random walk on a network of complex connectivity [A. Berezhkovskii, G. Hummer, and A. Szabo, J. Chem. Phys. 130, 205102 (2009), 10.1063/1.3139063]. It is shown that the Kramers-type formula leads to the same result for the reactive flux as the sum of the rate constants.

  9. [A new procedure for the estimation of physical fitness of patients during clinical rehabilitation using the 6-minutes walk test].

    PubMed

    Marek, W; Marek, E; Friz, Y; Vogel, P; Mückenhoff, K; Kotschy-Lang, N

    2010-03-01

    AIMS OF THE INVESTIGATION: The repetition of the 6-minutes walk test (6 MWT) in older patients is frequently performed in order to document the maximal walking distance, although it is not recommended in any guidelines on exercise tests and although there is common consent to save clinical resources in terms of time and staff. Therefore, we have examined whether and to what extent the repetition of the walk tests helps patients to get more familiar with this kind of exercise test. Thus the acquired physiological data should reliably describe the physical fitness of the patients at the beginning and at the end of their clinical rehabilitation. 35 patients performed their walk tests before and after 3 - 4 weeks of clinical rehabilitation. Each test has been repeated after one hour of recovery. The patients were instructed to walk during 6 minutes as fast as possible. They were equipped with a mobile pulse oximeter for recording oxygen saturation and heart rate. The distance, S, and the heart rate, fc, were measured. Measurements were performed every 30 seconds and recorded. The efficiency, E (E = S/6/fc), was calculated as the ratio of distance per minute and the mean heart rate during the test. In the first test the patients walked 416 +/- 63 m at a heart rate of 104.7 +/- 15.7 beats/min, in the first repeated test 454 +/- 71 m at a heart of 106.3 +/- 17.4 beats/min. In the second test, after clinical therapy, they walked 438 +/- 58 m at a heart rate of 106.3 +/- 17.4 beats/min, in the second repeated test 473 +/- 56 m at 108.6 +/- 13.2/min. The difference of the walking distances of the tests at the entrance were found to be 38.4 +/- 26.2 m (+ 9.3 +/- 6.2%), at the end of clinical rehabilitation 35 +/- 26 m (+ 8.4 +/- 6.4%). Both differences are found to be independent from the distance of the first test. They are not significantly different. The efficiency was not significantly different in the initial and final test (0.673 +/- 0.129 and 0.689 +/- 0.085 m

  10. Field Test: Results of Tandem Walk Performance Following Long-Duration Spaceflight

    NASA Technical Reports Server (NTRS)

    Rosenberg, M. J. F.; Reschke, M. F.; Cerisano, J. M.; Kofman, I. S.; Fisher, E. A.; Gadd, N. E.; May-Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.; hide

    2016-01-01

    BACKGROUND: Coordinated locomotion has proven to be challenging for many astronauts following long duration spaceflight. As NASA's vision for spaceflight points toward interplanetary travel, we must prepare for unassisted landings, where crewmembers may need to perform mission critical tasks within minutes of landing. Thus, it is vital to develop a knowledge base from which operational guidelines can be written that define when astronauts can be expected to safely perform certain tasks. Data obtained during the Field Test experiment (FT) will add important insight to this knowledge base. Specifically, we aim to develop a recovery timeline of functional sensorimotor performance during the first 24 hours and several days after landing. METHODS: FT is an ongoing study of 30 long-duration ISS crewmembers. Thus far, 9 have completed the full FT (5 U.S. Orbital Segment [USOS] astronauts and 4 Russian cosmonauts) and 4 more consented and launching within the next year. This is in addition to the eighteen crewmembers that participated in the pilot FT (11 USOS and 7 Russian crewmembers). The FT is conducted three times preflight and three times during the first 24 hours after landing. All crewmembers were tested in Kazakhstan in either the medical tent at the Soyuz landing site (one hour post-landing), or at the airport (four hours post-landing). The USOS crewmembers were also tested at the refueling stop (12 hours post-landing) and at the NASA Johnson Space Center (24 hours post-landing) and a final session 7 days post-landing. Crewmembers are instrumented with 9 inertial measurement unit sensors that measure acceleration and angular displacement (APDM's Emerald Sensors) and foot pressure-sensing insoles that measure force, acceleration, and center of pressure (Moticon GmbH, Munich, Germany) along with heart rate and blood pressure recording instrumentation. The FT consists of 12 tasks, but here we will focus on the most challenging task, the Tandem Walk, which was also

  11. Pilot Field Test: The Ability to Ambulate Following Landing as Assessed with Seat Egress, Walk and Obstacle Testing

    NASA Technical Reports Server (NTRS)

    Fisher, E. A.; Fomina, E. V; Reschke, M. F.; Cerisano, J. M.; Kofman, I. S.; Gadd, N. E.; Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.; Bloomberg, J. J.; Mulavara, A. P.; Kozlovskaya, I. B.; Tomilovskaya, E. S.

    2016-01-01

    To date, changes in functional performance have been systematically studied after short-duration space flight. As important as the postflight functional changes have been, full functional recovery has never been investigated or established for long-duration flights. The Pilot Field Test (PFT) experiment, conducted with participation of ISS crewmembers traveling on Soyuz expeditions 34S - 41S, is comprised of several tasks designed to study the recovery of sensorimotor abilities of astronauts during the first 24 hours after landing and beyond. The objective of the Seat Egress - Walk and Obstacle Test, developed by NASA's Russian collaborators at the Institute for Biomedical Problems, is to address this gap in knowledge. This will allow us to characterize the ability of crewmembers to perform critical mission requirements that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity.

  12. Outdoor Reproducibility of a 1-km Treadmill Walking Test to Predict Peak Oxygen Uptake in Cardiac Patients.

    PubMed

    Grazzi, Giovanni; Chiaranda, Giorgio; Myers, Jonathan; Pasanisi, Giovanni; Lordi, Rosario; Conconi, Francesco; Mazzoni, Gianni

    2017-09-01

    The aim of this study was to determine whether the 1-km treadmill walking test, previously developed to predict peak oxygen uptake ((Equation is included in full-text article.)O2peak) in stable cardiac outpatients, could be reproduced outdoors. Fifty male cardiac outpatients performed the 1-km walking test on a treadmill and on a flat track within 1 week. (Equation is included in full-text article.)O2peak was estimated for both testing conditions considering age, height, weight, walking speed, and heart rate. Average walking speed was slightly higher during outdoor conditions (5.73 ± 0.77 km/h vs 5.55 ± 0.84 km/h), whereas mean heart rates were similar for both testing conditions (102 ± 18 beats/min vs 103 ± 16 beats/min). (Equation is included in full-text article.)O2peak values for treadmill and outdoor tests were not significantly different (26.4 ± 4.1 mL/kg/min vs 26.8 ± 4.5 mL/kg/min) and were strongly correlated (r = 0.93, P < .0001). The slope and the intercept of the (Equation is included in full-text article.)O2peak values were not different from the line of identity. This moderate and perceptually regulated 1-km walking test administered outdoors gives similar results compared with a similar test performed on a treadmill. Therefore, (Equation is included in full-text article.)O2peak can be reasonably estimated using both testing modalities. This suggests that the outdoor 1-km test can be applied for indirect estimations of cardiorespiratory fitness in an outpatient setting.

  13. Does the Incremental Shuttle Walking Test require maximal effort in healthy subjects of different ages?

    PubMed

    Gonçalves, Cristiane Golias; Mesquita, Rafael; Hayashi, Daniela; Merli, Myriam Fernanda; Vidotto, Laís Silva; Fernandes, Karen Barros Parron; Probst, Vanessa S

    2015-06-01

    To evaluate if the Incremental Shuttle Walking Test (ISWT) requires maximal effort in healthy subjects of different ages. Cross-sectional. University-based research laboratory. 331 healthy subjects separated into six groups according to age: G1, 18 to 28 years; G2, 29 to 39 years; G3, 40 to 50 years; G4, 51 to 61 years; G5, 62 to 72 years and; G6, 73 to 83 years. Two ISWTs were performed and participants were permitted to run and to exceed 12 levels during the test, if necessary. Heart rate (HR) and symptoms of dyspnoea and fatigue were recorded before and after the test, and the percentage of age-predicted maximal HR (HRmax) was calculated. Maximal effort was defined as HRmax >90% of age-predicted HRmax. Almost 31% of the subjects exceeded 12 levels in the ISWT. At the end of the test, all groups presented a median [interquartile range] HR greater than 90% of HRmax (G1: 100 [95 to 104]; G2: 100 [96 to 105]; G3: 103 [97 to 108]; G4: 99 [91 to 106]; G5: 96 [87 to 106] and G6: 96 [91 to 109]% HRmax). Regarding symptoms, all groups showed higher values after the test (P<0.05). A multiple logistic regression analysis identified female gender, older age and a lower HR before the test as determinants of not achieving 90% of HRmax at the end of the test. The ISWT requires maximal effort in healthy individuals, but for that it is necessary to extend the test beyond twelve levels. Female gender, older age and lower heart rate before the test are the determinants of not reaching maximal effort. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  14. Does physiotherapy based on the Bobath concept, in conjunction with a task practice, achieve greater improvement in walking ability in people with stroke compared to physiotherapy focused on structured task practice alone?: a pilot randomized controlled trial.

    PubMed

    Brock, Kim; Haase, Gerlinde; Rothacher, Gerhard; Cotton, Susan

    2011-10-01

    To compare the short-term effects of two physiotherapy approaches for improving ability to walk in different environments following stroke: (i) interventions based on the Bobath concept, in conjunction with task practice, compared to (ii) structured task practice alone. Randomized controlled trial. Two rehabilitation centres Participants: Twenty-six participants between four and 20 weeks post-stroke, able to walk with supervision indoors. Both groups received six one-hour physiotherapy sessions over a two-week period. One group received physiotherapy based on the Bobath concept, including one hour of structured task practice. The other group received six hours of structured task practice. The primary outcome was an adapted six-minute walk test, incorporating a step, ramp and uneven surface. Secondary measures were gait velocity and the Berg Balance Scale. Measures were assessed before and after the intervention period. Following the intervention, there was no significant difference in improvement between the two groups for the adapted six-minute walk test (89.9 (standard deviation (SD) 73.1) m Bobath versus 41 (40.7) m task practice, P = 0.07). However, walking velocity showed significantly greater increases in the Bobath group (26.2 (SD 17.2) m/min versus 9.9 (SD = 12.9) m/min, P = 0.01). No significant differences between groups were recorded for the Berg Balance Scale (P = 0.2). This pilot study indicates short-term benefit for using interventions based on the Bobath concept for improving walking velocity in people with stroke. A sample size of 32 participants per group is required for a definitive study.

  15. Oxygen desaturation in healthy subjects undergoing the incremental shuttle walk test*

    PubMed Central

    Seixas, Daniel Machado; Seixas, Daniela Miti Tsukumo; Pereira, Monica Corso; Moreira, Marcos Mello; Paschoal, Ilma Aparecida

    2013-01-01

    OBJECTIVE: To determine the probability of oxygen desaturation in healthy individuals undergoing the incremental shuttle walk test (ISWT). METHODS: We enrolled 83 healthy subjects: 55 males (including 1 smoker) and 28 females. We determined pre-ISWT FEV1, FEV6, HR and SpO2, as well as post-ISWT HR and SpO2. RESULTS: Mean values overall were as follows: age, 35.05 ± 12.53 years; body mass index, 24.30 ± 3.47 kg/m2; resting HR, 75.12 ± 12.48 bpm; resting SpO2, 97.96 ± 1.02%; FEV1, 3.75 ± 0.81 L; FEV6, 4.45 ± 0.87 L; FEV1/FEV6 ratio, 0.83 ± 0.08 (no restriction or obstruction); incremental shuttle walk distance, 958.30 ± 146.32 m; post-ISWT HR, 162.41 ± 18.24 bpm; and post-ISWT SpO2, 96.27 ± 2.21%. In 11 subjects, post-ISWT SpO2 was higher than was pre-ISWT SpO2. In 17 subjects, there was a 4% decrease in SpO2 after the ISWT. There were no statistically significant differences between the groups with and without post-ISWT oxygen desaturation in terms of age, gender, FEV1, FEV6, FEV1/FEV6, pre-ISWT SpO2, incremental shuttle walk distance, HR, or percentage of maximal HR. In the individuals with post-ISWT oxygen desaturation, the body mass index was higher (p = 0.01) and post-ISWT SpO2 was lower (p = 0.0001). CONCLUSIONS: Healthy individuals can present oxygen desaturation after the ISWT. Using the ISWT to predict subtle respiratory abnormalities can be misleading. In healthy subjects, oxygen desaturation is common after the ISWT, as it is during any intense physical activity. PMID:24068265

  16. Comparison between the 6-minute walk tests performed in patients with chronic obstructive pulmonary disease at different altitudes

    PubMed Central

    Squassoni, Selma Denis; Machado, Nadine Cristina; Lapa, Mônica Silveira; Cordoni, Priscila Kessar; Bortolassi, Luciene Costa; de Oliveira, Juliana Nascimento; Tavares, Cecilia Melo Rosa; Fiss, Elie

    2014-01-01

    Objective To evaluate the influence of the altitude on the 6-minute walking test in patients with moderate to severe pulmonary disease. Methods Twenty-nine patients performed the 6-minute walk test at a pulmonary rehabilitation clinic in Santo André (above sea level), in São Paulo State, and at the Enseada Beach, in Guarujá (at sea level), also in São Paulo State. Of these 29 patients, 8 did the test both on hard sand and on asphalt to analyze if there were differences in performance during the tests. Data such as heart rate, oxygen saturation, test distance, and Borg scale were compared. Results We found no statistical difference in relation to oxygen saturation at rest before the beginning of the walking test in Santo André 94.67±2.26% and at sea level 95.56±2% (p=0.71). The minimum saturation measured during the test was 87.27±6.54% in Santo André and 89.10±5.41% in Guarujá (p=0.098). There were no differences in the performed distance between the different kinds of terrains; the distance on sand was 387.75±5.02m and on asphalt it was 375.00±6.54m (p=0.654). Regarding oxygen saturation during walking, the pulse oximetry on sand was 95.12±1.80% and on asphalt it was 96.87±1.64% (p=1.05). Conclusion Altitude did not affect the performance of the walking test in patients with moderate to severe pulmonary disease and the results were similar in both cases, on sand and on asphalt. PMID:25628195

  17. Incremental shuttle walk test distance and autonomic dysfunction predict survival in pulmonary arterial hypertension.

    PubMed

    Billings, Catherine G; Hurdman, Judith A; Condliffe, Robin; Elliot, Charlie A; Smith, Ian A; Austin, Matthew; Armstrong, Iain J; Hamilton, Neil; Charalampopoulos, Athanasios; Sabroe, Ian; Swift, Andrew J; Rothman, Alexander M; Wild, Jim M; Lawrie, Allan; Waterhouse, Judith C; Kiely, David G

    2017-08-01

    To ensure effective monitoring of pulmonary arterial hypertension (PAH), a simple, reliable assessment of exercise capacity applicable over a range of disease severity is needed. The aim of this study was to assess the ability of the incremental shuttle walk test (ISWT) to correlate with disease severity, measure sensitivity to change, and predict survival in PAH. We enrolled 418 treatment-naïve patients with PAH with baseline ISWT within 3 months of cardiac catheterization. Clinical validity and prognostic value of ISWT distance were assessed at baseline and 1 year. ISWT distance was found to correlate at baseline with World Health Organization functional class, Borg score, and hemodynamics without a ceiling effect (all p < 0.001). Walking distance at baseline and after treatment predicted survival; the area under the receiver operating characteristic curve for ability of ISWT distance to predict mortality was 0.655 (95% confidence interval 0.553-0.757; p = 0.004) at baseline and 0.737 (95% confidence interval 0.643-0.827; p < 0.001) at 1 year after initiation of treatment. Change in ISWT distance also predicted survival (p = 0.04). Heart rate (HR) and systolic blood pressure (SBP) parameters reflecting autonomic response to exercise (highest HR, change in HR, HR recovery at 1 minute >18 beats/min, highest SBP, change in SBP, and 3-minute SBP ratio) were significant predictors of survival (all p < 0.05). In patients with PAH, the ISWT is simple to perform, allows assessment of maximal exercise capacity, is sensitive to treatment effect, predicts outcome, and has no ceiling effect. Also, measures of autonomic function made post-exercise predict survival in PAH. Copyright © 2017. Published by Elsevier Inc.

  18. The 1-Minute Sit-to-Stand Test in Adults With Cystic Fibrosis: Correlations With Cardiopulmonary Exercise Test, 6-Minute Walk Test, and Quadriceps Strength.

    PubMed

    Gruet, Mathieu; Peyré-Tartaruga, Leonardo Alexandre; Mely, Laurent; Vallier, Jean-Marc

    2016-12-01

    Exercise testing is part of the regular assessment of patients with cystic fibrosis (CF). We aimed to evaluate (1) the convergent validity of the 1-min sit-to-stand (STS) test in CF by investigating its relationships with peak oxygen uptake (peak V̇O2 ), quadriceps strength, and quality of life and (2) to compare these associations with those of the 6-min walk test (6MWT). Twenty-five adults with CF (FEV1 = 59 ± 24%) performed the STS test, the 6MWT, quadriceps strength assessment, and cardiopulmonary exercise test (CPET). Physical activity level, quality of life, and self-esteem were assessed by questionnaires. STS repetitions, 6-min walk distance, quadriceps strength, and peak V̇O2 were, respectively, 71 ± 12, 90 ± 10, 93 ± 29, and 62 ± 16% of predicted. The STS test had moderate associations with peak V̇O2 (r = 0.56, P = .004), quadriceps strength (r = 0.52, P = .008), and some questionnaire items (eg, perceived physical strength, r = 0.67, P < .001) only when repetitions were expressed as a product of body weight. Overall, these associations were weaker than those obtained from 6-min walk distance × weight. Oxygen desaturation during the STS test was strongly associated with oxygen desaturation during CPET (r = 0.80, P < .001). Peak heart rate was lower during the STS test as compared with CPET (P < .001) and the 6MWT (P = .009). The STS test cannot be used as a replacement for CPET to accurately assess peak exercise capacity in CF. The STS test may have utility in detecting patients with CF who may exhibit a high level of oxygen desaturation during heavy exercise. Further studies should identify the factors contributing to STS performance to confirm the potential interest of STS repetitions × body weight outcome as a useful submaximal exercise parameter in CF. Copyright © 2016 by Daedalus Enterprises.

  19. The six-spot-step test - a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy.

    PubMed

    Kreutzfeldt, Melissa; Jensen, Henrik B; Ravnborg, Mads; Markvardsen, Lars H; Andersen, Henning; Sindrup, Søren H

    2017-06-01

    The aim of this study was to evaluate whether the six-spot-step test (SSST) is more suitable for monitoring walking ability in patients with chronic inflammatory polyneuropathy than the timed 25-foot-walking test (T25FW). In the SSST, participants have to walk as quickly as possible across a field measuring 1 × 5 m, while kicking blocks out of five circles on the floor. Sixty-two patients and 61 controls performed the SSST and T25FW. Patients also performed the overall disability sumscore, INCAT sensory sumscore, Medical Research Council sumscore, and 9-hole-peg-test. Twenty-one patients treated with intravenous immunoglobulin (IVIG) every 4-6 weeks were tested prior to and 2-3 weeks after treatment and judged change in their own clinical condition using the patient global impression of change (PGIC) scale. In patients, SSST ranged from 5.7 to 26.8 s and T25FW ranged from 3.6 to 12.9 s. Intra-class correlation between repeated tests was 0.97 for SSST and 0.95 for T25FW. Correlation with the additional tests was stronger for SSST than T25FW. In IVIG-treated patients, the mean change in walking time was -2.3 s for SSST and -0.6 s for T25FW. The SSST showed larger responsiveness in terms of effect size, standardized response means, and relative efficiency. Both ambulation tests correlated moderately to PGIC. The SSST may be superior to the T25FW in terms of dynamic range, floor effect, and responsiveness which makes the SSST a possible alternative for monitoring walking ability in patients with chronic inflammatory polyneuropathy. © 2017 Peripheral Nerve Society.

  20. Random walk designs for selecting pool sizes in group testing estimation with small samples.

    PubMed

    Haber, Gregory; Malinovsky, Yaakov

    2017-08-09

    Group testing estimation, which utilizes pooled rather than individual units for testing, has been an ongoing area of research for over six decades. While it is often argued that such methods can yield large savings in terms of resources and/or time, these benefits depend very much on the initial choice of pool sizes. In fact, when poor group sizes are used, the results can be much worse than those obtained using standard techniques. Tools for addressing this problem in the literature have been based on either large sample results or prior knowledge of the parameter being estimated, with little guidance when these assumptions are not met. In this paper, we introduce and study random walk designs for choosing pool sizes when only a small number of tests can be run and prior knowledge is vague. To illustrate these methods, application is made to the estimation of prevalence for two diseases among Australian chrysanthemum crops. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Validation of the Rockport Fitness Walking Test in college males and females.

    PubMed

    Dolgener, F A; Hensley, L D; Marsh, J J; Fjelstul, J K

    1994-06-01

    The purposes of this study were (a) to validate the Rockport Fitness Walking Test (RFWT) in college students, and (b) to develop prediction equations on this college sample if the RFWT proved invalid. Subjects were administered a test to determine maximal oxygen uptake (VO2max) on a treadmill and the RFWT in a field testing environment. Comparisons were made between the measured VO2max and the VO2max predicted from the equations of Kline, Porcari, Hintermeister, et al. (1987). The Kline, Porcari, Hintermeister, et al. equations overpredicted VO2max by 16-18% in the males and by 22-23% in the females. The correlation coefficients between the measured and predicted VO2max values ranged from .39 to .59. Derivation of new prediction equations using the same variables as in the RFWT produced only one equation that had sufficient accuracy to recommend its use. It was concluded that the original RFWT overpredicts VO2max in college students and should not be used with this population.

  2. Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials.

    PubMed

    Nyman, Samuel R; Goodwin, Kelly; Kwasnicka, Dominika; Callaway, Andrew

    2016-01-01

    Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals. Eight adults aged 60-87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions. Walking was objectively measured using pedometers. Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time. We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people's physical activity.

  3. Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials

    PubMed Central

    Nyman, Samuel R.; Goodwin, Kelly; Kwasnicka, Dominika; Callaway, Andrew

    2016-01-01

    Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals. Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions. Main outcome measures: Walking was objectively measured using pedometers. Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time. Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity. PMID:26387689

  4. Association between dual task-related decrease in walking speed and real versus imagined Timed Up and Go test performance.

    PubMed

    Bridenbaugh, Stephanie A; Beauchet, Olivier; Annweiler, Cédric; Allali, Gilles; Herrmann, François; Kressig, Reto W

    2013-06-01

    To examine whether older people with markedly dual task-related decreases in walking speed - a marker of disturbed higher-level gait control and falls - have a larger discrepancy between real and imagined Timed Up and Go (TUG) test times than those with less dual task-related decreases in walking speed. Based on a prospective cross-sectional study, 193 older adults (mean age 77.4 ± 5.9 years; 44.0 % women) referred to and consecutively assessed at a Swiss university clinic for a gait analysis to assess either gait disorders, fall risk or memory disorders were included. For all participants, walking speed was measured using a GAITRite(®) electronic walkway system during usual walking at self-selected pace and while dual tasking (i.e., usual walking and simultaneously counting backwards out loud). In addition, real Timed Up and Go (TUGr) and imagined Timed Up and Go (TUGi) (i.e., the time needed to imagine performing the TUGr) times were measured with a stopwatch. Differences between both walking conditions for walking speed (delta of walking speed) and both TUG conditions (delta of TUG time) were calculated. Age, gender, height, total number drugs taken per day, daily use of psychoactive drugs, use of walking aid, history of falls, Mini-Mental State Examination score, near vision and education level were used as covariables in this analysis. Participants were categorized into two groups based on being in the lowest tertian (i.e., <33 %: group A corresponding to participants undisturbed by dual task) or not (i.e., ≥33 %: group B corresponding to participants disturbed by dual task) of the delta of walking speed. In both groups, TUGr and TUGi times were similar (P = .169 and P = .839). In both groups, TUGi was faster than TUGr (P < .001). Delta of TUG time was significantly greater in group B compared to group A (P < .001). After adjustment for all covariables, only the delta of walking speed was significantly associated with the delta of TUG

  5. Convergent validity of the Timed Up and Go Test and Ten-metre Timed Walk Test in pregnant women with pelvic girdle pain.

    PubMed

    Evensen, Natalie Michelle; Kvåle, Alice; Brækken, Ingeborg Hoff

    2016-02-01

    Pregnant women with pelvic girdle pain (PGP) often experience functional difficulties, in particular walking difficulties. Currently, however, there is a lack of validated performance-orientated outcome measures available for use in this population. The Timed Up and Go (TUG) test and Ten-metre Timed Walk Test (10 mTWT) are two short-distance walking tests that have demonstrated reliability in pregnant women with PGP, but as yet have no established validity. The aim of the present study was to evaluate the convergent validity of the TUG and 10 mTWT by comparing performances on these two walking tests with scores achieved on the Active Straight Leg Raise (ASLR) test and the Pelvic Girdle Questionnaire (PGQ). Eighteen pregnant women with PGP aged 31.4 years (SD = 2.7) and 28.9 weeks pregnant (SD = 7.3) were included. Spearman rank correlation coefficient (rs) was used to determine convergent validity. Strong correlations were found between the TUG and ASLR (rs = 0.73, p = 0.001), and the 10 mTWT and ASLR (rs = -0.65, p = 0.003). Relationships between the TUG and PGQ were moderate (rs = 0.41 to 0.52) and between the 10 mTWT and PGQ low to moderate (rs = -0.25 to -0.56). The strong relationships between the walking tests and the ASLR may suggest these tests all assess the same construct. The weaker relationships found between the walking tests and the PGQ may be related to the self-report and multiple functional activities nature of the questionnaire. This study found both the TUG and 10 mTWT to be valid weight-bearing physical performance measures, although more research is warranted due to the small study sample.

  6. Electromechanical-assisted training for walking after stroke.

    PubMed

    Mehrholz, J; Werner, C; Kugler, J; Pohl, M

    2007-10-17

    Electromechanical and robotic-assisted gait training devices are used in rehabilitation and might help to improve walking after stroke. To investigate the effect of automated electromechanical and robotic-assisted gait training devices for improving walking after stroke. We searched the Cochrane Stroke Group Trials Register (last searched September 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 3, 2006), MEDLINE (1966 to September 2006), EMBASE (1980 to September 2006), CINAHL (1982 to October 2006), AMED (1985 to October 2006), SPORTDiscus (1949 to August 2006), the Physiotherapy Evidence Database (PEDro, searched September 2006) and the engineering databases COMPENDEX (1972 to October 2006) and INSPEC (1969 to October 2006). We handsearched relevant conference proceedings, searched trials and research registers, checked reference lists and contacted authors in an effort to identify further published, unpublished and ongoing trials. We included studies using random assignment. Two review authors independently selected trials for inclusion, assessed trial quality and extracted the data. The primary outcome was the proportion of patients walking independently (without assistance or help of a person) at follow up. Eight trials (414 participants) were included in this review. Electromechanical-assisted gait training in combination with physiotherapy increased the odds of becoming independent in walking (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.85 to 5.06; P < 0.001), and increased walking capacity (mean difference (MD) = 34 metres walked in six minutes, 95% CI 8 to 60; P = 0.010), but did not increase walking velocity significantly (MD = 0.08 m/sec, 95% CI -0.01 to 0.17; P = 0.08). However, the results must be interpreted with caution because (1) variations between the trials were found with respect to duration and frequency of treatment and differences in ambulatory status of patients, and (2) some trials

  7. Minimal important difference for 6-minute walk test distances among patients with chronic heart failure.

    PubMed

    Täger, Tobias; Hanholz, Wiebke; Cebola, Rita; Fröhlich, Hanna; Franke, Jennifer; Doesch, Andreas; Katus, Hugo A; Wians, Frank H; Frankenstein, Lutz

    2014-09-01

    The 6-minute walk test (6 WT) is an established tool in the assessment of endurance and prognosis in patients with chronic heart failure (CHF). For these patients there is very limited data on biological variation of 6 WT distances. We determined the minimal important difference (MID) for the 6 WT in patients with stable systolic CHF. Two cohorts of patients with stable systolic CHF were included from the outpatients' clinic of the University of Heidelberg. In these cohorts, two 6 WT measurements were performed - in cohort 1 (n=461) 180 days and in cohort 2 (n=512) 365 days apart. Stability was defined as the absence of clinical events (3 months before the first test, between both tests, and 6 months after the second test) and stability of symptoms (NYHA) between tests. Using a standard error of measurement (SEM)-based approach, we determined the MID for both cohorts. The intraclass correlation coefficient was 0.89 at 180 days and 0.88 at 365 days. The results were consistent for groups stratified for age, gender, etiology of CHF, and individual NYHA class. The MID for the 6 WT in stable CHF patients was 35 m and 37 m between presentation and 180 and 365 days, respectively. Submaximal exercise capacity as represented by the 6 WT varies little in stable CHF patients for up to 1-year intervals. The MID for changes in 6 WT values in patients with stable CHF over a period of 6 to 12 months is ~ 36 m. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. The 6-min Walk Test Reflects Functional Capacity in Primary Care and Obese Patients.

    PubMed

    Baillot, A; Baillargeon, J-P; Brown, C; Langlois, M-F

    2015-06-01

    The main purpose of this study was to determine the association between the 6-min walk test distance (6MWTD) and physical functional capacity (PF) in primary care patients, as well as in obese individuals. We studied 351 subjects (age=56.8±14.6 years; BMI=29.4±5.7 kg/m(2); 68% women), including 141 obese subjects (BMI≥30 kg/m(2)), recruited in 10 different family practices. Physical (PCS) and mental component summary of the health-related quality of life (HRQOL) and the 8 sub-scores were measured using the Short Form-36 Health Survey. Anthropometry, vital signs and physical testing were measured according to standardized protocols. Recreational physical activity (LPA) and sedentary levels were determined using the Canadian Community Health Survey. In a stepwise multivariate analysis, 65% of the 6MWTD variance was explained by PF of the HRQOL, age, quadriceps strength, number of chronic diseases, LPA categories, BMI, resting heart rate, PCS, height and TV-viewing categories in primary care subjects. In the obese individuals, PF, age, quadriceps strength and BMI explained 57% of the 6MWTD variance. In these 2 groups, 44% of the 6MWTD variance is explained by PF only. To conclude, the 6MWTD is strongly associated with PF of the HRQOL. Thus, it adequately reflects physical limitations in daily life activities of primary care patients, including obese individuals. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Does the incremental shuttle walk test require maximal effort in young obese women?

    PubMed

    Jürgensen, S P; Trimer, R; Di Thommazo-Luporini, L; Dourado, V Z; Bonjorno-Junior, J C; Oliveira, C R; Arena, R; Borghi-Silva, A

    2016-07-11

    Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX) on a treadmill to responses obtained by the incremental shuttle walk test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 - age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05) with ISWT peak VO2 (r=0.79) as well as ISWT distance (r=0.65). The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option.

  10. Responsiveness of the ten-metre walk test, Step Test and Motor Assessment Scale in inpatient care after stroke

    PubMed Central

    2014-01-01

    Background Responsiveness of a measurement tool is its ability to detect change over time. The aim of this study was to determine the responsiveness and floor/ceiling effects of the ten-metre walk test (10mWT), Step Test and Motor Assessment Scale (MAS) lower limb items. Methods An inception cohort study was conducted, including 190 stroke survivors admitted to a comprehensive stroke unit. The 10mWT, Step Test and MAS were administered within 48 hours of admission and repeated in the 48 hours before discharge. Responsiveness was analysed with Effect Size (ES), Standardised Response Mean (SRM) and a median-based Effect Size (mES). Floor/ceiling effects were calculated as the percentage of participants scoring the lowest/highest possible scores. Results Responsiveness of each outcome measure varied according to the statistic used. Values for the 10mWT were ES 1.44, SRM 0.93, mES 0.45; the step test ES 1.99, SRM 0.88, mES 0.36; MAS sit-to-stand (item 4) score ES 1.27, SRM 1.00, mES 0.50; and for MAS item 5 (walking) ES 1.43, SRM 1.10, mES 0.50. The MAS item 3 (sitting balance) was moderately responsive in all analyses (ES 0.72, SRM 0.71, mES 0.50). The MAS mobility score (summed items 3-5) consistently showed large responsiveness (ES 1.42, SRM 1.16, mES 0.92). The Step Test had the highest proportion of participants who didn’t change (46%) and item 4 of the MAS showed the largest ceiling effect on discharge (44%). Conclusions Most measures were able to detect change in motor performance during inpatient stroke rehabilitation but the MAS mobility score was the only measure that demonstrated large responsiveness and no marked floor or ceiling effects. PMID:24934859

  11. Measuring Steady-State Oxygen Uptake during the 6-Min Walk Test in Adults with Cerebral Palsy: Feasibility and Construct Validity

    ERIC Educational Resources Information Center

    Maltais, Desiree B.; Robitaille, Nancy-Michelle; Dumas, Francine; Boucher, Normand; Richards, Carol L.

    2012-01-01

    This study evaluated the feasibility of measuring steady-state oxygen uptake (V[Combining Dot Above]O[subscript 2]) during the 6-min walk test (6MWT) in adults with cerebral palsy (CP) who walk without support and whether there is construct validity for net 6MWT V[Combining Dot Above]O[subscript 2] as a measure of their walking ability.…

  12. Measuring Steady-State Oxygen Uptake during the 6-Min Walk Test in Adults with Cerebral Palsy: Feasibility and Construct Validity

    ERIC Educational Resources Information Center

    Maltais, Desiree B.; Robitaille, Nancy-Michelle; Dumas, Francine; Boucher, Normand; Richards, Carol L.

    2012-01-01

    This study evaluated the feasibility of measuring steady-state oxygen uptake (V[Combining Dot Above]O[subscript 2]) during the 6-min walk test (6MWT) in adults with cerebral palsy (CP) who walk without support and whether there is construct validity for net 6MWT V[Combining Dot Above]O[subscript 2] as a measure of their walking ability.…

  13. Comparing the Predictive Value of Task Performance and Task-Specific Sensitivity During Physical Function Testing Among People With Knee Osteoarthritis.

    PubMed

    Wideman, Timothy H; Edwards, Robert R; Finan, Patrick H; Haythornthwaite, Jennifer A; Smith, Michael T

    2016-05-01

    Study Design Cross-sectional cohort. Background Knee osteoarthritis (OA) is a leading cause of pain and mobility restriction. Past research has advocated the use of brief, functional tasks to evaluate these restrictions, such as the six-minute-walk test and the timed up-and-go test. Typically, only task performance (ie, walking distance, completion time) is used to inform clinical practice. Recent research, however, suggests that individual variance in how people feel while completing these tasks (ie, task sensitivity) might also have important clinical value. Objective To compare the predictive value of task performance and task-specific sensitivity in determining OA-related physical function (measured by the Western Ontario and McMaster Universities Osteoarthritis Index) and pain-related interference (measured by the Multidimensional Pain Inventory). Methods One hundred eight participants with chronic knee OA completed the six-minute-walk test and the timed up-and-go test, and reported levels of discomfort and affective response (mood) associated with each test. Results In separate regression models, both task performance and task-specific sensitivity predicted OA-related physical function and pain-related interference. A final regression model including all significant predictors showed that task-specific sensitivity (specifically, post-six-minute-walk discomfort) emerged as a unique predictor of both outcomes. Conclusion These findings highlight the value of a novel clinical assessment strategy for patients with knee OA. While clinicians commonly focus on how patients perform on standardized functional tasks, these results highlight the value of also considering levels of posttask sensitivity. Measures of task-specific sensitivity relate to Maitland's concept of pain irritability, which may be a useful framework for future research on sensitizing factors and pain-related disability. J Orthop Sports Phys Ther 2016;46(5):346-356. Epub 21 Mar 2016. doi:10

  14. Submaximal exercise testing may be superior to the 6-min walk test in assessing pulmonary arterial hypertension disease severity.

    PubMed

    Neal, Jennifer E; Lee, Augustine S; Burger, Charles D

    2014-10-01

    Submaximal exercise testing (SET) assesses functional exercise capacity in pulmonary arterial hypertension (PAH) patients and provides additional physiologic information compared with the 6-min walk test (6MWT). The relative correlations of the 6MWT and SET using SHAPE-HF™ with other markers of PAH severity, particularly echocardiogram (ECHO)-derived mean pulmonary artery pressure (MPAP), have not been investigated. (i) Examine the correlation between SHAPE measures with the 6-min walk distance (6MWD), and (ii) Compare SHAPE parameters and the 6MWD to clinical measures of PAH severity. Fifty-five consecutive group 1 PAH outpatients were evaluated in a single pulmonary hypertension referral center from March 2011 to June 2012. World Health Organization (WHO) functional class (FC), brain natriuretic peptide (BNP), ECHO, 6MWD and SHAPE results. Data are reported using mean ± standard deviation and Spearman correlation coefficients (r). Nine patients were excluded. Of the 46 remaining patients, 78% were women and the average age was 61 ± 13 years. PAH characteristics: WHO FC III-IV 48%; idiopathic PAH 52%; BNP 198 ± 277 pg/mL; 6MWD 399 ± 97 m; ECHO right atrial pressure (RAP) 7 ± 4, pulmonary artery systolic pressure (PASP) 63 ± 29 and MPAP 45 ± 17 mmHg. SET with SHAPE results: mean partial pressure of end-tidal (PET ) CO2 31 ± 6 mmHg at end-exercise; ventilatory efficiency (VE/VCO2 ) 43 ± 16. Significant correlations were found between the 6MWD and SHAPE variables: VE/VCO2 (r = -0.57, P < 0.0001) and end-exercise PET CO2 (r = 0.42, P = 0.004). VE/VCO2 correlated with WHO FC, BNP, RAP, MPAP and PASP and 6MWD only with WHO FC, BNP and PASP. SHAPE outperformed 6MWD in comparison with other measures of PAH disease severity. © 2013 John Wiley & Sons Ltd.

  15. Does the incremental shuttle walk test require maximal effort in young obese women?

    PubMed Central

    Jürgensen, S.P.; Trimer, R.; Di Thommazo-Luporini, L.; Dourado, V.Z.; Bonjorno-Junior, J.C.; Oliveira, C.R.; Arena, R.; Borghi-Silva, A.

    2016-01-01

    Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX) on a treadmill to responses obtained by the incremental shuttle walk test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 – age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05) with ISWT peak VO2 (r=0.79) as well as ISWT distance (r=0.65). The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option. PMID:27409333

  16. 6 Minute Walk Test in Duchenne MD Patients with Different Mutations: 12 Month Changes

    PubMed Central

    Pane, Marika; Mazzone, Elena S.; Sormani, Maria Pia; Messina, Sonia; Vita, Gian Luca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; D'Amico, Adele; Lanzillotta, Valentina; Viggiano, Emanuela; D'Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Bianco, Flaviana; Van der Haawue, Marlene; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Alfonsi, Chiara; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano C.; Napolitano, Sara; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P.; Bertini, Enrico; Morandi, Lucia; Gualandi, Francesca; Ferlini, Alessandra; Goemans, Nathalie; Mercuri, Eugenio

    2014-01-01

    Objective In the last few years some of the therapeutical approaches for Duchenne muscular dystrophy (DMD) are specifically targeting distinct groups of mutations, such as deletions eligible for skipping of individual exons. The aim of this observational study was to establish whether patients with distinct groups of mutations have different profiles of changes on the 6 minute walk test (6MWT) over a 12 month period. Methods The 6MWT was performed in 191 ambulant DMD boys at baseline and 12 months later. The results were analysed using a test for heterogeneity in order to establish possible differences among different types of mutations (deletions, duplications, point mutations) and among subgroups of deletions eligible to skip individual exons. Results At baseline the 6MWD ranged between 180 and 560,80 metres (mean 378,06, SD 74,13). The 12 month changes ranged between −325 and 175 (mean −10.8 meters, SD 69.2). Although boys with duplications had better results than those with the other types of mutations, the difference was not significant. Similarly, boys eligible for skipping of the exon 44 had better baseline results and less drastic changes than those eligible for skipping exon 45 or 53, but the difference was not significant. Conclusions even if there are some differences among subgroups, the mean 12 month changes in each subgroup were all within a narrow Range: from the mean of the whole DMD cohort. This information will be of help at the time of designing clinical trials with small numbers of eligible patients. PMID:24421885

  17. Reliability, validity, and norms of the 2-min walk test in children with and without neuromuscular disorders aged 6-12.

    PubMed

    Pin, Tamis W; Choi, H L

    2017-03-03

    The 2-min walk test may be more appropriate functional exercise test for young children. This study aimed to examine the 2-min walk test's reliability; validity; and minimal clinically important difference; and to establish norms for children aged 6-12. Sixty-one healthy children were recruited to examine the 2-min walk test's reliability. Forty-six children with neuromuscular disorders (63% cerebral palsy) were recruited to test the validity. The normative study involved 716 healthy children without neuromuscular disorders (male = 51%, female = 49%). They walked at a self-selected speed for 2 min along a smooth, flat path 15 m in length. The mean distance covered in the 2-min walk test was 152.8 m (SD =27.5). No significant difference was found in the children's test-retest results (p > 0.05). The intra- and inter-rater reliability were high (all intra-class correlation coefficients >0.8). All children, except one with neuromuscular disorders, completed the 2-min walk test, of which the minimal clinically important difference at 95% confidence interval was 23.2 m for the entire group, 15.7 m for children walking with aids, and 16.6 m for those walking independently. The 2-min walk test is a feasible, reliable, and valid exercise test for children with and without neuromuscular disorders aged 6-12. The first normative references and minimal clinically important difference for children with neuromuscular disorders were established for children of this age group. Implications for rehabilitation The 2-min walk test is a feasible, safe, reliable, and valid time-based walk test for children aged 6-12 years. Normative references have been established for healthy children aged 6-12 years. Minimal clinically important difference at 95% confidence interval were calculated for children with neuromuscular disorders who walked without aids (i.e., independent and stand-by supervision) and those who walked with aids equal to 16.6 and 15.7 m, respectively

  18. [Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test].

    PubMed

    Bokov, P; Delclaux, C

    2016-02-01

    Resting pulmonary function tests (PFT) include the assessment of ventilatory capacity: spirometry (forced expiratory flows and mobilisable volumes) and static volume assessment, notably using body plethysmography. Spirometry allows the potential definition of obstructive defect, while static volume assessment allows the potential definition of restrictive defect (decrease in total lung capacity) and thoracic hyperinflation (increase in static volumes). It must be kept in mind that this evaluation is incomplete and that an assessment of ventilatory demand is often warranted, especially when facing dyspnoea: evaluation of arterial blood gas (searching for respiratory insufficiency) and measurement of the transfer coefficient of the lung, allowing with the measurement of alveolar volume to calculate the diffusing capacity of the lung for CO (DLCO: assessment of alveolar-capillary wall and capillary blood volume). All these pulmonary function tests have been the subject of an Americano-European Task force (standardisation of lung function testing) published in 2005, and translated in French in 2007. Interpretative strategies for lung function tests have been recommended, which define abnormal lung function tests using the 5th and 95th percentiles of predicted values (lower and upper limits of normal values). Thus, these recommendations need to be implemented in all pulmonary function test units. A methacholine challenge test will only be performed in the presence of an intermediate pre-test probability for asthma (diagnostic uncertainty), which is an infrequent setting. The most convenient exertional test is the 6-minute walk test that allows the assessment of walking performance, the search for arterial desaturation and the quantification of dyspnoea complaint.

  19. Comparison of the Sit-to-Stand Test with 6 min walk test in patients with chronic obstructive pulmonary disease.

    PubMed

    Ozalevli, S; Ozden, A; Itil, O; Akkoclu, A

    2007-02-01

    To discuss the utility of Sit-to-Stand Test (STST) compared to the 6min walking test (6MWT) for the evaluation of functional status in patients with chronic obstructive pulmonary disease (COPD). Fifty-three patients with stable COPD (mean forced expiratory volume in 1s (FEV(1)) 46+/-9% predicted, mean age 71+/-12 year) and 15 healthy individuals (mean FEV(1) 101+/-13% predicted and mean age 63+/-8) were included. Functional performance was evaluated by STST and 6MWT. During the tests, severity of dyspnea (by Modified Borg Scale), heart rate, pulsed oxygen saturation (SpO(2), by Modified Borg Scale) (by pulse oxymeter), blood pressure were measured. The pulmonary function (by spirometry), quadriceps femoris muscle strength (by manual muscle test) and quality of life (by Nottingham Health Profile Survey) were evaluated. The STST and 6MWT results were lower in COPD group than the healthy group (P<0.05). During the 6MWT the rise in the heart rate, systolic blood pressure and the decrease in SpO(2) were statistically significant according to STST in COPD groups (P<0.05). The STST and 6MWT were strongly correlated with each other in both groups (P<0.05). Similarly, they were correlated with age, quality of life, peripheral muscle strength and dyspnea severity in COPD groups (P<0.05). Similar to 6MWT, STST is also able to determine the functional state correctly. Additionally, it produces less hemodynamical stress compared to the 6MWT. In conclusion, STST can be used as an alternative of the 6MWT in patients with COPD.

  20. Factors Shaping the Decision of College Students to Walk or Drive under the Influence of Alcohol: A Test of Rational Choice Theory

    ERIC Educational Resources Information Center

    Mason, Ashley; Monk-Turner, Elizabeth

    2010-01-01

    Aims: Rational Choice theory was tested to better understand the differences in behaviour regarding walking and driving under the influence of alcohol. Methods: Students at a residential college campus in Virginia were surveyed. Findings: Results show that students were less likely to walk or drive while intoxicated if they believed such behaviour…

  1. The Use of the 6-Min Walk Test as a Proxy for the Assessment of Energy Expenditure during Gait in Individuals with Lower-Limb Amputation

    ERIC Educational Resources Information Center

    Kark, Laurena; McIntosh, Andrew S.B; Simmons, Annea

    2011-01-01

    The objective of this study was to determine, and compare, the utility of the 6-min walk test (6 MWT) and self-selected walking speed over 15 m as proxies for the assessment of energy expenditure during gait in individuals with lower-limb amputation. Patients with unilateral, transfemoral amputation (n = 6) and patients with unilateral,…

  2. Factors Shaping the Decision of College Students to Walk or Drive under the Influence of Alcohol: A Test of Rational Choice Theory

    ERIC Educational Resources Information Center

    Mason, Ashley; Monk-Turner, Elizabeth

    2010-01-01

    Aims: Rational Choice theory was tested to better understand the differences in behaviour regarding walking and driving under the influence of alcohol. Methods: Students at a residential college campus in Virginia were surveyed. Findings: Results show that students were less likely to walk or drive while intoxicated if they believed such behaviour…

  3. The Use of the 6-Min Walk Test as a Proxy for the Assessment of Energy Expenditure during Gait in Individuals with Lower-Limb Amputation

    ERIC Educational Resources Information Center

    Kark, Laurena; McIntosh, Andrew S.B; Simmons, Annea

    2011-01-01

    The objective of this study was to determine, and compare, the utility of the 6-min walk test (6 MWT) and self-selected walking speed over 15 m as proxies for the assessment of energy expenditure during gait in individuals with lower-limb amputation. Patients with unilateral, transfemoral amputation (n = 6) and patients with unilateral,…

  4. Comparison between an indoor and an outdoor 6-minute walk test among individuals with chronic obstructive pulmonary disease.

    PubMed

    Brooks, Dina; Solway, Sherra; Weinacht, Krisztina; Wang, David; Thomas, Scott

    2003-06-01

    To investigate the feasibility of an outdoor 6-minute walk test (6MWT) as a measure of functional status among individuals with chronic obstructive pulmonary disease (COPD), and to examine the relationship between performance on an indoor and an outdoor 6MWT. An experimental, repeated-measures crossover design. Subjects were studied on 2 separate days in the same week. Two 6MWTs-one indoors and the other outdoors-were performed on each study day, with a rest in between. The test order was randomly selected on the first day and reversed on the second day. Outdoor tests were performed on days of moderate weather conditions (mean temperature +/- standard deviation, 21 degrees +/-3 degrees C; mean wind speed, 15+/-7km/h; no precipitation) and on a flat surface (sidewalk). Outpatient rehabilitation program in Ontario. Eighteen subjects with COPD (10 men, 8 women; age, 70+/-8y), 5 using supplemental oxygen at rest (forced expiratory volume in 1s, 1.0+/-0.3L; 42%+/-8% of predicted). Not applicable. Distance walked in 6 minutes (in meters), duration of rest (in seconds), and change in rate of perceived dyspnea. There was no significant effect of setting (indoors vs outdoors) on distance walked (394+/-86m vs 398+/-84m, P=0.4), duration of rest (13+/-28s vs 9+/-20s, P=0.4), or change in rate of perceived dyspnea (2.3+/-1.7 vs 2.3+/-2.0, P=0.8). Testing day had no significant effect on walk test performance (all P>0.1). The results indicate that the 6MWT performed outdoors within reasonable climatic parameters may be reflective of 6MWT performance indoors.

  5. Assessments of Motor Abnormalities on the Grid-Walking and Foot-Fault Tests From Undernutrition in Wistar Rats.

    PubMed

    Horiquini Barbosa, Everton; Vallim, José Henrique; Lachat, João-José; de Castro, Vera Lucia S S

    2016-01-01

    This study was designed to verify whether different lactation conditions influenced nervous system development. The authors used motor tasks to verify changes in exploratory activity and muscle strength of weaned rats from different litter sizes and evaluated the applicability of the grid-walking test for assessing motor abnormalities caused by undernutrition. Alterations in litter size during the suckling period perturbed the nutritional status of pups, which exhibited body weight differences between the groups. Large-litter (L) pups showed significant delays in achieving developmental milestones and neurological reflexes compared to the small-litter (S) and medium-litter (M) pups. The S, M, and L group pups exhibited similar exploratory responses and muscle strength. In the grid-walking and foot-fault tests, the L group pups traveled shorter distances and, consequently, had less footsteps. However, the percentages of foot faults in the L group were higher than S and M groups. These results reflect delayed maturation of structures responsible for sensorimotor responses, such as the cerebellum, because much cerebellar maturation takes place postnatally. This is the first study to report that early undernutrition in pups resulted in suboptimal performances on the grid-walking and foot-fault tests and that the former test was sensitive to alterations caused by nutritional deficiency.

  6. Functional outcome assessment of lower limb amputees and prosthetic users with a 2-minute walk test.

    PubMed

    Frlan-Vrgoc, Ljubinka; Vrbanić, Tea Schnurrer-Luke; Kraguljac, Darko; Kovacević, Miljenko

    2011-12-01

    The aim of this study was to assess the functional outcome of a population of lower limb amputees supplied with prosthesis. The research was conducted from June to September of 2010 at the Center for Physical and Rehabilitation Medicine, of the Clinical Hospital Center Rijeka, Croatia. The study included 50 adult subjects of both genders with a unilateral transtibial or transfemoral lower limb amputations. The 2-minute walk test (2MWT) was used to assess the functional outcome of these individuals. Data were statistically analyzed. Subjects were divided into groups according to age. The best results were obtained by subjects between the age of 45 and 59 years. The difference between groups was statistically significant (p < 0.001). Taking into account the cause of amputation, there was a statistically significant difference in the results of the 2 MWT between subjects in whom the cause of amputation was circulatory and those where the cause of the amputation was not due to circulatory problems. The best results were obtained in subjects in whom the cause of amputation was not circulatory (p = 0.009). Considering the level of amputation there was a statistically significant difference in the results of the 2MWT between subjects with transtibial and those with transfemoral amputations. Better results were obtained in transtibial amputees (p = 0.039). Considering the first prosthetic supply, better results were obtained in subjects using prosthetic devices over 9 years (p = 0.031). Our research confirmed that age, gender, level and cause of amputation, including the time from the first prosthetic supply have an effect on the 2MWT results.

  7. Heart rate recovery after the 10-m incremental shuttle walking test in older adults with intellectual disabilities.

    PubMed

    Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M

    2014-03-01

    Heart rate recovery (HRR) after exercise is an independent predictor for cardiovascular and all-cause mortality. To investigate the usefulness of HRR in cardiorespiratory exercise testing in older adults with intellectual disabilities (ID), the aims of this study were (a) to assess HRR in older adults with ID after the 10-m incremental shuttle walking test (ISWT) and (b) its association with personal characteristics (gender, age, distance walked on the ISWT, level of ID, genetic syndrome causing ID, autism, behavioral problems, and peak heart rate (HRpeak)). HRR was assessed after the 10-m incremental shuttle walking test in 300 older adults (>50 years) with borderline to profound ID. HRR was defined as the change from HRpeak during the ISWT to heart rate measured after 1, 2, 3, 4, and 5 min of passive recovery. The largest decrease in heart rate was in the first minute of recovery leveling off toward the fifth minute of recovery. An abnormal HHR (≤12 bpm) was seen in 36.1% of the participants with Down syndrome (DS) and in 30.7% of the participants with ID by other causes. After the fifth minute the heart rates of 69.4% of the participants with DS and of 61.4% of the participants with ID by other causes returned to resting levels. HRpeak and distance walked on the ISWT were positively related to all HRR measures. More severe ID was negatively related and having DS positively related to HRR after 3-5 min of recovery. The other characteristics were not significantly associated to HRR. HRR is a potentially useful outcome measure in cardiorespiratory fitness testing of older adults with ID with a direct, objective, and non-invasive measurement. Further research is needed to identify the relation between HRR and adverse health outcomes in this population.

  8. Translation of a Motor Learning Walking Rehabilitation Program into a Group-based Exercise Program for Community-Dwelling Older Adults

    PubMed Central

    Brach, Jennifer S.; Francois, Sara J.; VanSwearingen, Jessie M.; Gilmore, Sandra; Perera, Subashan; Studenski, Stephanie A.

    2016-01-01

    Background Traditional exercise programs for older adults, which focus on aerobic and strength training, have had only modest effects on walking. Recently, a motor learning exercise program was shown to have greater effects on walking when compared to a traditional exercise program. Translating this novel motor learning exercise program into a group exercise program would allow it to be offered as an evidence-based community-based program for older adults. Objective To translate a walking rehabilitation program based on motor learning theory from one-on- one to group delivery (On the Move©) and evaluate multiple aspects of implementation in older adults with impaired mobility. Design The translation process involved multiple iterations including meetings of experts in the field (Phase I), focus groups (Phase II) and implementation of the newly developed program (Phase III). Phase III was based on a one- group model of intervention development for feasibility, safety, potential effects and acceptability. Setting Community sites including two independent living facilities, an apartment building and a community center. Participants Adults 65 years of age or older who could ambulate independently and who were medically stable. Thirty-one adults, mean age 82.3±5.6 years, were eligible to participate. Methods The group exercise program was held twice a week for twelve weeks. Main Outcome Measurements Acceptability of the program was determined by retention and adherence rates and a satisfaction survey. Risk was measured by adverse events and questions on perceived challenge and safety. Mobility was assessed pre and post intervention by gait speed, figure of eight walk test (F8WT), and six minute walk test (6MWT). Results Modifications to the program included adjustments to format/length, music, education, and group interaction. The 12 week program was completed by 24/31 entrants (77%). Adherence was high with participants attending on average 83% of the classes. Safety

  9. Effects of Lower Limb Length and Body Proportions on the Energy Cost of Overground Walking in Older Persons

    PubMed Central

    Vannetti, Federica

    2014-01-01

    Background. Although walking has been extensively investigated in its biomechanical and physiological aspects, little is known on whether lower limb length and body proportions affect the energy cost of overground walking in older persons. Methods. We enrolled 50 men and 12 women aged 65 years and over, mean 69.1 ± SD 5.4, who at the end of their cardiac rehabilitation program performed the six-minute walk test while wearing a portable device for direct calorimetry and who walked a distance comparable to that of nondisabled community-dwelling older persons. Results. In the multivariable regression model (F = 12.75, P < 0.001, adjusted R2 = 0.278) the energy cost of overground walking, expressed as the net energy expenditure, in kg−1 sec−1, needed to provide own body mass with 1 joule kinetic energy, was inversely related to lower limb length and directly related to lower limb length to height ratio (β ± SE(β) = −3.72∗10−3 ± 0.74∗10−3, P < 0.001, and 6.61∗10−3 ± 2.14∗10−3, P = 0.003, resp.). Ancillary analyses also showed that, altogether, 1 cm increase in lower limb length reduced the energy cost of overground walking by 2.57% (95%CI 2.35–2.79). Conclusions. Lower limb length and body proportions actually affect the energy cost of overground walking in older persons. PMID:25050389

  10. The development and examination of a new walking executive function test for people over 50years of age.

    PubMed

    Leyva, Arturo; Balachandran, Anoop; Britton, Jennifer C; Eltoukhy, Moataz; Kuenze, Christopher; Myers, Nicholas D; Signorile, Joseph F

    2017-03-15

    A reduction in executive function (EF) performance is a major factor associated with the loss of functional independence among older adults. Computer-based tests are commonly used to evaluate EF; however, these mouse or keyboard tests are upper limb dominant while most activities of daily living (ADL, e.g. crossing a street) are lower limb dominant. The purpose of this study was to examine the utility of a newly developed walking EF test called the Walking Response and Inhibition Test (WRIT). The WRIT was validated by comparing its results a number of established computer-based tests and to an ADL-related test known to require EF, the Timed "Up & Go" Test (TUG). Fifty healthy adults, ranging in age from 50 to 86years (mean±SD, 65.5±9.6y) were evaluated using the WRIT, three computer-based EF tests, the TUG, a verbal memory test and an agility test. All computer-based EF tests were positively correlated to the WRIT (p<0.05); however, regression analyses revealed that the WRIT explained 37.5% of the variance in the TUG, while a composite of traditional computer-based tests explained 10.5%. As indicated by Lin's Concordance reliability (pc=0.82) between testing days was high and was supported by a Cronbach's alpha of 0.90. Bland-Altman analyses also demonstrated good agreement between the testing days with a small mean difference 3.48 (-3.71, 10.67). These results support the validity and reliability of the WRIT, and indicate that when assessing EF as it relates to functionality, the WRIT test may be a more appropriate measure than existing computer-based mouse and keyboard tests.

  11. Reliability of the Timed Up and Go test and Ten-Metre Timed Walk Test in Pregnant Women with Pelvic Girdle Pain.

    PubMed

    Evensen, Natalie M; Kvåle, Alice; Braekken, Ingeborg H

    2015-09-01

    There is a lack of functional objective tests available to measure functional status in women with pelvic girdle pain (PGP). The purpose of this study was to establish test-retest and intertester reliability of the Timed Up and Go (TUG) test and Ten-metre Timed Walk Test (10mTWT) in pregnant women with PGP. A convenience sample of women was recruited over a 4-month period and tested on two occasions, 1 week apart to determine test-retest reliability. Intertester reliability was established between two assessors at the first testing session. Subjects were instructed to undertake the TUG and 10mTWT at maximum speed. One practise trial and two timed trials for each walking test was undertaken on Day 1 and one practise trial and one timed trial on Day 2. Seventeen women with PGP aged 31.1 years (SD [standard deviation] = 2.3) and 28.7 weeks pregnant (SD = 7.4) completed gait testing. Test-retest reliability using the intraclass correlation coefficient (ICC) was excellent for the TUG (0.88) and good for the 10mTWT (0.74). Intertester reliability was determined in the first 13 participants with excellent ICC values being found for both walking tests (TUG: 0.95; 10mTWT: 0.94). This study demonstrated that the TUG and 10mTWT undertaken at fast pace are reliable, objective functional tests in pregnant women with PGP. While both tests are suitable for use in the clinical and research settings, we would recommend the TUG given the findings of higher test-retest reliability and as this test requires less space and time to set up and score. Future studies in a larger sample size are warranted to confirm the results of this study. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Submaximal exercise testing in the assessment of interstitial lung disease secondary to systemic sclerosis: reproducibility and correlations of the 6‐min walk test

    PubMed Central

    Buch, M H; Denton, C P; Furst, D E; Guillevin, L; Rubin, L J; Wells, A U; Matucci‐Cerinic, M; Riemekasten, G; Emery, P; Chadha‐Boreham, H; Charef, P; Roux, S; Black, C M; Seibold, J R

    2007-01-01

    Background The 6‐min walk test (6MWT) is increasingly used as an outcome measure in interstitial lung disease (ILD). Aim To evaluate the usefulness of the 6MWT in a cohort of patients with ILD secondary to systemic sclerosis (SSc) and to correlate with established physiological parameters. Methods 163 patients with SSc‐ILD were recruited for a multicentre, randomised, double‐blind clinical trial. Available data at protocol screening included repeated 6MWTs, pulmonary function testing with diffusing capacity, Doppler echocardiography and high‐resolution computed tomography of the thorax. Borg Dyspnoea Index was evaluated before and after 6MWT. Results Mean (standard deviation (SD)) distance walked during walk test 1 was 396.6 (84.55) m compared with 399.5 (86.28) m at walk test 2. The within‐subject, intertest correlation as determined by Pearson's correlation coefficient testing was 0.95 (p<0.001). However, only weak correlations of 6MWT with percentage forced vital capacity and the Borg Dyspnoea Index were observed, and no correlation was observed with percentage diffusing capacity. Conclusion These data confirm the high reproducibility of the 6MWT in patients with SSc‐ILD and therefore the validity of the test in this cohort. The lack of correlation of 6MWT with standard physiological parameters of ILD suggests a multifactorial basis for limited exercise capacity in patients with SSc and calls into question the utility of the 6MWT as a measure of outcome in future studies on SSc‐ILD. PMID:16868020

  13. Comparison of the efficacy of a demand oxygen delivery system with continuous low flow oxygen in subjects with stable COPD and severe oxygen desaturation on walking.

    PubMed Central

    Roberts, C. M.; Bell, J.; Wedzicha, J. A.

    1996-01-01

    BACKGROUND: Provision of ambulatory oxygen using an intermittent pulsed flow regulated by a demand oxygen delivery system (DODS) greatly increases the limited supply time of standard portable gaseous cylinders. The efficacy of such a system has not previously been studied during submaximal exercise in subjects with severe chronic obstructive pulmonary disease (COPD) in whom desaturation is likely to be great and where usage is often most appropriate. METHODS: Fifteen subjects with severe COPD and oxygen desaturation underwent six minute walk tests performed in random order to compare the efficacy of a demand oxygen delivery system (DODS) with continuous flow oxygen. Walk distance, breathlessness, oxygen saturation, resting time, and recovery time (objective and subjective) were recorded and compared for each walk. RESULTS: Breathing continuous oxygen compared with baseline air breathing improved mean walk distance (295 m versus 271 m) and recovery time (47 seconds versus 112 seconds), whilst the lowest recorded saturation (81% versus 74%) and time desaturated below 90% (201 seconds versus 299 seconds) were reduced. When the DODS was compared with air breathing only the walk distance changed (283 m versus 271 m). A comparison of the DODS with continuous oxygen breathing showed the DODS to be less effective at oxygenating subjects with inferior lowest saturation (78% versus 81%), time spent below 90% (284 seconds versus 201 seconds), time to objective recovery (83 seconds versus 47 seconds), and walk distance (283 m versus 295 m). CONCLUSIONS: Neither of the delivery systems was able to prevent desaturation in these subjects. The use of continuous flow oxygen, however, was accompanied by improvements in oxygenation, walk distance, and recovery time compared with air breathing. The DODS produced only a small increase in walk distance without elevation of oxygen saturation, but was inferior to continuous flow oxygen in most of the measured variables when compared

  14. Accelerometer-based quantification of 6-minute walk test performance in patients with chronic heart failure: applicability in telemedicine.

    PubMed

    Jehn, Melissa; Schmidt-Trucksäess, Arno; Schuster, Tibor; Hanssen, Henner; Weis, Michael; Halle, Martin; Koehler, Friedrich

    2009-05-01

    Distance walked in the 6-minute walk test (6MWT) is an important prognostic parameter used clinically to assess functional status in patients with chronic heart failure (CHF). In this study, we investigated if alternative performance parameters with similar prognostic value can be gained from accelerometers. Fifty CHF patients (age, 60.9 +/- 14.0 years) were asked to perform a 6MWT while wearing 2 accelerometers and 1 pedometer. Total 6MWT step frequency (SF) and activity counts (VMU) were correlated to 6MWT distance. The accelerometer was highly accurate at quantifying SF (detected vs. observed: r = 0.99; P < .001), whereas the pedometer was unreliable below 50 m/min. VMU increased linearly with walking speed (r = 0.99), and both SF and VMU correlated strongly with 6MWT distance (VMU: r = 0.91; SF: r = 0.87, respectively; P < .001) and each other (r = 0.80, P < .001). Accelerometers are reliable in measuring physical performance during the 6MWT in CHF patients. Besides the simple acquisition of 6MWT distance currently used for patient assessment, accelerometers provide new data that might be useful to evaluate exercise performance during the 6MWT. This allows for routine assessment of exercise capacity in a home-based setting in the context of telemedicine.

  15. Plantar Temperature Response to Walking in Diabetes with and without Acute Charcot: The Charcot Activity Response Test

    PubMed Central

    Najafi, Bijan; Wrobel, James S.; Grewal, Gurtej; Menzies, Robert A.; Talal, Talal K.; Zirie, Mahmoud; Armstrong, David G.

    2012-01-01

    Objective. Asymmetric plantar temperature differences secondary to inflammation is a hallmark for the diagnosis and treatment response of Charcot foot syndrome. However, little attention has been given to temperature response to activity. We examined dynamic changes in plantar temperature (PT) as a function of graduated walking activity to quantify thermal responses during the first 200 steps. Methods. Fifteen individuals with Acute Charcot neuroarthropathy (CN) and 17 non-CN participants with type 2 diabetes and peripheral neuropathy were recruited. All participants walked for two predefined paths of 50 and 150 steps. A thermal image was acquired at baseline after acclimatization and immediately after each walking trial. The PT response as a function of number of steps was examined using a validated wearable sensor technology. The hot spot temperature was identified by the 95th percentile of measured temperature at each anatomical region (hind/mid/forefoot). Results. During initial activity, the PT was reduced in all participants, but the temperature drop for the nonaffected foot was 1.9 times greater than the affected side in CN group (P = 0.04). Interestingly, the PT in CN was sharply increased after 50 steps for both feet, while no difference was observed in non-CN between 50 and 200 steps. Conclusions. The variability in thermal response to the graduated walking activity between Charcot and non-Charcot feet warrants future investigation to provide further insight into the correlation between thermal response and ulcer/Charcot development. This stress test may be helpful to differentiate CN and its response to treatment earlier in its course. PMID:22900177

  16. Quantum centrality testing on directed graphs via P T -symmetric quantum walks

    NASA Astrophysics Data System (ADS)

    Izaac, J. A.; Wang, J. B.; Abbott, P. C.; Ma, X. S.

    2017-09-01

    Various quantum-walk-based algorithms have been proposed to analyze and rank the centrality of graph vertices. However, issues arise when working with directed graphs: the resulting non-Hermitian Hamiltonian leads to nonunitary dynamics, and the total probability of the quantum walker is no longer conserved. In this paper, we discuss a method for simulating directed graphs using P T -symmetric quantum walks, allowing probability-conserving nonunitary evolution. This method is equivalent to mapping the directed graph to an undirected, yet weighted, complete graph over the same vertex set, and can be extended to cover interdependent networks of directed graphs. Previous work has shown centrality measures based on the continuous-time quantum walk provide an eigenvectorlike quantum centrality; using the P T -symmetric framework, we extend these centrality algorithms to directed graphs with a significantly reduced Hilbert space compared to previous proposals. In certain cases, this centrality measure provides an advantage over classical algorithms used in network analysis, for example, by breaking vertex rank degeneracy. Finally, we perform a statistical analysis over ensembles of random graphs, and show strong agreement with the classical PageRank measure on directed acyclic graphs.

  17. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease.

    PubMed

    Singh, Sally J; Puhan, Milo A; Andrianopoulos, Vasileios; Hernandes, Nidia A; Mitchell, Katy E; Hill, Catherine J; Lee, Annemarie L; Camillo, Carlos Augusto; Troosters, Thierry; Spruit, Martijn A; Carlin, Brian W; Wanger, Jack; Pepin, Véronique; Saey, Didier; Pitta, Fabio; Kaminsky, David A; McCormack, Meredith C; MacIntyre, Neil; Culver, Bruce H; Sciurba, Frank C; Revill, Susan M; Delafosse, Veronica; Holland, Anne E

    2014-12-01

    This systematic review examined the measurement properties of the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. Studies that report the evaluation or use of the 6MWT, ISWT or ESWT were included. We searched electronic databases for studies published between January 2000 and September 2013. The 6-min walking distance (6MWD) is a reliable measure (intra-class correlation coefficients ranged from 0.82 to 0.99 in seven studies). There is a learning effect, with greater distance walked on the second test (pooled mean improvement of 26 m in 13 studies). Reliability was similar for ISWT and ESWT, with a learning effect also evident for ISWT (pooled mean improvement of 20 m in six studies). The 6MWD correlates more strongly with peak work capacity (r=0.59-0.93) and physical activity (r=0.40-0.85) than with respiratory function (r=0.10-0.59). Methodological factors affecting 6MWD include track length, encouragement, supplemental oxygen and walking aids. Supplemental oxygen also affects ISWT and ESWT performance. Responsiveness was moderate to high for all tests, with greater responsiveness to interventions that included exercise training. The findings of this review demonstrate that the 6MWT, ISWT and ESWT are robust tests of functional exercise capacity in adults with chronic respiratory disease. ©ERS 2014.

  18. Partial correlation between lower muscle thickness, 10-meter walk test, and the timed up & go test in children with spastic cerebral palsy.

    PubMed

    Yun, Chang-Kyo; Kim, Won-Hyo; Kim, Seong-Gil

    2016-05-01

    [Purpose] The purpose of this study was to examine the correlation between lower extremity muscle thickness and gait ability through the 10-meter walk and timed up and go tests. [Subjects and Methods] A total of 28 children (20 males and 8 females) with spastic cerebral palsy undergoing physical therapy at D hospital in D city, South Korea participated in this study. Partial correlation analysis was performed to analyze the correlation between lower extremity muscle thickness and gait ability (10-meter walk test and timed up and go test). [Results] There was a positive correlation between muscle thickness and the 10-meter walk test (RF=0.41 and VL=0.52). Correlation between the muscle thickness and the timed up and go had a negative correlation (VL=-0.45, MG=-0.51, and LG=-0.39). [Conclusion] In children with cerebral palsy, knee extensor muscles that are more developed increased gait ability and calf muscles that are more developed increased sit to stand ability.

  19. [A new procedure for the estimation of physical fitness of patients during clinical rehabilitation using the 6-minute-walk-test].

    PubMed

    Marek, W; Marek, E; Vogel, P; Mückenhoff, K; Kotschy-Lang, N

    2008-11-01

    AIMS OF THE INVESTIGATION: The 6-minute-walk-test (6-MW) is an effective tool for measuring physical fitness in elderly patients. The increased walking distance is taken as a parameter for improved physical conditions. Frequently an unaltered walking distance is found after clinical treatment, but heart rate is significantly lower in the second challenge, indicating an improved physical fitness. This positive effect is not recognised when only the walking distance is analysed. An analysis of the 6-MW test was performed on 263 patients before and after 3 - 4 weeks clinical rehabilitation. In a control group of 26 patients 6-MW was repeated after recovery at the beginning and the end of the clinical treatment. Instrumented by a mobile pulse oximeter for recording oxygen saturation and heart rate, patients were instructed to walk as fast as they can do during 6 minutes. Measurements were performed every 30 seconds and printed out. Two new parameters, efficiency (E = S/f (C)), the ratio of distance and mean heart rate, and the theoretical increase in walking distance (S (z) = Delta f (C1)/Delta f (C2) x S (2) - S (1)) were introduced and tested. S (z) = theoretical increase in distance, Delta f (C1) = difference in heart rate at rest and mean heart rate at steady state during the first walk test with distance, S1. Delta f (C2), and S2 are measured during the second walk. Thus, the increase in distance is calculated under the assumption that the second walk test would have been performed by the patient with the same difference in heart rate that he/she achieved in the first walk. The patient groups walked 353 +/- 80 m at 106 +/- 14.3 beats/min in the 1st. 6-MW and 368 +/- 76.9 m at a heart rate of 105 +/- 14.0 beats/min in the final test. The increase of the walking distance was most significant in patients with shorter distances in the 1st 6-MW. A significant increase in the walking distance and in efficiency was found in patients with shorter walking distances or

  20. Criterion-Related Validity of the Distance- and Time-Based Walk/Run Field Tests for Estimating Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis

    PubMed Central

    Mayorga-Vega, Daniel; Bocanegra-Parrilla, Raúl; Ornelas, Martha; Viciana, Jesús

    2016-01-01

    Objectives The main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating cardiorespiratory fitness among apparently healthy children and adults. Materials and Methods Relevant studies were searched from seven electronic bibliographic databases up to August 2015 and through other sources. The Hunter-Schmidt’s psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the following walk/run tests: 5,000 m, 3 miles, 2 miles, 3,000 m, 1.5 miles, 1 mile, 1,000 m, ½ mile, 600 m, 600 yd, ¼ mile, 15 min, 12 min, 9 min, and 6 min. Results From the 123 included studies, a total of 200 correlation values were analyzed. The overall results showed that the criterion-related validity of the walk/run tests for estimating maximum oxygen uptake ranged from low to moderate (rp = 0.42–0.79), with the 1.5 mile (rp = 0.79, 0.73–0.85) and 12 min walk/run tests (rp = 0.78, 0.72–0.83) having the higher criterion-related validity for distance- and time-based field tests, respectively. The present meta-analysis also showed that sex, age and maximum oxygen uptake level do not seem to affect the criterion-related validity of the walk/run tests. Conclusions When the evaluation of an individual’s maximum oxygen uptake attained during a laboratory test is not feasible, the 1.5 mile and 12 min walk/run tests represent useful alternatives for estimating cardiorespiratory fitness. As in the assessment with any physical fitness field test, evaluators must be aware that the performance score of the walk/run field tests is simply an estimation and not a direct measure of cardiorespiratory fitness. PMID:26987118

  1. Criterion-Related Validity of the Distance- and Time-Based Walk/Run Field Tests for Estimating Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis.

    PubMed

    Mayorga-Vega, Daniel; Bocanegra-Parrilla, Raúl; Ornelas, Martha; Viciana, Jesús

    2016-01-01

    The main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating cardiorespiratory fitness among apparently healthy children and adults. Relevant studies were searched from seven electronic bibliographic databases up to August 2015 and through other sources. The Hunter-Schmidt's psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the following walk/run tests: 5,000 m, 3 miles, 2 miles, 3,000 m, 1.5 miles, 1 mile, 1,000 m, ½ mile, 600 m, 600 yd, ¼ mile, 15 min, 12 min, 9 min, and 6 min. From the 123 included studies, a total of 200 correlation values were analyzed. The overall results showed that the criterion-related validity of the walk/run tests for estimating maximum oxygen uptake ranged from low to moderate (rp = 0.42-0.79), with the 1.5 mile (rp = 0.79, 0.73-0.85) and 12 min walk/run tests (rp = 0.78, 0.72-0.83) having the higher criterion-related validity for distance- and time-based field tests, respectively. The present meta-analysis also showed that sex, age and maximum oxygen uptake level do not seem to affect the criterion-related validity of the walk/run tests. When the evaluation of an individual's maximum oxygen uptake attained during a laboratory test is not feasible, the 1.5 mile and 12 min walk/run tests represent useful alternatives for estimating cardiorespiratory fitness. As in the assessment with any physical fitness field test, evaluators must be aware that the performance score of the walk/run field tests is simply an estimation and not a direct measure of cardiorespiratory fitness.

  2. Electromyographic Manifestations of Fatigue Correlate With Pulmonary Function, 6-Minute Walk Test, and Time to Exhaustion in COPD.

    PubMed

    Boccia, Gennaro; Dardanello, Davide; Rinaldo, Nicoletta; Coratella, Giuseppe; Schena, Federico; Rainoldi, Alberto

    2015-09-01

    The aim of this study was to investigate whether electromyographic manifestations of fatigue and exercise tolerance were related to stage of disease in men with a COPD diagnosis. Fourteen men with COPD with a diagnosis of mild to severe air flow obstruction were involved in 2 separate testing sessions. The first one consisted of a pulmonary function (FEV1 and FEV1/FVC) and an exercise tolerance assessment using the 6-min walk test. During the second session, a multichannel surface electromyography was recorded from vastus medialis and vastus lateralis muscles during an isometric knee extension at 70% of maximum voluntary contraction. The slope of muscle fiber conduction velocity during the contraction was calculated as the index of fatigue. Conduction velocity slope significantly correlated with FEV1 (vastus medialis: r = 0.86, P < .001; vastus lateralis: r = 0.68, P = .01), FEV1/FVC (vastus medialis: r = 0.70, P = .006), and 6-min walk test (vastus medialis: r = 0.72, P = .005; vastus lateralis: r = 0.80, P = .001). The electromyographic manifestations of fatigue during sustained quadriceps contraction significantly correlated with disease severity and exercise tolerance in moderate to severe COPD. Copyright © 2015 by Daedalus Enterprises.

  3. Improved Leg Tracking Considering Gait Phase and Spline-Based Interpolation during Turning Motion in Walk Tests.

    PubMed

    Yorozu, Ayanori; Moriguchi, Toshiki; Takahashi, Masaki

    2015-09-04

    Falling is a common problem in the growing elderly population, and fall-risk assessment systems are needed for community-based fall prevention programs. In particular, the timed up and go test (TUG) is the clinical test most often used to evaluate elderly individual ambulatory ability in many clinical institutions or local communities. This study presents an improved leg tracking method using a laser range sensor (LRS) for a gait measurement system to evaluate the motor function in walk tests, such as the TUG. The system tracks both legs and measures the trajectory of both legs. However, both legs might be close to each other, and one leg might be hidden from the sensor. This is especially the case during the turning motion in the TUG, where the time that a leg is hidden from the LRS is longer than that during straight walking and the moving direction rapidly changes. These situations are likely to lead to false tracking and deteriorate the measurement accuracy of the leg positions. To solve these problems, a novel data association considering gait phase and a Catmull-Rom spline-based interpolation during the occlusion are proposed. From the experimental results with young people, we confirm   that the proposed methods can reduce the chances of false tracking. In addition, we verify the measurement accuracy of the leg trajectory compared to a three-dimensional motion analysis system (VICON).

  4. Improved Leg Tracking Considering Gait Phase and Spline-Based Interpolation during Turning Motion in Walk Tests

    PubMed Central

    Yorozu, Ayanori; Moriguchi, Toshiki; Takahashi, Masaki

    2015-01-01

    Falling is a common problem in the growing elderly population, and fall-risk assessment systems are needed for community-based fall prevention programs. In particular, the timed up and go test (TUG) is the clinical test most often used to evaluate elderly individual ambulatory ability in many clinical institutions or local communities. This study presents an improved leg tracking method using a laser range sensor (LRS) for a gait measurement system to evaluate the motor function in walk tests, such as the TUG. The system tracks both legs and measures the trajectory of both legs. However, both legs might be close to each other, and one leg might be hidden from the sensor. This is especially the case during the turning motion in the TUG, where the time that a leg is hidden from the LRS is longer than that during straight walking and the moving direction rapidly changes. These situations are likely to lead to false tracking and deteriorate the measurement accuracy of the leg positions. To solve these problems, a novel data association considering gait phase and a Catmull–Rom spline-based interpolation during the occlusion are proposed. From the experimental results with young people, we confirm that the proposed methods can reduce the chances of false tracking. In addition, we verify the measurement accuracy of the leg trajectory compared to a three-dimensional motion analysis system (VICON). PMID:26404302

  5. Heart rate slopes during 6‐min walk test in pulmonary arterial hypertension, other lung diseases, and healthy controls

    PubMed Central

    Tonelli, Adriano R.; Wang, Xiao‐Feng; Alkukhun, Laith; Zhang, Qi; Dweik, Raed A.; Minai, Omar A.

    2014-01-01

    Abstract Six‐minute walk test (6MWT) continues to be a useful tool to determine the functional capacity in patients with vascular and other lung diseases; nevertheless, it has a limited ability to predict prognosis in this context. We tested whether the heart rate (HR) acceleration and decay slopes during the 6‐m walk test are different in patients with pulmonary arterial hypertension (PAH), other lung diseases, and healthy controls. In addition, we assessed whether the HR slopes are associated with clinical worsening. Using a portable, signal‐morphology‐based, impedance cardiograph (PhysioFlow Enduro, Paris, France) with real‐time wireless monitoring via a Bluetooth USB adapter we determined beat‐by‐beat HR. We included 50 subjects in this pilot study, 20 with PAH (all on PAH‐specific treatment), 17 with other lung diseases (obstructive [n = 12, 71%] or restrictive lung diseases [5, 29%]), and 13 healthy controls. The beat‐by‐beat HR curves were significantly different among all three groups of subjects either during the activity or recovery of the 6MWT. HR curves were less steep in PAH than the other two groups (P < 0.001). HR acceleration rates were slower in patients with PAH or other lung diseases with progression of their disease (P < 0.001). In conclusion, the acceleration and decay slopes during 6MWT are different among patients with PAH, other lung diseases, and healthy controls. The HR slopes during 6MWT were steeper in patients without clinical worsening. PMID:24920122

  6. Evidence for the different physiological significance of the 6- and 2-minute walk tests in multiple sclerosis

    PubMed Central

    2012-01-01

    Background Researchers have recently advocated for the 2-minute walk (2MW) as an alternative for the 6-minute walk (6MW) to assess long distance ambulation in persons with multiple sclerosis (MS). This recommendation has not been based on physiological considerations such as the rate of oxygen consumption (V·O2) over the 6MW range. Objective This study examined the pattern of change in V·O2 over the range of the 6MW in a large sample of persons with MS who varied as a function of disability status. Method Ninety-five persons with clinically-definite MS underwent a neurological examination for generating an Expanded Disability Status Scale (EDSS) score, and then completion of the 6MW protocol while wearing a portable metabolic unit and an accelerometer. Results There was a time main effect on V·O2 during the 6MW (p = .0001) such that V·O2 increased significantly every 30 seconds over the first 3 minutes of the 6MW, and then remained stable over the second 3 minutes of the 6MW. This occurred despite no change in cadence across the 6MW (p = .84). Conclusions The pattern of change in V·O2 indicates that there are different metabolic systems providing energy for ambulation during the 6MW in MS subjects and steady state aerobic metabolism is reached during the last 3 minutes of the 6MW. By extension, the first 3 minutes would represent a test of mixed aerobic and anaerobic work, whereas the second 3 minutes would represent a test of aerobic work during walking. PMID:22380843

  7. The 6-minute walk test in outpatient cardiac rehabilitation: validity, reliability and responsiveness--a systematic review.

    PubMed

    Bellet, R Nicole; Adams, Lewis; Morris, Norman R

    2012-12-01

    The 6-minute walk test (6MWT) is a common outcome measurement in cardiac rehabilitation. However, a search of the literature found no established guidelines for use of the 6MWT in cardiac rehabilitation. Systematic review of the validity, reliability and responsiveness of the 6MWT in cardiac rehabilitation. OvidMEDLINE, SPORTdiscus, EMBASE, CINAHL, Cochrane Reviews and Cochrane Clinical Trials between January 1948 and April 2011. Studies using 6MWTs in subjects with coronary artery disease undergoing cardiac rehabilitation on an outpatient basis, published in English, were included. STUDY APPRAISAL AND METHODS: Quantitative and qualitative analyses were conducted, including quality assessment of methodology, meta-analysis and assessment against level of evidence criteria. Fifteen articles met the inclusion criteria. One high-quality study was identified for reliability, six high-quality studies were identified for validity and 11 high-quality studies were identified for responsiveness. The meta-analysis found strong evidence that the 6MWT was responsive to change in clinical status following cardiac rehabilitation, with an estimated mean difference in 6-minute walk distance of 60.43m (95% confidence interval 54.57 to 66.30m; P<0.001). Qualitative analysis indicated moderate evidence for repeatability of the 6MWT in patients undergoing cardiac rehabilitation, for a 2% to 8% learning effect between repeated 6MWTs, for a relationship between peak heart rate during the 6MWT and during cycle exercise at the ventilatory threshold, and for moderate-to-high correlation between the 6-minute walk distance and maximum metabolic equivalents achieved on symptom-limited exercise tests. Few studies assessed similar aspects of validity for the 6MWT. Strong evidence suggests that the 6MWT is responsive to clinical change following cardiac rehabilitation. Intra- and intertester reliability of the 6MWT and its validity in patients undergoing cardiac rehabilitation requires further

  8. Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial

    PubMed Central

    2010-01-01

    Introduction The objective of this study was to investigate the effects of moderate-to-high intensity Nordic walking (NW) on functional capacity and pain in fibromyalgia (FM). Methods A total of 67 women with FM were recruited to the study and randomized either to moderate-to-high intensity Nordic Walking (n = 34, age 48 ± 7.8 years) or to a control group engaging in supervised low-intensity walking (LIW, n = 33, age 50 ± 7.6 years). Primary outcomes were the six-minute walk test (6MWT) and the Fibromyalgia Impact Questionnaire Pain scale (FIQ Pain). Secondary outcomes were: exercise heart rate in a submaximal ergometer bicycle test, the FIQ Physical (activity limitations) and the FIQ total score. Results A total of 58 patients completed the post-test. Significantly greater improvement in the 6MWT was found in the NW group (P = 0.009), as compared with the LIW group. No between-group difference was found for the FIQ Pain (P = 0.626). A significantly larger decrease in exercise heart rate (P = 0.020) and significantly improved scores on the FIQ Physical (P = 0.027) were found in the NW group as compared with the LIW group. No between-group difference was found for the change in the FIQ total. The effect sizes were moderate for the above mentioned outcomes. Conclusions Moderate-to-high intensity aerobic exercise by means of Nordic walking twice a week for 15 weeks was found to be a feasible mode of exercise, resulting in improved functional capacity and a decreased level of activity limitations. Pain severity did not change over time during the exercise period. Trial registration Clinicaltrials.gov identifier NCT00643006. PMID:20942911

  9. [Trail walking test for assessment of motor cognitive interference in older adults. Development and evaluation of the psychometric properties of the procedure].

    PubMed

    Schott, Nadja

    2015-12-01

    Activities of daily living (ADL), such as walking, often involve the added complexity of walking while doing other activities (i.e. dual task walking). A complex walking task may require a greater motor and mental capacity, resulting in decrements in gait performance not seen for simple walking tasks. The purpose of this study was to determine if the trail walking test (TWT), the mobile adaptation of the trail making test (TMT), could be a reliable and valid early detection tool to discriminate between non-fallers and fallers. This study examined dual task costs of a cognitive and a sensorimotor task (walking) in 94 older adults aged 50-81 years (average age M = 67.4 years, SD ± 7.34). Based on the idea of the paper and pencil TMT, participants walked along a fixed pathway (TWT-1), stepped on targets with increasing sequential numbers (i.e. 1, 2, 3, TWT-2), and increasing sequential numbers and letters (i.e. 1, A, 2, B, 3, C, TWT-3). The dual task costs were calculated for each task. Additionally, the following tests were conducted: TMT, block tapping test (BTT), timed up and go (TUG) test, 30s chair rising test, 10 m walking time test with and without head turns, German physical activity questionnaire (German PAQ-50 +) and the activities-specific balance confidence (ABC-D) scale. The TWT performance times as well as errors increased with increasing age. Reliability coefficients were high (interclass correlation ICC > 0.90). Correlations between the different TWT conditions and potential falls-related predictors were moderate to high (r = -0.430 to 0.699). Of the participants 34 % reported falling in the past year. The stepwise logistic regression analysis revealed that the dual task costs for the numbers and letters (odds ratio OR 1.162, 95 % confidence interval CI 1.058-1.277, p = 0.002), the ABC-D (OR 0.767, 95 % CI 0.651-0.904, p = 0.002) and exercise (OR 1.027, 95 % CI 1.008-1.046, p = 0.006) were significantly related to

  10. Assessing Minimal Detectable Changes and Test-Retest Reliability of the Timed Up and Go Test and the 2-Minute Walk Test in Patients With Total Knee Arthroplasty.

    PubMed

    Yuksel, Ertugrul; Kalkan, Serpil; Cekmece, Senol; Unver, Bayram; Karatosun, Vasfi

    2017-02-01

    Two-minute walk test (2MWT) and the Timed Up and Go test (TUG) are simple, quick, and can be applied in a short time as part of the routine medical examination. They were shown to be reliable and valid tests in many patient groups. The aims of the present study were: (1) to determine test-retest reliability of data for the TUG and 2MWT and (2) to determine minimal detectable change (MDC) scores for the TUG and 2MWT in patients with TKA. Forty-eight patients with total knee arthroplasty, operated by the same surgeon, were included in this study. Patients performed trials for TUG and 2MWT twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. The TUG and 2MWT showed an excellent test-retest reliability in this study. Intraclass correlation coefficient [ICC(2,1)] for TUG and 2MWT were 0.98 and 0.97, respectively. Standard error of measurement and MDC95 for TUG were 0.82 and 2.27, respectively. Standard error of measurement and MDC95 for 2MWT were 5.40 and 14.96, respectively. The TUG and 2MWT have an excellent test-retest reliability in patients with TKA. Clinicians and researchers can be confident that changes in TUG time above 2.27 seconds and changes in 2MWT distances above 14.96 meters, represent a "real" clinical change in an individual patient with TKA. We, therefore, recommend the use of these 2 tests as complementary outcome measures for functional evaluation in patients TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Inter and Intra Rater Reliability of the 10 Meter Walk Test in the Community Dweller Adults with Spastic Cerebral Palsy

    PubMed Central

    BAHRAMI, Fariba; NOORIZADEH DEHKORDI, Shohreh; DADGOO, Mehdi

    2017-01-01

    Objective We aimed to investigation the intra-rater and inter-raters reliability of the 10 meter walk test (10 MWT) in adults with spastic cerebral palsy (CP). Materials & Methods Thirty ambulatory adults with spastic CP in the summer of 2014 participated (19 men, 11 women; mean age 28 ± 7 yr, range 18- 46 yr). Individuals were non-randomly selected by convenient sampling from the Ra’ad Rehabilitation Goodwill Complex in Tehran, Iran. They had GMFCS levels below IV (I, II, and III). Retest interval for inter-raters study lasted a week. During the tests, participants walked with their maximum speed. Intraclass correlation coefficients (ICC) estimated reliability. Results The 10 MWT ICC for intra-rater was 0.98 (95% confidence interval (CI) 0.96-0.99) for participants, and >0.89 in GMFCS subgroups (95% confidence interval (CI) lower bound>0.67). The 10 MWT inter-raters’ ICC was 0.998 (95% confidence interval (CI) 0/996-0/999), and >0.993 in GMFCS subgroups (95% confidence interval (CI) lower bound>0.977). Standard error of the measurement (SEM) values for both studies was small (0.02< SEM< 0.07). Conclusion Excellent intra-rater and inter-raters reliability of the 10 MWT in adults with CP, especially in the moderate motor impairments (GMFCS level III), indicates that this tool can be used in clinics to assess the results of interventions. PMID:28277557

  12. The Walk on Floor Eyes Closed Tandem Step Test as a Quantitative Measure of Ataxia After Space Flight

    NASA Technical Reports Server (NTRS)

    Fisher, E. A.; Reschke, M. F.; Kofman, I. S.; Cerisano, J. M.; Lawrence, E. L.; Peters, B. T.; Bloomberg, J. J.; Harm, D. L.

    2010-01-01

    INTRODUCTION Posture and locomotion are among the functions most affected by space flight. Postflight ataxia can be quantified easily by using the walk on the floor line test with the eyes closed (WOFEC). Data from a modified WOFEC were obtained as part of an ongoing interdisciplinary pre- and postflight study (Functional Task Test, FTT) designed to evaluate both postflight functional performance of astronauts and related physiological changes. METHODS Five astronauts with flight durations of 12 to 16 days participated in this study. Performance measurements were obtained in 2 preflight sessions, on landing day, and 1, 6, and 30 days after landing. The WOFEC test consisted of walking with the feet placed heel to toe in tandem, arms folded across the chest and eyes closed, for 10 steps. A trial was initiated after the eyes were closed and the front foot was aligned with the rear foot. The performance metric was the average percentage of correct steps completed over 3 trials. A step was not counted as correct if the crewmember sidestepped, opened eyes, or paused for more than 3 seconds between steps. Step accuracy was scored independently by 3 examiners. RESULTS Immediately after landing subjects seemed to be unaware of their foot position relative to their body or the floor. The percentage of correct steps was significantly decreased on landing day. Partial recovery was observed the next day, and full recovery to baseline on the sixth day post landing. CONCLUSION These data clearly demonstrate the sensorimotor challenges facing crewmembers after they return from space flight. Although this simple test is intended to complement the FTT battery of tests, it has some stand-alone value as it provides investigators with a means to quantify vestibular ataxia as well as provide instant feedback on postural stability without the use of complex test equipment.

  13. The quality of life of patients with lupus erythematosus influences cardiovascular capacity in 6-minute walk test.

    PubMed

    Balsamo, Sandor; Nascimento, Dahan da Cunha; Tibana, Ramires Alsamir; de Santana, Frederico Santos; da Mota, Licia Maria Henrique; Dos Santos-Neto, Leopoldo Luiz

    2013-02-01

    To assess the association between quality of life and distance walked in the 6-minute walk test (6MWT) in Brazilian premenopausal patients with systemic lupus erythematosus (SLE) and compare their results with those of healthy controls. Twenty-five premenopausal (18-45 years) patients diagnosed with low-activity SLE (mean SLEDAI: 1.52 ± 1.61) and 25 controls were matched for age, physical characteristics, and physical activity level (International Physical Activity Questionnaire/s-IPAQ). Both groups should not be involved in regular physical activity for at least six months before the study. The 6MWT distance (American Thoracic Society protocol), posttest heart rate (HRpost), posttest oxygen saturation (SpO2post) and the Borg scale of subjective perception of effort (SPE/CR10) were evaluated. The quality of life was assessed by use of the Short Form Health Survey 36 (SF-36). Patients with SLE had a significantly poorer quality of life, a shorter 6MWT distance (598 ± 45 m versus 642 ± 14 m, P < 0.001), and greater values of SPE/CR10 (6.28 ± 2.0 versus 5.12 ± 1.60, P< 0.05) and HRpost (134 ± 15 bpm versus 123 ± 23 bpm, P< 0.05) when compared with controls. The linear regression model suggested that quality of life was a significant predictor of 70% of the 6MWT distance. When compared with controls, patients with SLE walked a shorter distance in the 6MWT, which was associated with poorer quality of life.

  14. Pre-Discharge Evaluation in Heart Failure – Additive Predictive Value of the 6-Minute Walking Test to Clinical Scores.

    PubMed

    La Rovere, Maria Teresa; Maestri, Roberto; Caporotondi, Angelo; Corbellini, Daniela; Guazzotti, Giampaolo; Pinna, Gian Domenico; Febo, Oreste

    2015-01-01

    We aimed to investigate whether the assessment of functional capacity by the 6-minute walking test (6MWT) might improve the predictive ability of 2 validated clinical scores for risk stratification in heart failure (HF). The Cardiac and Comorbid Conditions HF (3C-HF) and the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) scores were evaluated in 466 consecutive HF patients who completed a pre-discharge 6MWT. The 12-month event rate was 7.7%. Both the 2 scores and the 6MWT predicted all-cause mortality (all P<0.0001), with a hazard ratio of 2.650 [95%CI 1.879-3.737], 2.754 [95%CI 1.870-4.056] for each one SD increase in the 3C-HF and MAGGIC, respectively, and of 2.080 [95% CI 1.619-2.671] for each one SD decrease in the meters walked. The addition of a 6MWT to both the 3C-HF and MAGGIC scores significantly improved predictive discrimination (c-index 0.793 [95% CI 0.722-0.864] and 0.802 [95% CI 0.733-0.871], respectively) and risk classification (integrated discrimination improvement, IDI 0.052 [95% CI 0.024-0.101] and 0.046 [95% CI 0.020-0.102], respectively). In the intermediate and high risk strata identified on the basis of both the 3C-HF and MAGGIC scores, mortality rates significantly differed according to a distance walked < or ≥376 m. In HF patients, a pre-discharge evaluation combining the 6MWT to clinical scores improves prediction of 12-month mortality.

  15. Faller Classification in Older Adults Using Wearable Sensors Based on Turn and Straight-Walking Accelerometer-Based Features.

    PubMed

    Drover, Dylan; Howcroft, Jennifer; Kofman, Jonathan; Lemaire, Edward D

    2017-06-07

    Faller classification in elderly populations can facilitate preventative care before a fall occurs. A novel wearable-sensor based faller classification method for the elderly was developed using accelerometer-based features from straight walking and turns. Seventy-six older individuals (74.15 ± 7.0 years), categorized as prospective fallers and non-fallers, completed a six-minute walk test with accelerometers attached to their lower legs and pelvis. After segmenting straight and turn sections, cross validation tests were conducted on straight and turn walking features to assess classification performance. The best "classifier model-feature selector" combination used turn data, random forest classifier, and select-5-best feature selector (73.4% accuracy, 60.5% sensitivity, 82.0% specificity, and 0.44 Matthew's Correlation Coefficient (MCC)). Using only the most frequently occurring features, a feature subset (minimum of anterior-posterior ratio of even/odd harmonics for right shank, standard deviation (SD) of anterior left shank acceleration SD, SD of mean anterior left shank acceleration, maximum of medial-lateral first quartile of Fourier transform (FQFFT) for lower back, maximum of anterior-posterior FQFFT for lower back) achieved better classification results, with 77.3% accuracy, 66.1% sensitivity, 84.7% specificity, and 0.52 MCC score. All classification performance metrics improved when turn data was used for faller classification, compared to straight walking data. Combining turn and straight walking features decreased performance metrics compared to turn features for similar classifier model-feature selector combinations.

  16. Relationship of Bode Index to Functional Tests in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Regueiro, Eloisa Maria Gatti; Di Lorenzo, Valéria Amorim Pires; Basso, Renata Pedrolongo; Pessoa, Bruna Varanda; Jamami, Mauricio; Costa, Dirceu

    2009-01-01

    OBJECTIVE To determine if there is a correlation between the BODE Index and variables assessed during the Activities of Daily Living assessment, performance on lower limber tests, and peripheral muscle impairment of the upper limb in patients with chronic obstructive pulmonary disease. MATERIALS AND METHODS Ten men (aged 58 to 80 years old) with moderate to very severe obstruction were evaluated and classified by the BODE Index. They were evaluated by pulmonary ventilation (V̇E), oxygen consumption (V̇O2), and carbonic gas production (V̇CO2) on the ADL assessment; Distance Walking (DW) in the Six Minute Walking Test (6MWT) and the Six Minute Walking Test on Treadmill (6MWTT); number of repetitions in the Sit-to-Stand Test; and the Hand Grip Strength Test. Correlations were evaluated between the classification and the tests performed (Pearson and Spearman test, p<0.05). RESULTS The mean of the total score for the BODE Index was 2.80 (±1.03), with three patients scoring in the first quartile (Q1) and seven scoring in the second quartile (Q2). This Index showed a negative correlation with the 6MWTT (r=−0.86), the Sit-to-Stand Test (r=−0.66), and the Hand Grip Strength Test (r=−0.83). CONCLUSIONS Our results show that there is no correlation between the BODE Index and the ventilatory and metabolic responses in the Activities of Daily Living assessment. On the other hand, a correlation was observed between the BODE Index and the variables assessed in the 6MWTT, Sit-to-Stand Test, and Hand Grip Strength Test in moderate to very severe Chronic Obstructive Pulmonary Disease patients. This suggests that these tests can be employed as predictors of physical exercise capacity, perhaps as complementary tests to the BODE Index. PMID:19841705

  17. Load carrying walking test and its relationships to endurance and neuromuscular capabilities in women and men of different ages.

    PubMed

    Holviala, J; Häkkinen, A; Nyman, K; Aho, J; Karavirta, L; Häkkinen, K

    2011-03-01

    The aim of this study was to examine load carrying walking test (TMload) performance on the treadmill and its associations to endurance and neuromuscular capabilities in women and men of different ages. Sixty participants (aged 28 to 71 years) were divided into young, middle-aged and old groups of both genders. Clinical stress test was performed by stationary cycle ergometer (CEload). Peak oxygen uptake (VO2peak), heart rate and lactate concentration were measured using maximal TMload test. Isometric strength and EMG-activity of upper and lower extremities were measured before and after TMload. VO2peak of TMload correlated significantly with TMload exercise time (ET) in all other groups (r=0.67 to 0.91 and p ≤ 0.05 to p<0.001) except old men. Leg extension force decreased (p ≤ 0.05 to p<0.001) after TMload in all groups, grip force in young groups (p ≤ 0.05), while plantar flexion force and all EMGs remained unchanged. In men VO2peak explained 81% and in women VO2peak and age explained 87% of the total variation of the TMload ET. In conclusion, ET of TMload is associated with high VO2peak, but not with muscle strength or its changes during the loading. The present load carrying walking test may be used for testing workers with heavy loading in their occupation or in rehabilitation purposes. Further research is needed to examine in more detailed the loading model of the present study as well as the effects of different types of training on load carrying performance.

  18. [Clinical application of the "Stop walking while talking test". Relationship with geriatric assessment parameters and other tests of balance and gait].

    PubMed

    González-Ávila, Bárbara; Roqueta, Cristina; Farriols, Cristina; Álvaro, Margarita; Roig, Alba; Cervera, Anton Maria; Miralles, Ramón

    To assess the relationship between the Stop Walking While Talking (SWWT) test and some parameters of the geriatric assessment, as well as other tests of balance and gait. A prospective, observational and cross-sectional study conducted on 108 patients (62% women), with a mean age of 80.5±8.4 years. Twenty-three of them were living at home, 24 in a nursing home, and 61 in an intermediate care unit. A record was made of the Barthel index, Mini-Mental State Examination of Folstein (MMSE), comorbidity (Charlson index), the presence of previous falls, and fear of falling. Timed Up and Go (TUG), Tinetti test, and Stop Walking While Talking (SWWT) test, were performed on all the patients. Based on the results of the SWWT test patients were divided in two groups: "stoppers" and "non-stoppers". All patients were able to walk (with or without walking aids). The stoppers group of patients had a mean age 82.2±8.7; Barthel index 64.6±20.7; MMSE 21.6±5.1; Charlson index 1.8±1.7, and the non-stoppers 78.5±7.6 (P=.024), 86.0±18.1 (P<.001), 24.3±4.0 (P=.004), and 1.3±1.6 (P=.130), respectively. Of the 58 stoppers patients, 39 (67.2%) had a previous fall, and 19 (32.8%) had not (P=.002); 43 (74.1%) had fear of falling, and 15 (25.9%) had not (P<0.009). Of the 63 patients with TUG>20seconds, 52 (82.5%) were stoppers and 11 (17.5%) non-stoppers. Of the 31 with TUG between 10-20seconds, 5 (16.1%) were stoppers and 26 (83.9%) non-stoppers. Of the 14 with TUG<10 seconds, 1 (7.1%) were stoppers, and 13 (92.9%) non-stoppers (P<0.0001). The score of Tinetti test in the stoppers group was 15.4±5.2, and in non-stoppers 23.9±4.6 (P<0.001). Those in the stopper group were significantly older, were more dependent in activities of daily living, had greater cognitive impairment, more previous falls, had greater fear of falling, lower scores on the Tinetti test, and longer times in the TUG. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. How to walk a conveyor

    SciTech Connect

    2007-06-15

    The article gives a check list of what one should know before walking a belt conveyor, and what to do during the walk. It then presents a list of what to look at on a walk along the conveyor system (excluding related equipment which could be inspected or maintained during the walk). It gives advice on when to stop the conveyor, on testing the emergency stop system, on recording problems and on acting on things noted. 1 tab.

  20. Testing the imprint of nonstandard cosmologies on void profiles using Monte Carlo random walks

    NASA Astrophysics Data System (ADS)

    Achitouv, Ixandra

    2016-11-01

    Using Monte Carlo random walks of a log-normal distribution, we show how to qualitatively study void properties for nonstandard cosmologies. We apply this method to an f (R ) modified gravity model and recover the N -body simulation results of [1 I. Achitouv, M. Baldi, E. Puchwein, and J. Weller, Phys. Rev. D 93, 103522 (2016).] for the void profiles and their deviation from GR. This method can potentially be extended to study other properties of the large scale structures such as the abundance of voids or overdense environments. We also introduce a new way to identify voids in the cosmic web, using only a few measurements of the density fluctuations around random positions. This algorithm allows us to select voids with specific profiles and radii. As a consequence, we can target classes of voids with higher differences between f (R ) and standard gravity void profiles. Finally, we apply our void criteria to galaxy mock catalogues and discuss how the flexibility of our void finder can be used to reduce systematic errors when probing the growth rate in the galaxy-void correlation function.

  1. A series test of the scaling limit of self-avoiding walks

    NASA Astrophysics Data System (ADS)

    Guttmann, Anthony J.; Jacobsen, Jesper L.

    2013-11-01

    It is widely believed that the scaling limit of self-avoiding walks (SAWs) at the critical temperature is conformally invariant, and consequently describable by Schramm-Loewner evolution with parameter κ = 8/3. We consider SAWs in a rectangle, which originate at its centre and end at the boundary. We assume that the boundary density transforms covariantly in a way that depends precisely on κ, as conjectured by Lawler, Schramm and Werner (2004 Fractal Geometry and Applications: A Jubilee of Benoit Mandelbrot part 2, pp 339-64). It has previously been shown by Guttmann and Kennedy (2013 J. Eng. Math. at press) that, in the limit of an infinitely large rectangle, the ratio of the fraction of SAWs hitting the side of the rectangle to the fraction that hit the end of the rectangle can be calculated. By considering rectangles of fixed aspect ratio 2, and also rectangles of aspect ratio 10, we calculate this ratio exactly for larger and larger rectangles. By extrapolating this data to infinite rectangle size, and invoking the above conjectures, we obtain the estimate κ = 2.666 64 ± 0.000 07 for rectangles of aspect ratio 2 and κ = 2.666 75 ± 0.000 15 for rectangles of aspect ratio 10. We also provide numerical evidence supporting the conjectured distribution of SAWs striking the boundary at various points in the case of rectangles with aspect ratio 2.

  2. The 6-minute walk test in Duchenne/Becker muscular dystrophy: longitudinal observations.

    PubMed

    McDonald, Craig M; Henricson, Erik K; Han, Jay J; Abresch, R Ted; Nicorici, Alina; Atkinson, Leone; Elfring, Gary L; Reha, Allen; Miller, Langdon L

    2010-12-01

    In this study we used the 6-minute walk distance (6MWD) to characterize ambulation over time in Duchenne/Becker muscular dystrophy (DBMD). The 6MWD was assessed in 18 boys with DBMD and 22 healthy boys, ages 4-12 years, over mean [range] intervals of 58 [39-87] and 69 [52-113] weeks, respectively. Height and weight increased similarly in both groups. At 52 weeks, 6MWD decreased in 12 of 18 (67%) DBMD subjects (overall mean [range]: 357 [125-481] to 300 [0-510] meters; Δ -57 meters, -15.9%), but increased in 14 of 22 (64%) healthy subjects (overall mean [range]: 623 [479-754] to 636 [547-717] meters; Δ +13 meters, +2.1%). Two DBMD subjects lost ambulation. Changes in 6MWD depended on stride length and age; improvements usually occurred by 7-8 years of age; older DBMD subjects worsened, whereas older healthy subjects were stable. The 6MWD changes at 1 year confirm the validity of this endpoint and emphasize that preserving ambulation must remain a major goal of DBMD therapy.

  3. Evaluation of Timed Up and Go Test as a tool to measure postoperative function and prediction of one year walking ability for patients with hip fracture.

    PubMed

    Nygard, Heid; Matre, Kjell; Fevang, Jonas Meling

    2016-05-01

    To evaluate if the Timed Up and Go Test is a useful tool to measure postoperative function and to predict one-year results of rehabilitation in patients operated owing to hip fracture. Prospective cohort study. The department of orthopaedic surgery at five hospitals in Norway. Patients were assessed five days postoperatively and after one year. A total of 684 patients over 60 years with trochanteric or subtrochanteric hip fractures were included. A total of 171 (25%) patients died within a year and 373 (73% of patients still alive) attended follow-up one year after surgery. Timed Up and Go Test and walking ability. A total of 258 (38%) patients passed the postoperative Timed Up and Go Test. A total of 217 (56%) patients with a prefracture independent outdoor walking ability, passed the test. The average Timed Up and Go Test score was 71 seconds. A total of 171 (25%) patients could not rise from a chair without assistance; 8% of the patients with cognitive impairment, and 8% of those admitted from nursing homes, were able to pass the postoperative Timed Up and Go Test. The sensitivity and specificity of the Timed Up and Go Test in predicting walking ability one year after the operation were low. At one year follow-up, 38% of the patients not able to perform the postoperative Timed Up and Go Test, passed the test. A total of 81 (21%) patients did not use any walking-aid, 17 of them did not pass the postoperative Timed Up and Go Test. The Timed Up and Go Test performed the fifth postoperative day was not a suitable tool to assess functional mobility for the majority of the patients with hip fractures in our study. Neither was the postoperative Timed Up and Go Test a suitable tool to predict the walking ability one year after the operation. © The Author(s) 2015.

  4. Evaluation of Timed Up and Go Test as a tool to measure postoperative function and prediction of one year walking ability for patients with hip fracture

    PubMed Central

    Nygard, Heid; Matre, Kjell; Fevang, Jonas Meling

    2015-01-01

    Objective: To evaluate if the Timed Up and Go Test is a useful tool to measure postoperative function and to predict one-year results of rehabilitation in patients operated owing to hip fracture. Design: Prospective cohort study. Setting: The department of orthopaedic surgery at five hospitals in Norway. Patients were assessed five days postoperatively and after one year. Subjects: A total of 684 patients over 60 years with trochanteric or subtrochanteric hip fractures were included. A total of 171 (25%) patients died within a year and 373 (73% of patients still alive) attended follow-up one year after surgery. Main measures: Timed Up and Go Test and walking ability. Results: A total of 258 (38%) patients passed the postoperative Timed Up and Go Test. A total of 217 (56%) patients with a prefracture independent outdoor walking ability, passed the test. The average Timed Up and Go Test score was 71 seconds. A total of 171 (25%) patients could not rise from a chair without assistance; 8% of the patients with cognitive impairment, and 8% of those admitted from nursing homes, were able to pass the postoperative Timed Up and Go Test. The sensitivity and specificity of the Timed Up and Go Test in predicting walking ability one year after the operation were low. At one year follow-up, 38% of the patients not able to perform the postoperative Timed Up and Go Test, passed the test. A total of 81 (21%) patients did not use any walking-aid, 17 of them did not pass the postoperative Timed Up and Go Test. Conclusion: The Timed Up and Go Test performed the fifth postoperative day was not a suitable tool to assess functional mobility for the majority of the patients with hip fractures in our study. Neither was the postoperative Timed Up and Go Test a suitable tool to predict the walking ability one year after the operation. PMID:26109590

  5. Questionnaire, walking time and button test measures of functional capacity as predictive markers for mortality in rheumatoid arthritis.

    PubMed

    Pincus, T; Callahan, L F; Vaughn, W K

    1987-04-01

    Mortality over 9 years in rheumatoid arthritis was studied according to baseline demographic, disease, therapy and comorbidity variables, and measures of functional capacity variables. Significant differences between patients who survived and died over the next 9 years were seen for 8 variables: age, joint count, oral corticosteroid use, presence of concurrent heart disease, formal educational level, and 3 quantitative measures of functional capacity, questionnaire responses regarding activities of daily living, modified walking time and the button test. Five-year survivals of 50% or less were seen in patients with severely dysfunctional values for the 3 quantitative measures of functional capacity. Increased relative risk of mortality according to functional capacity measures was not explained by age, sex, duration of disease, smoking history, joint count, hand radiograph score, grip strength, morning stiffness, formal educational level, oral corticosteroid or parenteral gold use, or various comorbidities, and was not expected by a majority of physicians.

  6. Reference values for the incremental shuttle walk test in patients with cardiovascular disease entering exercise-based cardiac rehabilitation.

    PubMed

    Cardoso, Fernando M F; Almodhy, Meshal; Pepera, Garyfalia; Stasinopoulos, Dimitrios M; Sandercock, Gavin R H

    2017-01-01

    The incremental shuttle walk test (ISWT) is used to assess functional capacity of patients entering cardiac rehabilitation. Factors such as age and sex account for a proportion of the variance in test performance in healthy individuals but there are no reference values for patients with cardiovascular disease. The aim of this study was to produce reference values for the ISWT. Participants were n = 548 patients referred to outpatient cardiac rehabilitation who underwent a clinical examination and performed the ISWT. We used regression to identify predictors of performance and produced centile values using the generalised additive model for location, scale and shape model. Men walked significantly further than women (395 ± 165 vs. 269 ± 118 m; t = 9.5, P < 0.001) so data were analysed separately by sex. Age (years) was the strongest predictor of performance in men (β = -5.9; 95% CI: -7.1 to -4.6 m) and women (β = -4.8; 95% CI: -6.3 to 3.3). Centile curves demonstrated a broadly linear decrease in expected ISWT values in males (25-85 years) and a more curvilinear trend in females. Patients entering cardiac rehabilitation present with highly heterogeneous ISWT values. Much of the variance in performance can be explained by patients' age and sex. Comparing absolute values with age-and sex-specific reference values may aid interpretation of ISWT performance during initial patient assessment at entry to cardiac rehabilitation.

  7. Postexercise peripheral oxygen saturation after completion of the 6-minute walk test predicts successfully reaching the summit of Aconcagua.

    PubMed

    Lazio, Matthew P; Van Roo, Jon D; Pesce, Carlos; Malik, Sanjeev; Courtney, D Mark

    2010-12-01

    The 6-minute walk test (6MWT) is a single measurement of functional status in patients with cardiovascular disease. It has not been studied at high altitude. We investigate the screening value of 6-minute walk distance (6MWD) and postexercise vital sign (VS) measurements as predictors of successfully reaching the summit or development of acute mountain sickness (AMS) on Aconcagua (6962 m). Prospective observational cohort in Aconcagua Provincial Park, Argentina. Adults climbing the normal route who registered with base camp physicians were included. There were no exclusion criteria. VSs were measured before (resting) and after (postexercise) completion of 6MWT while volunteers acclimatized at Plaza de Mulas base camp (4365 m). Volunteers proceeded towards the summit at their own pace and upon descent returned a questionnaire with maximum altitude reached and Lake Louise AMS Self-report Score (LLSelf). One hundred twenty-four volunteers completed the 6MWT. Sixty-four volunteers (51.6%) completed questionnaires; 56% summited. Median LLSelf was 4 (IQR: 3.0-6.5). There was no association between any resting or postexercise VS measurements and AMS. However, mean postexercise SpO(2) was 80.8% in summiters and 76.4% in nonsummiters, a difference of -4.4% (95% CI: -6.7 to -2.0, p = 0.0005). Postexercise SpO(2) < 75% had 97.2% sensitivity and negative likelihood ratio of 0.086 in predicting the outcome of successfully reaching the summit: only one climber with SpO(2) < 75% successfully reached the summit. This study provides the first published data on 6MWD recorded in the field at high altitude. Postexercise SpO(2) < 75% may be a useful screening test for predicting the outcome of successfully reaching the summit of Aconcagua. Copyright © 2010 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  8. Validity and reliability of the 1/4 mile run-walk test in physically active children and adolescents.

    PubMed

    Ruiz, Jonatan R; Ortega, Francisco B; Castro-Piñero, Jose

    2014-11-30

    We investigated the criterion-related validity and the reliability of the 1/4 mile run-walk test (MRWT) in children and adolescents. A total of 86 children (n=42 girls) completed a maximal graded treadmill test using a gas analyzer and the 1/4MRW test. We investigated the test-retest reliability of the 1/4MRWT in a different group of children and adolescents (n=995, n=418 girls). The 1/4MRWT time, sex, and BMI significantly contributed to predict measured VO2peak (R2= 0.32). There was no systematic bias in the cross-validation group (P>0.1). The root mean sum of squared errors (RMSE) and the percentage error were 6.9 ml/kg/min and 17.7%, respectively, and the accurate prediction (i.e. the percentage of estimations within ±4.5 ml/kg/min of VO2peak) was 48.8%. The reliability analysis showed that the mean inter-trial difference ranged from 0.6 seconds in children aged 6-11 years to 1.3 seconds in adolescents aged 12-17 years (all P.

  9. Walk a Mile in My Shoes: Stakeholder Accounts of Testing Experience with a Computer-Administered Test

    ERIC Educational Resources Information Center

    Fox, Janna; Cheng, Liying

    2015-01-01

    In keeping with the trend to elicit multiple stakeholder responses to operational tests as part of test validation, this exploratory mixed methods study examines test-taker accounts of an Internet-based (i.e., computer-administered) test in the high-stakes context of proficiency testing for university admission. In 2013, as language testing…

  10. The 6-minute walk test in female fibromyalgia patients: relationship with tenderness, symptomatology, quality of life, and coping strategies.

    PubMed

    Carbonell-Baeza, Ana; Ruiz, Jonatan R; Aparicio, Virginia A; Ortega, Francisco B; Delgado-Fernández, Manuel

    2013-12-01

    The purpose of this study was to examine the relationship between the 6-minute walk test (6-MWT) and tenderness, symptomatology, quality of life, and coping strategies in women with fibromyalgia. One hundred eighteen women with fibromyalgia aged 51.9 ± 7.3 years participated in the study. The examination included the 6-MWT, tender points, and the following questionnaires: Fibromyalgia Impact Questionnaire (FIQ), Short-Form Health Survey 36 (SF-36), and Vanderbilt Pain Management Inventory. Fair correlations between the 6-MWT and the subscales of physical impairment (FIQ) and physical function (SF-36) were observed (ρ -0.365 and 0.347, respectively, both p < .001). The 6-MWT showed a weak relationship with tenderness (ρ 0.201 and -0.191 for algometer score and tender points count, respectively, both p < .05). The relationship between the 6-MWT and global score of FIQ, and FIQ subscales of pain and fatigue were weak (ρ -0.201, -0.211, and -0.226, respectively, all p < .05). The 6-MWT showed a weak relationship with bodily pain and vitality scales of SF-36 (ρ 0.256 and 0.258, respectively, both p = .005) and with passive and active coping strategies (ρ -0.255 and 0.223, both p < .05). This study in women with fibromyalgia shows significant relationships, ranging from weak to fair, between the 6-MWT and tenderness, symptomatology, quality of life, and coping strategies. These findings indicate that functional capacity, as assessed by the distance walked in 6 minutes, might be important when planning the assessment, treatment, and monitoring of patients with fibromyalgia.

  11. The Effects of Walking Behavior on Mood.

    ERIC Educational Resources Information Center

    Snodgrass, Sara E.; And Others

    Past research has shown that the way one walks reflects one's personality traits and mood states. A study was conducted to examine whether the way one walks can reciprocally affect one's mood. The study tested the hypothesis that walking vigorously would cause a person to feel happier, and that a shuffling walk would cause a person to feel more…

  12. The association between the maximum step length test and the walking efficiency in children with cerebral palsy.

    PubMed

    Kimoto, Minoru; Okada, Kyoji; Sakamoto, Hitoshi; Kondou, Takanori

    2017-05-01

    [Purpose] To improve walking efficiency could be useful for reducing fatigue and extending possible period of walking in children with cerebral palsy (CP). For this purpose, current study compared conventional parameters of gross motor performance, step length, and cadence in the evaluation of walking efficiency in children with CP. [Subjects and Methods] Thirty-one children with CP (21 boys, 10 girls; mean age, 12.3 ± 2.7 years) participated. Parameters of gross motor performance, including the maximum step length (MSL), maximum side step length, step number, lateral step up number, and single leg standing time, were measured in both dominant and non-dominant sides. Spatio-temporal parameters of walking, including speed, step length, and cadence, were calculated. Total heart beat index (THBI), a parameter of walking efficiency, was also calculated from heartbeats and walking distance in 10 minutes of walking. To analyze the relationships between these parameters and the THBI, the coefficients of determination were calculated using stepwise analysis. [Results] The MSL of the dominant side best accounted for the THBI (R(2)=0.759). [Conclusion] The MSL of the dominant side was the best explanatory parameter for walking efficiency in children with CP.

  13. A comparative study of two protocols for treadmill walking exercise testing in ambulating subjects with incomplete spinal cord injury.

    PubMed

    Lundgaard, E; Wouda, M F; Strøm, V

    2017-05-23

    This is a comparative study of two exercise testing protocols. The objective of this study was to compare maximal oxygen uptake (VO2 max) and achieved criteria for maximal exercise testing between the Sunnaas Protocol-a newly designed treadmill exercise test protocol-and the Modified Bruce Protocol in persons with incomplete spinal cord injury (SCI). This study was conducted in Sunnaas Rehabilitation Hospital, Norway. Twenty persons (19 men) with incomplete SCI (AIS D) capable of ambulating without assistive devices performed two treadmill walking exercise tests (Sunnaas Protocol and Modified Bruce Protocol) until exhaustion 1-3 days apart. The key differences between the protocols are the smaller increments in speed and shorter duration on each workload in the Sunnaas Protocol. Cardiovascular responses were measured continuously throughout both tests. The subjects exhibited statistically significantly higher VO2 max when using the Sunnaas Protocol (37.1±9.9 vs 35.4±9.8 ml kg(-1) min(-1), P=0.01), with a mean between-test difference of 1.8 ml kg(-1) min(-1) (95% confidence interval: 0.49-3.16). There was no significant difference in mean maximal heart rate (HR max). Nineteen (95%) subjects achieved at least three of the four criteria for maximal oxygen uptake using the Sunnaas Protocol. Thirteen (65%) subjects achieved at least three of the criteria using a Modified Bruce protocol. The small differences in both VO2 max and achieved criteria in favor of the Sunnaas Protocol suggest that it could be a useful alternative treadmill exercise test protocol for ambulating persons with incomplete SCI.Spinal Cord advance online publication, 23 May 2017; doi:10.1038/sc.2017.34.

  14. An Evaluation of the Canadian Forces Two-Mile Walk as a Test of Aerobic Fitness in Males over 45 Years of Age

    DTIC Science & Technology

    1977-03-01

    individuals have a rather sedentary lifestyle and do not realize the benefits of regular exercise. Since, for a variety of reasons, they are often...categories of "good" and "excellent" indicated by the walk test were high in view of the mainly sedentary lifestyle of the twelve subjects. These

  15. Pilot Field Test: Results of Tandem Walk Performance Following Long-Duration Spaceflight

    NASA Technical Reports Server (NTRS)

    Cerisano, J. M.; Reschke, M. F.; Kofman, I. S.; Fisher, E. A.; Gadd, N. E.; Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.; Bloomberg, J. J.; Mulavara, A.; Kozlovskaya, I.; Tomilovskaya, E.

    2016-01-01

    Coordinated locomotion has proven to be challenging for many astronauts following long duration spaceflight. As NASA's vision for spaceflight points toward interplanetary travel and missions to distant objects, astronauts will not have assistance once they land. Thus, it is vital to develop a knowledge base from which operational guidelines can be written that define when astronauts can be expected to safely perform certain tasks. Data obtained during the Field Test experiment will add important insight to this knowledge base. Specifically, we aim to develop a recovery timeline of functional sensorimotor performance during the first 24 hours and several days after landing. A forerunner of the full Field Test study, the Pilot Field Test (PFT) comprised a subset of the tasks and measurements to be included in the ultimate set.

  16. Test-retest reliability of the Tekscan® F-Scan® 7 in-shoe plantar pressure system during treadmill walking in healthy recreationally active individuals.

    PubMed

    Patrick, Kyle; Donovan, Luke

    2017-09-20

    In-shoe plantar pressure systems are commonly used in clinical and research settings to assess foot function during functional tasks. Recently, Tekscan® has updated their F-Scan® in-shoe plantar pressure system; however, this system's test-retest reliability has not been established. Therefore, the purpose of this study was to determine the test-retest reliability of the F-Scan® 7 system in recreationally active individuals during treadmill walking. Seventeen healthy adults completed 2 sessions of treadmill walking. For each session, participants were fitted for shoes and pressure insoles and walked on a treadmill at a self-selected pace for 30 s. Following the sessions, the test-retest reliability peak pressure, pressure time integral, average pressure and pressure contact area over 4 regions of the foot (heel, mid-foot, forefoot and toes) was assessed by calculating intraclass coefficients (ICC 2,k) and coefficient of variation percentage (CoV%). Pressure contact area consistently had the highest ICCs and lowest CoV% (ICCs: 0.91-0.98; CoV%: 2.7-7.8%). Whereas, the forefoot and toe regions had the highest ICCs for all 4 measures (ICCs: 0.83-0.98; CoV%: 3.1-13.4%). During treadmill walking in healthy recreationally active individuals, the reliability of the new Tekscan F-Scan® ranged from poor to high and was dependent on the measure and region of the foot.

  17. Cardiorespiratory Responses and Prediction of Peak Oxygen Uptake during the Shuttle Walking Test in Healthy Sedentary Adult Men

    PubMed Central

    Neves, Camila D. C.; Lacerda, Ana Cristina Rodrigues; Lage, Vanessa K. S.; Lima, Liliana P.; Fonseca, Sueli F.; de Avelar, Núbia C. P.; Teixeira, Mauro M.; Mendonça, Vanessa A.

    2015-01-01

    Background The application of the Shuttle Walking Test (SWT) to assess cardiorespiratory fitness and the intensity of this test in healthy participants has rarely been studied. This study aimed to assess and correlate the cardiorespiratory responses of the SWT with the cardiopulmonary exercise testing (CEPT) and to develop a regression equation for the prediction of peak oxygen uptake (VO2 peak) in healthy sedentary adult men. Methods In the first stage of this study, 12 participants underwent the SWT and the CEPT on a treadmill. In the second stage, 53 participants underwent the SWT twice. In both phases, the VO2 peak, respiratory exchange ratio (R), and heart rate (HR) were evaluated. Results Similar results in VO2 peak (P>0.05), R peak (P>0.05) and predicted maximum HR (P>0.05) were obtained between the SWT and CEPT. Both tests showed strong and significant correlations of VO2 peak (r = 0.704, P = 0.01) and R peak (r = 0.737, P<0.01), as well as the agreement of these measurements by Bland-Altman analysis. Body mass index and gait speed were the variables that explained 40.6% (R2 = 0.406, P = 0.001) of the variance in VO2 peak. The results obtained by the equation were compared with the values obtained by the gas analyzer and no significant difference between them (P>0.05) was found. Conclusions The SWT produced maximal cardiorespiratory responses comparable to the CEPT, and the developed equation showed viability for the prediction of VO2 peak in healthy sedentary men. PMID:25659094

  18. Short-term Effects of Supplemental Oxygen on 6-Min Walk Test Outcomes in Patients With COPD: A Randomized, Placebo-Controlled, Single-blind, Crossover Trial.

    PubMed

    Jarosch, Inga; Gloeckl, Rainer; Damm, Eva; Schwedhelm, Anna-Lena; Buhrow, David; Jerrentrup, Andreas; Spruit, Martijn A; Kenn, Klaus

    2017-04-01

    The acute effect of supplemental oxygen during exercise has been shown to differ largely among patients with COPD. It is unknown what factors influence oxygen response. In a randomized, single-blind fashion, 124 patients with COPD underwent one 6-min walk test on supplemental oxygen (6MWTO2) and one 6-min walk test on room air after a practice 6-min walk test. Both gases were delivered via standard nasal prongs (2 L/min). For analyses, patients were stratified on the basis of PaO2 values and compared: (1) 34 patients with resting hypoxemia (HYX); (2) 43 patients with exercise-induced hypoxemia (EIH); and (3) 31 patients with normoxemia (NOX). Oxygen supplementation resulted in an increase in the 6-min walk distance in the total cohort (27 ± 42 meters; P < .001) and in the subgroups of HYX (37 ± 40 meters; P < .001) and EIH (28 ± 44 meters; P < .001) but not in the NOX subgroup (15 ± 43 meters; P = .065). Forty-two percent of patients with HYX and 47% of patients with EIH improved their 6-min walk distance to a clinically relevant extent (≥ 30 meters) by using oxygen. These oxygen responders were characterized by significantly lower 6-min walk distance using room air compared with patients without a relevant response (306 ± 106 meters vs 358 ± 113 meters; P < .05). Although oxygen saturation was significantly higher during 6MWTO2 compared with the 6-min walk test on room air in all 3 subgroups, it dropped to < 88% during 6MWTO2 in 73.5% of patients with HYX. In contrast to patients with NOX, patients with HYX and EIH generally benefit from supplemental oxygen by increasing exercise capacity. However, less than one-half of patients reached the threshold of clinically relevant improvements. These oxygen responders were characterized by significantly lower exercise capacity levels. ClinicalTrials.gov; No.: NCT00886639; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  19. Walking Problems

    MedlinePlus

    ... Parkinson's disease Diseases such as arthritis or multiple sclerosis Vision or balance problems Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.

  20. Evaluation of the microsoft kinect skeletal versus depth data analysis for timed-up and go and figure of 8 walk tests.

    PubMed

    Hotrabhavananda, Benjamin; Mishra, Anup K; Skubic, Marjorie; Hotrabhavananda, Nijaporn; Abbott, Carmen

    2016-08-01

    We compared the performance of the Kinect skeletal data with the Kinect depth data in capturing different gait parameters during the Timed-up and Go Test (TUG) and Figure of 8 Walk Test (F8W). The gait parameters considered were stride length, stride time, and walking speed for the TUG, and number of steps and completion time for the F8W. A marker-based Vicon motion capture system was used for the ground-truth measurements. Five healthy participants were recruited for the experiment and were asked to perform three trials of each task. Results show that depth data analysis yields stride length and stride time measures with significantly low percentile errors as compared to the skeletal data analysis. However, the skeletal and depth data performed similar with less than 3% of absolute mean percentile error in determining the walking speed for the TUG and both parameters of F8W. The results show potential capabilities of Kinect depth data analysis in computing many gait parameters, whereas, the Kinect skeletal data can also be used for walking speed in TUG and F8W gait parameters.

  1. Fall prediction in thai elderly with timed up and go and tandem walk test: a cross-sectional study.

    PubMed

    Chantanachai, Thanwarat; Pichaiyongwongdee, Sopa; Jalayondeja, Chutima

    2014-07-01

    To examine the timed up and go (TUG) and tandem walk test (TWT) as fall prediction assessments in Thai elderly. Elderly subjects aged between 60 and 86 years and living in Nakhonpathom and Samutsakhon provinces were classified as fallers and non-fallers by self-report in the past six months. The TUG and TWT were used to predict falls. The optimal cutoff score and validity indexes were determined by plotting the receiver operating characteristic (ROC) curve and crosstabs analysis. One hundred and sixty-one elderly subjects were classified as fallers (7 males and 43 females) and non-fallers (24 males and 87 females). The area under the curve (AUC) of ROC were 0.62 (95% CI = 0.59, 0.76; p = 0.0001) for TUG and 0.605 (95% CI = 0.514, 0.696; p = 0.033) for TWT error score. The cutoff scores were 10.5 seconds for TUG (74% sensitivity and 57.7% specificity) and five scores for TWT error (62% sensitivity and 55% specificity). TUG and TWT error were useful tools to explain faller status in Thai community-dwelling for theelderly. TWT time was not sensitive enough to detect the elders who were at risk of falls.

  2. Design and Testing of a 2-Hour Oxygen Prebreathe Protocol for Space Walks from the International Space Station

    NASA Technical Reports Server (NTRS)

    Gernhardt, Michael L.; Conkin, J.; Foster, P. P.; Pilmanis, A. A.; Butler, B. D.; Beltran, E.; Fife, C. E.; Vann, R. D.; Gerth, W. A.; Loftin, K. C.; hide

    2000-01-01

    To develop and test a 2-hour prebreathe protocol for performing extravehicular activities (EVAs) from the International Space Station (ISS). Combinations of adynamia (non-walking), prebreathe exercise, and space suit donning options (10.2 vs. 14.7 psi) were evaluated, against timeline and consumable contraints to develop an operational 2- hour prebreathe protocol. Prospective accept/reject criteria were defined for decompression sickness (DCS) and venous gas emboli (VGE) from analysis of historical DCS data, combined with risk management of DCS under ISS mission circumstances. Maximum operational DCS levels were defined based on protecting for EVA capability with two crew-members at 95% confidence, throughout ISS lifetime (within the constraints of NASA DCS disposition policy JPG 1800.3). The accept/reject limits were adjusted for greater safety based on analysis of related medical factors. Monte-Carlo simulation was performed to design a closed sequential, multi-center human trial. Protocols were tested with 4 different prebreathe exercises (Phases I-IV), prior to exposure to 4.3 psi for 4 hrs. Subject selection, Doppler monitoring for VGE, test termination criteria, and DCS definitions were standardized. Phase I: upper and lower body exercises using dual-cycle ergometry (75% VO2 max for 10 min). Phase II: ergometry plus 24 min of light exercise (simulating space-suit preparations). Phase III: same 24 min of light exercise but no ergometry, and Phase IV: 56 min of light exercise without ergometry. A prebreathe procedure was accepted if, at 95% confidence, the incidence of DCS was less than 15% (with no Type II DCS), and Grade IV VGE was less than 20%.

  3. Design and Testing of a 2-Hour Oxygen Prebreathe Protocol for Space Walks from the International Space Station

    NASA Technical Reports Server (NTRS)

    Gernhardt, Michael L.; Conkin, J.; Foster, P. P.; Pilmanis, A. A.; Butler, B. D.; Beltran, E.; Fife, C. E.; Vann, R. D.; Gerth, W. A.; Loftin, K. C.; Paloski, William H. (Technical Monitor)

    2000-01-01

    To develop and test a 2-hour prebreathe protocol for performing extravehicular activities (EVAs) from the International Space Station (ISS). Combinations of adynamia (non-walking), prebreathe exercise, and space suit donning options (10.2 vs. 14.7 psi) were evaluated, against timeline and consumable contraints to develop an operational 2- hour prebreathe protocol. Prospective accept/reject criteria were defined for decompression sickness (DCS) and venous gas emboli (VGE) from analysis of historical DCS data, combined with risk management of DCS under ISS mission circumstances. Maximum operational DCS levels were defined based on protecting for EVA capability with two crew-members at 95% confidence, throughout ISS lifetime (within the constraints of NASA DCS disposition policy JPG 1800.3). The accept/reject limits were adjusted for greater safety based on analysis of related medical factors. Monte-Carlo simulation was performed to design a closed sequential, multi-center human trial. Protocols were tested with 4 different prebreathe exercises (Phases I-IV), prior to exposure to 4.3 psi for 4 hrs. Subject selection, Doppler monitoring for VGE, test termination criteria, and DCS definitions were standardized. Phase I: upper and lower body exercises using dual-cycle ergometry (75% VO2 max for 10 min). Phase II: ergometry plus 24 min of light exercise (simulating space-suit preparations). Phase III: same 24 min of light exercise but no ergometry, and Phase IV: 56 min of light exercise without ergometry. A prebreathe procedure was accepted if, at 95% confidence, the incidence of DCS was less than 15% (with no Type II DCS), and Grade IV VGE was less than 20%.

  4. Clinical relevance of decreased oxygen saturation during 6-min walk test in preoperative physiologic assessment for lung cancer surgery.

    PubMed

    Nakagawa, Tatsuo; Chiba, Naohisa; Saito, Masao; Sakaguchi, Yasuto; Ishikawa, Shinya

    2014-10-01

    The Japanese Association for Chest Surgery (JACS) has released guidelines on preoperative physiologic assessment for lung cancer surgery. However, cardiopulmonary exercise testing (CPET), which is recommended for patients with poor pulmonary function, is available only in limited institutions. We investigated the possibility of 6-min walk test (6MWT) as a substitute of maximum oxygen consumption test (VO(2)max) on preoperative physiologic assessment for lung cancer surgery. The relationship between VO(2)max and 6MWT was retrospectively analyzed in 51 subjects other than lung cancer patients. Following the preliminary analysis, we modified the risk assessment in the JACS guidelines by substituting 6MWT for VO(2)max, and patients who underwent lung cancer surgery were retrospectively assessed using the modified assessment. Analysis of the correlation between VO(2)max and 6MWT revealed VO(2)max to be significantly correlated to minimum SpO(2) (SpO(2)min) and maximum decrease in SpO(2) (ΔSpO(2)) during 6MWT. Receiver operating characteristic analysis revealed that SpO(2)min and ΔSpO(2) were predictable for a VO(2)max of 15 mL/kg/min, which is the borderline between the average- and increased-risk groups in the JACS guidelines. A total of 1,066 patients were assigned to the average- or increased-risk group according to the modified JACS guidelines using the criteria of SpO(2)min < 91 % and ΔSpO(2) > 4 %. The increased-risk group was significantly inferior to the average-risk group in Home Oxygen Therapy induction rate, cardiopulmonary-related 30- and 90-day mortality (p < 0.001). In clinical practice, decreased saturation during 6MWT may be simple and substitutive for CPET in risk assessment for lung cancer surgery using the JACS guidelines.

  5. Nine-hole Peg Test and Ten-meter Walk Test for Evaluating Functional Loss in Chinese Charcot-Marie-Tooth Disease.

    PubMed

    Niu, Hui-Xia; Wang, Rui-Hao; Xu, Hong-Liang; Song, Bo; Yang, Jing; Shi, Chang-He; Li, Yu-Sheng; Zhang, Bing-Qian; Wang, Shao-Ping; Yong, Quan; Wang, Yuan-Yuan; Xu, Yu-Ming

    2017-08-05

    The 9-hole peg test (9-HPT) and 10-meter walk test (10-MWT) are commonly used to test finger motor function and walking ability. The aim of this present study was to investigate the efficacy of these tests for evaluating functional loss in Chinese Charcot-Marie-Tooth (CMT) disease. Thirty-four Chinese CMT patients (CMT group) from August 2015 to December 2016 were evaluated with 9-HPT, 10-MWT, CMT disease examination score, overall neuropathy limitation scale (ONLS), functional disability score, and Berg Balance Scale (BBS). Thirty-five age- and gender-matched healthy controls (control group) were also included in the study. Student's nonpaired or paired t-test were performed to compare data between two independent or related groups, respectively. The Pearson test was used to examine the correlations between recorded parameters. The mean 9-HPT completion time in the dominant hand of CMT patients was significantly slower than that in the healthy controls (29.60 ± 11.89 s vs. 19.58 ± 3.45 s; t = -4.728, P < 0.001). Women with CMT completed the 9-HPT significantly faster than men with CMT (dominant hand: 24.74 ± 7.93 s vs. 33.01 ± 13.14 s, t = 2.097, P = 0.044). The gait speed of the average self-selected velocity and the average fast-velocity assessed using 10-MWT for CMT patients were significantly slower than those in the control group (1.03 ± 0.18 m/s vs. 1.44 ± 0.17 m/s, t = 9.333, P < 0.001; 1.31 ± 0.30 m/s vs. 1.91 ± 0.25 m/s, t = 8.853, P < 0.001, respectively). There was no difference in gait speed between men and women. Both 9-HPT and 10-MWT were significantly correlated with the ONLS, functional disability score, and BBS (P < 0.05 for all). The 9-HPT and 10-MWT might be useful for functional assessment in Chinese patients with CMT.

  6. Prediction of physiological responses and performance at altitude using the 6-minute walk test in normoxia and hypoxia.

    PubMed

    Gibson, Oliver R; Richardson, Alan J; Hayes, Mark; Duncan, Ben; Maxwell, Neil S

    2015-06-01

    The 6-minute walk test (6MWT) is a reliable and valid tool for determining an individual's functional capacity, and has been used to predict summit success. The primary aim of the study was to evaluate whether a 6MWT in normobaric hypoxia could predict physiological responses and exercise performance at altitude. The secondary aim was to determine construct validity of the 6MWT for monitoring acclimatization to 3400 m (Cuzco, Peru). Twenty-nine participants performed six 6MWTs in four conditions: normoxic outdoor (NO), normoxic treadmill (NT), and hypoxic treadmill (HT) were each performed once; and hypoxic outdoor (HO) was performed three times, at 42 hours (HO1), 138 hours (HO2), and 210 hours (HO3) after arrival at Cuzco. One-way analysis of variance revealed no difference (P>.05) between NO and HO1 for 6MWT distance. HT and HO protocols were comparable for the measurement of delta heart rate (HR) and post-test peripheral oxygen saturation (%Spo2; P>.05). Acclimatization was evidenced by reductions (P<.05) in resting HR and respiratory rate (RR) between HO1, HO2, and HO3, and preservation of Spo2 between HO1 and HO2. Postexercise HR and RR were not different (P>.05) with acclimatization. The duration to ascend to 4215 m on a trek was moderately correlated (P<.05) to HR during the trek and the 6MWT distance during HT; no other physiological markers predicted performance. The 6MWT is a simple, time-efficient tool for predicting physiological responses to simulated and actual altitude, which are comparable. The 6MWT is effective at monitoring elements of acclimatization to moderate altitude. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  7. SenseWear Armband and Stroke: Validity of Energy Expenditure and Step Count Measurement during Walking.

    PubMed

    Manns, Patricia J; Haennel, Robert G

    2012-01-01

    The purpose of this study was to test the validity of the SenseWear Pro Armband (SWA) for the measurement of energy expenditure (EE) and step count against a criterion in persons with stroke. Twelve participants with chronic stroke (mean age 64.2 ± 10.4 years; mean gait speed 0.67 ± 0.25 m/sec) completed two trials of a six-minute walk test, while wearing a SenseWear Armband (SWA) on each arm and being continuously monitored using a portable metabolic cart. Agreement between estimates of energy expenditure from the SWA and the metabolic cart was fair for the armband on the hemiplegic arm (intraclass correlation cefficient (ICC) = 0.586) and good for the armband on the unaffected arm (ICC = 0.702). Agreement between the SWA estimate of step count, and step count as measured by the Step Activity Monitor was poor (ICC < 0.352), with significant underestimation by the SWA. Our results show that, for these moderately impaired persons with stroke, the SWA should be used with caution for the measurement of energy expenditure and should not be used to measure step count.

  8. The effect of reduced gravity on the kinematics of human walking: a test of the dynamic similarity hypothesis for locomotion.

    PubMed

    Donelan, J M; Kram, R

    1997-12-01

    To gain insight into the basic principles that govern the biomechanics of locomotion, we investigated the effect of reduced gravity on walking kinematics. We hypothesized that humans walk in a dynamically similar fashion at combinations of speed and simulated gravity that provide equal values of the Froude number, v2/gLleg, where v is forward speed, g is gravitational acceleration and Lleg is leg length. The Froude number has been used to predict the kinematics and kinetics of legged locomotion over a wide range of animal sizes and speeds, and thus provides a potentially unifying theory for the combined effects of speed, size and gravity on locomotion biomechanics. The occurrence of dynamic similarity at equal Froude numbers has been attributed previously to the importance of gravitational forces in determining locomotion mechanics. We simulated reduced gravity using a device that applies a nearly constant upward force to the torso while subjects walked on a treadmill. We found that at equal Froude numbers, under different levels of gravity (0.25g-1.0g), the subjects walked with nearly the same duty factor (ratio of contact time to stride time), but with relative stride lengths (Ls/Lleg, where Ls is stride length) that differed by as much as 67 %, resulting in the rejection of our hypothesis. To understand the separate effects of speed and gravity further, we compared the mechanics of walking at the same absolute speed at different levels of gravity (0.25g-1.0g). In lower gravity, subjects walked with lower duty factors (10 %) and shorter relative stride lengths (16 %). These modest changes in response to the fourfold change in gravity indicate that factors other than gravitational forces are the primary determinants of walking biomechanics.

  9. [Clinical validity of the quantitative gait variables in patients with multiple sclerosis. A comparison of the Timed 25-foot Walk Test and the GAITRite ® Electronic Walkway system].

    PubMed

    Hochsprung, A; Heredia-Camacho, B; Castillo, M; Izquierdo, G; Escudero-Uribe, S

    2014-07-01

    INTRODUCTION. Multiple sclerosis is an inflammatory and degenerative disease in which gait alteration is one of the first symptoms. Its quantitative evaluation is often made by the Timed 25-foot Walk Test (T25FW), although it's limited to know only the distance, the time employed and number of steps. AIM. To compare the T25FW with the results from the GAITRite ® Electronic Walkway system (GEW), to know if there is some variability between them. PATIENTS AND METHODS. The sample consisted in 85 subjects with multiple sclerosis and able to walking, with or without aids (EDSS: 1.0-6.5). Four walkings were made along the 8 m-length carpet from GEW system, while a different evaluator measured the time employed with a chronometer, and the number of steps in a 25 feet distance marked side by side in the carpet. Velocity was calculated in function of distance and time employed. A mean from the four walkings was made and both of the measures were correlated with SPSS v. 18, considering a results of p < 0.001, statistically significant. RESULTS. Time employed (p = 1.000), velocity (p = 0.9995), cadence (p = 0.3296) and number of steps (p = 1.000) were not statistically different. CONCLUSIONS. GEW system has the same clinical validity in gait evaluation in multiple sclerosis patients than the T25FW.

  10. [Effect of different tests with physical exercise to change of the ankle-brachial index in aged patients].

    PubMed

    Sumin, A N; Krasilova, T A; Masin, A N

    2011-01-01

    The aim was to study the dynamics of ankle-brachial index (ABI) after treadmill test, after six-minute walk test (SWT) and after electric muscle stimulation (EMS) in aged patients. We conducted a survey of 80 aged patients (73,0 +/- 16,0 years). ABI was determined at rest and immediately after the following tests: 1) treadmill-test for five minutes, 2) SWT, and 3) EMS for five minutes. Atherosclerotic lesions of lower limb arteries was absent only in 21,3% of patients according to color duplex scanning. ABI significantly decreased on both limbs after treadmill-test ant after SWT. During EMS, in contrast, ABI was increased. Thus, you can use SWT in the diagnosis of subclinical atherosclerosis in a general clinical practice as an alternative to treadmill-tests. Good tolerability of EMS patients and ABI increase show the availability of EMS in physical rehabilitation of aged patients with peripheral atherosclerosis.

  11. The 6-minute walk test, motor function measure and quantitative thigh muscle MRI in Becker muscular dystrophy: A cross-sectional study.

    PubMed

    Fischer, Dirk; Hafner, Patricia; Rubino, Daniela; Schmid, Maurice; Neuhaus, Cornelia; Jung, Hans; Bieri, Oliver; Haas, Tanja; Gloor, Monika; Fischmann, Arne; Bonati, Ulrike

    2016-07-01

    Becker muscular dystrophy (BMD) has an incidence of 1 in 16 000 male births. This cross-sectional study investigated the relation between validated functional scores and quantitative MRI (qMRI) of thigh muscles in 20 ambulatory BMD patients, aged 18.3-60 years (mean 31.2; SD 11.1). Clinical assessments included the motor function measure (MFM) and its subscales, as well as timed function tests such as the 6-minute walk test (6MWT) and the timed 10-m run/walk test. Quantitative MRI of the thigh muscles included the mean fat fraction (MFF) using a 2-point Dixon (2-PD) technique, and transverse relaxation time (T2) measurements. The mean MFM value was 80.4%, SD 9.44 and the D1 subscore 54.5%, SD 19.9. The median 6MWT was 195m, IQR 160-330.2. The median 10-m run/walk test was 7.4 seconds, IQR 6.1-9.3. The mean fat fraction of the thigh muscles was 55.6%, SD 17.4%, mean T2 relaxation times of all muscles: 69.9 ms, SD 14.4. The flexors had the highest MFF and T2 relaxation times, followed by the extensors and the adductors. MFF and global T2 relaxation times were highly negatively correlated with the MFM total, D1-subscore and 6MWT, and positively correlated with the 10 m run/walk test time (p < 0.01). Age was not correlated with MFF, global T2 relaxation time or clinical assessments. Both MFF and T2 measures in the thigh muscle were well correlated with clinical function in BMD and may serve as a surrogate outcome measure in clinical trials. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Effect of Combination Exercise Therapy on Walking Distance, Postural Balance, Fatigue and Quality of Life in Multiple Sclerosis Patients: A Clinical Trial Study

    PubMed Central

    Sangelaji, Bahram; Nabavi, Seyed Massood; Estebsari, Fatemeh; Banshi, Mohammad Reza; Rashidian, Hamideh; Jamshidi, Ensiyeh; Dastoorpour, Maryam

    2014-01-01

    Background: Multiple Sclerosis (MS) is a demyelinating disease of the nervous system which has numerous disabling effects on patients. Objectives: This study aimed at investigating the short- and long-term effects of a period of combination exercise therapy on walking distance, balance, fatigue and quality of life in multiple sclerosis patients referred to the physiotherapy clinic of Iran's Multiple Sclerosis Society in 2013. Patients and Methods: This study was a randomized controlled clinical trial on 59 patients divided into the intervention (n = 39) and control groups (n = 20). The intervention group received 10 weeks of combination therapy including aerobic, strengthening, balancing and stretching exercises. A week before, a week later and a year after the beginning of the exercises, both groups of patients received BBSS, six minute walking, Family Support Services (FSS), Expanded Disability Status Scale (EDSS) and quality of life tests. The scores of two groups were then compared using statistical tests such as repeated measures ANOVA test. Results: The results indicated significant changes in the intervention group in comparison to the control group in the second phase of the study comparing to the first one for all tests except EDSS (Mean difference scores of EDSS: -0.13), P-value = 0.60; FSS: -6.9, P-value = 0.02, Mental Quality of Life (QOL): 16.36, P-value = 0.001; Physical QOL: 12.17, P-value = 0.001, six minute walking: 137.2, P-value < 0.0001; and Berg: 3.34, P-value < 0.0001. These changes were not significant in the second phase of the study comparing to the third one; however, they were again significant in the third phase comparing to the first phase of the study (P < 0.05). Conclusions: Exercise has significant effect on improving symptoms of multiple sclerosis, and cessation of exercise may cause recurrence of symptoms in the intervention group with a slope similar to that of the control group. Therefore, continuous rather than short period

  13. Agreement between adherences to four physical activity recommendations in patients with COPD: does the incremental shuttle walk test predict adherence?

    PubMed

    Mitchell, Katy E; Johnson, Vicki; Houchen-Wolloff, Linzy; Sewell, Louise; Morgan, Mike D; Steiner, Michael C; Singh, Sally J

    2016-09-22

    There are various recommendations for physical activity (PA). However agreement between all of these measures has not been established. Furthermore, given the challenges of measuring PA there is interest in evaluating whether a measure of exercise performance can be used as a surrogate measure to identify who is likely to achieve the recommendations. A total of 184 people with COPD were recruited, 128 of which had complete data for these analyses. Participants wore the SenseWear Armband for 7 consecutive days and all performed an incremental shuttle walk test (ISWT). We extracted moderate to vigorous physical activity (MVPA) in bouts of ≥10 min using a 3 metabolic equivalent (MET) threshold and an individually prescribed MET threshold (based on performance on the ISWT). Average daily step count and the physical activity level were also calculated. There was poor agreement between the four PA recommendations, with agreement on all four achieved in only 30 participants. People were least likely to be active using MVPA in ≥10 min bouts using 3 MET threshold (21.1% active), and most likely to be active using MVPA in ≥10 min bouts using an individually prescribed threshold (64.9% active). It was not possible to identify a threshold on the ISWT that would reliably predict those that achieved any of the four recommendations. Agreement between various physical activity recommendations is poor. This should be considered when measuring and describing physical activity adherence. The ISWT cannot be used to reliably predict adherence to physical activity guidelines. © 2016 John Wiley & Sons Ltd.

  14. 10 CFR 431.304 - Uniform test method for the measurement of energy consumption of walk-in coolers and walk-in...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... it is produced in its final chemical form. Foam produced inside of a panel (“foam-in-place”) must be... shall be tested after it is produced in its final chemical form. Foam produced inside of a panel (“foam... set forth in AHRI 1250 and recording the annual energy consumption term in the equation for...

  15. An Evaluation of Prediction Equations for the 6 Minute Walk Test in Healthy European Adults Aged 50-85 Years

    PubMed Central

    Duncan, Michael J.; Mota, Jorge; Carvalho, Joana; Nevill, Alan M.

    2015-01-01

    Objective This study compared actual 6 minute walk test (6MWT) performance with predicted 6MWT using previously validated equations and then determined whether allometric modelling offers a sounder alternative to estimating 6MWT in adults aged 50–80 years. Methods We compared actual 6MWT performance against predicted 6MWT in 125 adults aged 50–85 years (62 male, 63 female). In a second sample of 246 adults aged 50–85 years (74 male, 172 female), a new prediction equation for 6MWT performance was developed using allometric modelling. This equation was then cross validated using the same sample that the other prediction equations were compared with. Results Significant relationships were evident between 6MWT actual and 6MWT predicted using all of the commonly available prediction equations (all P<0.05 or better) with the exception of the Alameri et al prediction equation (P>0.05). A series of paired t-tests indicated significant differences between 6MWT actual and 6MWT predicted for all available prediction equations (all P<0.05 or better) with the exception of the Iwama et al equation (P = .540). The Iwama et al equation also had similar bias (79.8m) and a coefficient of variation of over 15%. Using sample 2, a log-linear model significantly predicted 6MWT from the log of body mass and height and age (P = 0.001, adjusted R2 = .526), predicting 52.6% of the variance in actual 6MWT. When this allometric equation was applied to the original sample, the relationship between 6MWT actual and 6MWT predicted was in excess of values reported for the other previously validated prediction equations (r = .706, P = 0.001). There was a significant difference between actual 6MWT and 6MWT predicted using this new equation (P = 0.001) but the bias, standard deviation of differences and coefficient of variation were all less than for the other equations. Conclusions Where actual assessment of the 6MWT is not possible, the allometrically derived equation presented in the current

  16. Quantum random walks without walking

    SciTech Connect

    Manouchehri, K.; Wang, J. B.

    2009-12-15

    Quantum random walks have received much interest due to their nonintuitive dynamics, which may hold the key to a new generation of quantum algorithms. What remains a major challenge is a physical realization that is experimentally viable and not limited to special connectivity criteria. We present a scheme for walking on arbitrarily complex graphs, which can be realized using a variety of quantum systems such as a Bose-Einstein condensate trapped inside an optical lattice. This scheme is particularly elegant since the walker is not required to physically step between the nodes; only flipping coins is sufficient.

  17. Using short vignettes to disentangle perceived capability from motivation: a test using walking and resistance training behaviors.

    PubMed

    Rhodes, Ryan E; Williams, David M; Mistry, Chetan D

    2016-07-01

    Self-efficacy is arguably the strongest correlate of physical activity, yet some researchers suggest this is because the construct confounds ability with motivation. We examine a more circumscribed construct, called perceived capability (PC), meant to measure ability but not motivation and propose that the construct will not be related to unskilled physical activities but may be linked to skilled behaviors. The purpose of this paper was to examine whether a PC construct can be stripped of motivation using a vignette approach in both walking and resistance training behaviors. Participants were a random sample of 248 university students, who were then randomly assigned to either answer resistance training or walking behavior questions. Both groups completed a PC measure and reasons for their answer before and after reading a vignette that clarified the phrasing of capability to a literal use of the term. PC was significantly (p < .01) higher post- compared to pre-vignette and the differences were greater (p < .01) for walking than for resistance training. PC had significantly (p < .01) smaller correlations with intention and self-reported behavior post-disambiguation, which resulted in a null relationship with walking but a small correlation with resistance training behavior. When PC was combined with intention to predict behavior, however, there was no significant (p > .05) difference in the amount of variance explained pre- to post-vignette. Thought listing showed that participants did not report capability barriers to walking and over half of the sample construed capability as motivation/other priorities pre-vignette. The findings support use of a vignette approach for researchers who wish to disentangle the assessment of PC from motivation while creating no overall loss in explained variance of physical activity.

  18. Perceived control predicting the recovery of individual-specific walking behaviours following stroke: testing psychological models and constructs.

    PubMed

    Bonetti, D; Johnston, M

    2008-09-01

    Perceived control predicts activity limitations, but there are many control belief concepts and how these are defined and measured has implications for intervention design. This study examined whether individual-specific activity limitations and recovery were predicted by theoretically derived control conceptualizations, the Theory of Planned Behaviour and an integrated model (Theory of Planned Behaviour with the World Health Organization ICF (International Classification of Functioning, Disability and Health) model). This predictive cohort study used measures of impairment, intention and perceived control (perceived behavioural control, Theory of Planned Behaviour; self-efficacy, Social Cognitive Theory; locus of control, Social Learning Theory), assessed 2 weeks after hospital discharge, to predict walking limitation (UK SIP: FLP) and recovery after 6 months. Theoretically derived items were individually tailored for patients' baseline walking limitation. Two hundred and three stroke patients (124 men and 79 women; mean age = 68.88, SD = 12.31 years) Walking limitation and walking recovery (respectively) were predicted by perceived behavioural control (r = -.36(**), .26(**)) and self-efficacy (r = -.30(**), .22(**)), but not locus of control (r = -.07, .02). Both theoretical models accounted for significant variance in walking limitation and recovery--but not beyond that explained by perceived behavioural control. Predictive power was not improved by modifying the control component or by including impairment in regression equations. Results suggest that perceived control predicts individual-specific disability and recovery and that reductions in activity limitations may be achieved by manipulating control cognitions. In addition, reducing impairments may not have maximal effect on reducing disability unless beliefs about control over performing the behaviour are also influenced.

  19. Reliability and validity of heart rate variability threshold assessment during an incremental shuttle-walk test in middle-aged and older adults

    PubMed Central

    Dourado, V.Z.; Guerra, R.L.F.

    2013-01-01

    Studies on the assessment of heart rate variability threshold (HRVT) during walking are scarce. We determined the reliability and validity of HRVT assessment during the incremental shuttle walk test (ISWT) in healthy subjects. Thirty-one participants aged 57 ± 9 years (17 females) performed 3 ISWTs. During the 1st and 2nd ISWTs, instantaneous heart rate variability was calculated every 30 s and HRVT was measured. Walking velocity at HRVT in these tests (WV-HRVT1 and WV-HRVT2) was registered. During the 3rd ISWT, physiological responses were assessed. The ventilatory equivalents were used to determine ventilatory threshold (VT) and the WV at VT (WV-VT) was recorded. The difference between WV-HRVT1 and WV-HRVT2 was not statistically significant (median and interquartile range = 4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h); the correlation between WV-HRVT1 and WV-HRVT2 was significant (r = 0.84); the intraclass correlation coefficient was high (0.92; 0.82 to 0.96), and the agreement was acceptable (-0.08 km/h; -0.92 to 0.87). The difference between WV-VT and WV-HRVT2 was not statistically significant (4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h) and the agreement was acceptable (0.04 km/h; -1.28 to 1.36). HRVT assessment during walking is a reliable measure and permits the estimation of VT in adults. We suggest the use of the ISWT for the assessment of exercise capacity in middle-aged and older adults. PMID:23369974

  20. Insect walking and robotics.

    PubMed

    Delcomyn, Fred

    2004-01-01

    With the advent of significant collaborations between researchers who study insect walking and robotics engineers interested in constructing adaptive legged robots, insect walking is once again poised to make a more significant scientific contribution than the numbers of participants in the field might suggest. This review outlines current knowledge of the physiological basis of insect walking with an emphasis on recent new developments in biomechanics and genetic dissection of behavior, and the impact this knowledge is having on robotics. Engineers have begun to team with neurobiologists to build walking robots whose physical design and functional control are based on insect biology. Such an approach may have benefits for engineering, by leading to the construction of better-performing robots, and for biology, by allowing real-time and real-world tests of critical hypotheses about how locomotor control is effected. It is argued that in order for the new field of biorobotics to have significant influence it must adopt criteria for performance and an experimental approach to the development of walking robots.

  1. Pain when walking: individual sensory profiles in the foot soles of torture victims - a controlled study using quantitative sensory testing

    PubMed Central

    2012-01-01

    Background With quantitative sensory testing (QST) we recently found no differences in sensory function of the foot soles between groups of torture victims with or without exposure to falanga (beatings under the feet). Compared to matched controls the torture victims had hyperalgesia to deep mechano-nociceptive stimuli and hypoesthesia to non-noxious cutaneous stimuli. The purpose of the present paper was to extend the group analysis into individual sensory profiles of victims’ feet to explore possible relations between external violence (torture), reported pain, sensory symptoms and QST data to help clarify the underlying mechanisms. Methods We employed interviews and assessments of the pain and sensory symptoms and QST by investigators blinded to whether the patients, 32 male torture victims from the Middle East, had (n=15), or had not (n=17) been exposed to falanga. Pain intensity, area and stimulus dependence were used to characterize the pain. QST included thresholds for touch, cold, warmth, cold-pain, heat-pain, deep pressure pain and wind-up to cutaneous noxious stimuli. An ethnically matched control group was available.The normality criterion, from our control group data, was set as the mean +/− 1.28SD, thus including 80% of all values.QST data were transformed into three categories in relation to our normality range; hypoesthesia, normoesthesia or hyperesthesia/hyperalgesia. Results Most patients, irrespective of having been exposed to falanga or not, reported severe pain when walking. This was often associated with hyperalgesia to deep mechanical pressure. Hypoesthesia to mechanical stimuli co-occurred with numbness, burning and with deep mechanical hyperalgesia more often than not, but otherwise, a hypoesthesia to cutaneous sensory modalities did not co-occur systematically to falanga, pain or sensory symptoms. Conclusion In torture victims, there seem to be overriding mechanisms, manifested by hyperalgesia to pressure pain, which is usually

  2. Physical and functional follow-up of tuberculosis patients in initial intensive phase of treatment in Cameroon using the 6-min walk test

    PubMed Central

    Guessogo, Wiliam R.; Mandengue, Samuel H.; Assomo Ndemba, Peguy B.; Medjo, Ubald Olinga; Minye, Edmond Ebal; Ahmaidi, Said; Temfemo, Abdou

    2016-01-01

    This study aimed to evaluate functional capacities of Cameroonian tuberculosis (TB) patients in initial intensive phase of treatment using the 6-min walk test (6MWT) and to compare them to an age-matched healthy group. Twenty-eight TB patients newly diagnosed and 19 healthy age-matched peoples participated in the study. Performance parameters were determined using the 6MWT. Anthropometric and cardiorespiratory parameters were measured at baseline and after 6MWT. Two months later, TB patients were submitted to the same evaluation. We found significant differences in anthropometric parameters between the two groups. The baseline cardiorespiratory parameters and performance characteristics of TB patients were lower than control group (571.7±121.0 m vs 841.6±53.0 m, P<0.0001 for 6-min walk distance (6MWD) and 18.1±2.8 mL/kg/min vs 24.3±1.2 mL/kg/min, P<0.001 for mean VO2 peak (peak oxygen consumption). Two months after, significant improvements were noted in anthropometric, cardiorespiratory and performance parameters except for bone mass and FEV1/FEV6 (forced expiratory volumes in 1 second/6 seconds) ratio. Significant correlations were found between the 2-min walked distance (P<0.0001, r=0.95), 4-min walked distance (P<0.0001, r=0.97) and 6MWD. In conclusion, TB patients have impaired physical functional capacity but they improved after 2 months of treatment. 6MWT can be a useful tool in the assessment of physical parameters and cardiorespiratory functional capacity rehabilitation of TB patients during the treatment. PMID:27656631

  3. Physical and functional follow-up of tuberculosis patients in initial intensive phase of treatment in Cameroon using the 6-min walk test.

    PubMed

    Guessogo, Wiliam R; Mandengue, Samuel H; Assomo Ndemba, Peguy B; Medjo, Ubald Olinga; Minye, Edmond Ebal; Ahmaidi, Said; Temfemo, Abdou

    2016-08-01

    This study aimed to evaluate functional capacities of Cameroonian tuberculosis (TB) patients in initial intensive phase of treatment using the 6-min walk test (6MWT) and to compare them to an age-matched healthy group. Twenty-eight TB patients newly diagnosed and 19 healthy age-matched peoples participated in the study. Performance parameters were determined using the 6MWT. Anthropometric and cardiorespiratory parameters were measured at baseline and after 6MWT. Two months later, TB patients were submitted to the same evaluation. We found significant differences in anthropometric parameters between the two groups. The baseline cardiorespiratory parameters and performance characteristics of TB patients were lower than control group (571.7±121.0 m vs 841.6±53.0 m, P<0.0001 for 6-min walk distance (6MWD) and 18.1±2.8 mL/kg/min vs 24.3±1.2 mL/kg/min, P<0.001 for mean VO2 peak (peak oxygen consumption). Two months after, significant improvements were noted in anthropometric, cardiorespiratory and performance parameters except for bone mass and FEV1/FEV6 (forced expiratory volumes in 1 second/6 seconds) ratio. Significant correlations were found between the 2-min walked distance (P<0.0001, r=0.95), 4-min walked distance (P<0.0001, r=0.97) and 6MWD. In conclusion, TB patients have impaired physical functional capacity but they improved after 2 months of treatment. 6MWT can be a useful tool in the assessment of physical parameters and cardiorespiratory functional capacity rehabilitation of TB patients during the treatment.

  4. The effects of gravity on human walking: a new test of the dynamic similarity hypothesis using a predictive model.

    PubMed

    Raichlen, David A

    2008-09-01

    The dynamic similarity hypothesis (DSH) suggests that differences in animal locomotor biomechanics are due mostly to differences in size. According to the DSH, when the ratios of inertial to gravitational forces are equal between two animals that differ in size [e.g. at equal Froude numbers, where Froude = velocity2/(gravity x hip height)], their movements can be made similar by multiplying all time durations by one constant, all forces by a second constant and all linear distances by a third constant. The DSH has been generally supported by numerous comparative studies showing that as inertial forces differ (i.e. differences in the centripetal force acting on the animal due to variation in hip heights), animals walk with dynamic similarity. However, humans walking in simulated reduced gravity do not walk with dynamically similar kinematics. The simulated gravity experiments did not completely account for the effects of gravity on all body segments, and the importance of gravity in the DSH requires further examination. This study uses a kinematic model to predict the effects of gravity on human locomotion, taking into account both the effects of gravitational forces on the upper body and on the limbs. Results show that dynamic similarity is maintained in altered gravitational environments. Thus, the DSH does account for differences in the inertial forces governing locomotion (e.g. differences in hip height) as well as differences in the gravitational forces governing locomotion.

  5. Gait velocity and walking distance to predict community walking after stroke.

    PubMed

    An, SeungHeon; Lee, YunBok; Shin, HyeonHui; Lee, GyuChang

    2015-12-01

    Gait speed and walking distance were evaluated as predictors for levels of community walking after stroke. In this study, 103 stroke survivors were identified as limited (n = 67) or independent community walkers (n = 36). Ten meter and six min walk tests were used to measure gait speed and walking distance, respectively. The discriminative properties of gait speed and walking distance for community walking were investigated using receiver operating characteristic curves. Cut-off values of 0.87 m/s for community walking gait speed for walking distance had positive predictive values of 65% and 55%, respectively. The negative predictive value ranged from 89% for gait speed to 79% for walking distance. Gait speed and walking distance showed significant differences between limited and independent community walking. Gait speed was more significantly related to community walking than walking distance. The results of this study suggest that gait speed is a better predictor for community walking than walking distance in moderately affected post-stroke survivors.

  6. Cryopyrin-Associated Autoinflammatory Syndromes (CAPS) - Juvenile

    MedlinePlus

    ... Clinician Researchers Six Minute Walk Test (SMWT) Arthritis Impact Measurement Scales (AIMS) Evidence Based Practice (EBP) Fibromyalgia Impact Questionnaire (FIQ) Fracture Risk Assessment Tool (FRAX) Multidimensional ...

  7. Does walking change the Romberg sign?

    PubMed

    Findlay, Gordon F G; Balain, Birender; Trivedi, Jayesh M; Jaffray, David C

    2009-10-01

    The Romberg sign helps demonstrate loss of postural control as a result of severely compromised proprioception. There is still no standard approach to applying the Romberg test in clinical neurology and the criteria for and interpretation of an abnormal result continue to be debated. The value of this sign and its adaptation when walking was evaluated. Detailed clinical examination of 50 consecutive patients of cervical myelopathy was performed prospectively. For the walking Romberg sign, patients were asked to walk 5 m with their eyes open. This was repeated with their eyes closed. Swaying, feeling of instability or inability to complete the walk with eyes closed was interpreted as a positive walking Romberg sign. This test was compared to common clinical signs to evaluate its relevance. Whilst the Hoffman's reflex (79%) was the most prevalent sign seen, the walking Romberg sign was actually present in 74.5% of the cases. The traditional Romberg test was positive in 17 cases and 16 of these had the walking Romberg positive as well. Another 21 patients had a positive walking Romberg test. Though not statistically significant, the mean 30 m walking times were slower in patients with traditional Romberg test than in those with positive walking Romberg test and fastest in those with neither of these tests positive. The combination of either Hoffman's reflex and/or walking Romberg was positive in 96% of patients. The walking Romberg sign is more useful than the traditional Romberg test as it shows evidence of a proprioceptive gait deficit in significantly more patients with cervical myelopathy than is found on conventional neurological examination. The combination of Hoffman's reflex and walking Romberg sign has a potential as useful screening tests to detect clinically significant cervical myelopathy.

  8. The walking robot project

    NASA Technical Reports Server (NTRS)

    Williams, P.; Sagraniching, E.; Bennett, M.; Singh, R.

    1991-01-01

    A walking robot was designed, analyzed, and tested as an intelligent, mobile, and a terrain adaptive system. The robot's design was an application of existing technologies. The design of the six legs modified and combines well understood mechanisms and was optimized for performance, flexibility, and simplicity. The body design incorporated two tripods for walking stability and ease of turning. The electrical hardware design used modularity and distributed processing to drive the motors. The software design used feedback to coordinate the system and simple keystrokes to give commands. The walking machine can be easily adapted to hostile environments such as high radiation zones and alien terrain. The primary goal of the leg design was to create a leg capable of supporting a robot's body and electrical hardware while walking or performing desired tasks, namely those required for planetary exploration. The leg designers intent was to study the maximum amount of flexibility and maneuverability achievable by the simplest and lightest leg design. The main constraints for the leg design were leg kinematics, ease of assembly, degrees of freedom, number of motors, overall size, and weight.

  9. Walking speed and step length asymmetry modify the energy cost of walking after stroke.

    PubMed

    Awad, Louis N; Palmer, Jacqueline A; Pohlig, Ryan T; Binder-Macleod, Stuart A; Reisman, Darcy S

    2015-06-01

    A higher energy cost of walking poststroke has been linked to reduced walking performance and reduced participation in the community. To determine the contribution of postintervention improvements in walking speed and spatiotemporal gait asymmetry to the reduction in the energy cost of walking after stroke. In all, 42 individuals with chronic hemiparesis (>6 months poststroke) were recruited to participate in 12 weeks of walking rehabilitation. The energy cost of walking, walking speed, and step length, swing time, and stance time asymmetries were calculated pretraining and posttraining. Sequential regression analyses tested the cross-sectional (ie, pretraining) and longitudinal (ie, posttraining changes) relationships between the energy cost of walking versus speed and each measure of asymmetry. Pretraining walking speed (β = -.506) and swing time asymmetry (β = .403) predicted pretraining energy costs: (adj)R(2) = 0.713; F(3, 37) = 34.05; P < .001. In contrast, change in walking speed (β = .340) and change in step length asymmetry (β = .934) predicted change in energy costs with a significant interaction between these independent predictors: (adj)R(2) = 0.699; F(4, 31) = 21.326; P < .001. Moderation by the direction or the magnitude of pretraining asymmetry was not found. For persons in the chronic phase of stroke recovery, faster and more symmetric walking after intervention appears to be more energetically advantageous than merely walking faster or more symmetrically. This finding has important functional implications, given the relationship between the energy cost of walking and community walking participation. © The Author(s) 2014.

  10. Imaging Shallow Aquitard Breaches with P waves: Results from a Walk-away test and a Reflection Survey at two Sites in Memphis, Tennessee, USA

    NASA Astrophysics Data System (ADS)

    Ge, J.; Magnani, M.; Waldron, B. A.

    2006-12-01

    We present the results of two seismic reflection experiments conducted in the Great Memphis area in April and July 2006. The two experiments consisted in a walk-away test and in the acquisition of a 1 km seismic reflection profile. The acquisition of the seismic data is part of a larger effort aimed at imaging the lateral continuity of the Upper Claiborne confining clay that separates the Memphis aquifer, the region's primary drinking water source, from the upper unconfined aquifer and protects the drinking aquifer from exposure to potential contamination. During the walk-away test, four P-wave sources, a 7.5 kg sledge hammer, a 20 kg weight drop, a 12-gauge Buffalo gun, and a Minivibe source were tested at two sites with the goal of selecting the best P-wave seismic source and acquisition parameters for shallow reflection surveys. Boreholes nearby both sites encountered the Upper Claiborne unit at a depth ranging from 10 m to 40 m. One site is located within a 100-meter length of road median that can be considered an urban environment. The second site is located at Shelby Farms within the City of Memphis yet reflects a rural setting with minimal noise and no subsurface infrastructure. Performing identical walk-away tests at both sites, the results indicate that the energy source selection is site dependent. At the urban site, the energy generated by the weight drop source is more coherent and can be interpreted with more confidence on the recorded data. However the Shelby Farms site the 12-gauge shotgun produced the strongest recorded energy, the highest dominant frequency and the broadest frequency band (6- 110 Hz). Strong attenuations are observed at both sites with a much higher attenuation in the urban road median site, where the near surface materials consisted of gravels, sands, clays, and pebbles. For both sites, surface waves and refractions dominate the seismic recordings. Filtering and gain of the data revealed the presence of shallow reflections related

  11. Walking drawings and walking ability in children with cerebral palsy.

    PubMed

    Chong, Jimmy; Mackey, Anna H; Stott, N Susan; Broadbent, Elizabeth

    2013-06-01

    To investigate whether drawings of the self walking by children with cerebral palsy (CP) were associated with walking ability and illness perceptions. This was an exploratory study in 52 children with CP (M:F = 28:24), mean age 11.1 years (range 5-18), who were attending tertiary level outpatient clinics. Children were asked to draw a picture of themselves walking. Drawing size and content was used to investigate associations with clinical walk tests and children's own perceptions of their CP assessed using a CP version of the Brief Illness Perception Questionnaire. Larger drawings of the self were associated with less distance traveled, higher emotional responses to CP, and lower perceptions of pain or discomfort, independent of age. A larger self-to-overall drawing height ratio was related to walking less distance. Drawings of the self confined within buildings and the absence of other figures were also associated with reduced walking ability. Drawing size and content can reflect walking ability, as well as symptom perceptions and distress. Drawings may be useful for clinicians to use with children with cerebral palsy to aid discussion about their condition. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  12. THE 6-MINUTE WALK TEST AND OTHER CLINICAL ENDPOINTS IN DUCHENNE MUSCULAR DYSTROPHY: RELIABILITY, CONCURRENT VALIDITY, AND MINIMAL CLINICALLY IMPORTANT DIFFERENCES FROM A MULTICENTER STUDY

    PubMed Central

    McDonald, Craig M; Henricson, Erik K; Abresch, R Ted; Florence, Julaine; Eagle, Michelle; Gappmaier, Eduard; Glanzman, Allan M; Spiegel, Robert; Barth, Jay; Elfring, Gary; Reha, Allen; Peltz, Stuart W

    2013-01-01

    Introduction: An international clinical trial enrolled 174 ambulatory males ≥5 years old with nonsense mutation Duchenne muscular dystrophy (nmDMD). Pretreatment data provide insight into reliability, concurrent validity, and minimal clinically important differences (MCIDs) of the 6-minute walk test (6MWT) and other endpoints. Methods: Screening and baseline evaluations included the 6-minute walk distance (6MWD), timed function tests (TFTs), quantitative strength by myometry, the PedsQL, heart rate–determined energy expenditure index, and other exploratory endpoints. Results: The 6MWT proved feasible and reliable in a multicenter context. Concurrent validity with other endpoints was excellent. The MCID for 6MWD was 28.5 and 31.7 meters based on 2 statistical distribution methods. Conclusions: The ratio of MCID to baseline mean is lower for 6MWD than for other endpoints. The 6MWD is an optimal primary endpoint for Duchenne muscular dystrophy (DMD) clinical trials that are focused therapeutically on preservation of ambulation and slowing of disease progression. Muscle Nerve 48: 357–368, 2013 PMID:23674289

  13. THE 6-MINUTE WALK TEST AND OTHER ENDPOINTS IN DUCHENNE MUSCULAR DYSTROPHY: LONGITUDINAL NATURAL HISTORY OBSERVATIONS OVER 48 WEEKS FROM A MULTICENTER STUDY

    PubMed Central

    Mcdonald, Craig M; Henricson, Erik K; Abresch, R Ted; Florence, Julaine M; Eagle, Michelle; Gappmaier, Eduard; Glanzman, Allan M; Spiegel, Robert; Barth, Jay; Elfring, Gary; Reha, Allen; Peltz, Stuart

    2013-01-01

    Introduction: Duchenne muscular dystrophy (DMD) subjects ≥5 years with nonsense mutations were followed for 48 weeks in a multicenter, randomized, double-blind, placebo-controlled trial of ataluren. Placebo arm data (N = 57) provided insight into the natural history of the 6-minute walk test (6MWT) and other endpoints. Methods: Evaluations performed every 6 weeks included the 6-minute walk distance (6MWD), timed function tests (TFTs), and quantitative strength using hand-held myometry. Results: Baseline age (≥7 years), 6MWD, and selected TFT performance are strong predictors of decline in ambulation (Δ6MWD) and time to 10% worsening in 6MWD. A baseline 6MWD of <350 meters was associated with greater functional decline, and loss of ambulation was only seen in those with baseline 6MWD <325 meters. Only 1 of 42 (2.3%) subjects able to stand from supine lost ambulation. Conclusion: Findings confirm the clinical meaningfulness of the 6MWD as the most accepted primary clinical endpoint in ambulatory DMD trials. PMID:23681930

  14. Validation of test performance characteristics and minimal clinically important difference of the 6-minute walk test in patients with idiopathic pulmonary fibrosis.

    PubMed

    Nathan, Steven D; du Bois, Roland M; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; Kartashov, Alex; Noble, Paul W; Sahn, Steven A; Valeyre, Dominique; Weycker, Derek; King, Talmadge E

    2015-07-01

    The 6-minute walk test distance (6MWD) has been shown to be a valid and responsive outcome measure in patients with idiopathic pulmonary fibrosis (IPF). The analyses were based, however, on a single phase 3 trial and require validation in an independent cohort. To confirm the performance characteristics and estimates of minimal clinically important difference (MCID) of 6MWD in an independent cohort of patients with IPF. Patients randomized to placebo in the phase 3 CAPACITY trials who had a baseline 6MWD measurement were included in these analyses. The 6MWD and other functional parameters (lung function, dyspnea, and health-related quality of life) were measured at baseline and 24-week intervals. Validity and responsiveness were examined using Spearman correlation coefficients. The MCID was estimated using distribution- and anchor-based methods. The analysis comprised 338 patients. Baseline 6MWD was significantly correlated with lung function measures, patient-reported outcomes, and quality-of-life measures (validity). Compared with baseline 6MWD, change in 6MWD (responsiveness) showed stronger correlations with change in lung function parameters and quality-of-life measures. Dyspnea measured by the University of California San Diego Shortness of Breath Questionnaire showed the strongest correlations with 6MWD (baseline: coefficient -0.35; 48-week change: coefficient -0.37; both p < 0.001). The distribution-based analyses of MCID using standard error of measurement yielded an MCID of 37 m, and distribution-based analyses by effect size resulted in 29.2 m. The MCID by anchor-based analysis using criterion referencing (health events of hospitalization or death) was 21.7 m. The 6MWD is a valid and responsive clinical endpoint, which provides objective and clinically meaningful information regarding functional status and near-term prognosis. These results confirm previous findings in an independent cohort of patients with IPF. Copyright © 2015 The Authors

  15. Long-term impact of pre-operative physical rehabilitation protocol on the 6-min walk test of patients with adolescent idiopathic scoliosis: A randomized clinical trial.

    PubMed

    Dos Santos Alves, V L; Stirbulov, R; Avanzi, O

    2015-01-01

    Monitored physical activities in patients with adolescent idiopathic scoliosis (AIS) have been shown to improve physical performance, endurance and cardiopulmonary function and may be assessed by the 6-min walk test (6MWT). We aimed to evaluate the long-term results of the 6MWT after a rehabilitation protocol employed before surgical correction for AIS. This prospective randomized clinical trial studied the impact of a 4-month pre-operative physical rehabilitation protocol on post-operative cardiopulmonary function and physical endurance, by using the 6MWT, in patients with AIS submitted to surgical correction, comparing them to matched controls without physical rehabilitation. Studied variables were heart and respiratory rate, systolic and diastolic blood pressure, peripheral blood oxygen saturation, Borg score, and distance walked. Patients were assessed at baseline, after 4 months of rehabilitation, and 3, 6 and 12 months post-operatively. A total of 50 patients with AIS were included in the study and allocated blindly, by simple randomization, into either one of the two groups, with 25 patients each: study group (pre-operative physical rehabilitation) and control group. The physical rehabilitation protocol promoted significant progressive improvement in heart and respiratory rate, peripheral blood oxygen saturation, distance walked, and level of effort assessed by the Borg scale after surgery. Post-surgical recovery, evaluated by 6MWT, was significantly better in patients who underwent a 4-month pre-operative physical rehabilitation protocol. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  16. Novel outcome measures for Charcot-Marie-Tooth disease: validation and reliability of the 6-min walk test and StepWatch(™) Activity Monitor and identification of the walking features related to higher quality of life.

    PubMed

    Padua, L; Pazzaglia, C; Pareyson, D; Schenone, A; Aiello, A; Fabrizi, G M; Cavallaro, T; Santoro, L; Manganelli, F; Gemignani, F; Vitetta, F; Quattrone, A; Mazzeo, A; Russo, M; Vita, G

    2016-08-01

    Charcot-Marie-Tooth (CMT) disease is the most common inherited neuropathy, but therapeutic options have been limited to symptom management. Past pharmacological trials have failed, possibly due to insensitive outcome measures (OMs). The aim of the current study was to evaluate the validity and reliability of the 6-min walk test (6MWT) and StepWatch(™) Activity Monitoring (SAM) with other previously validated OMs in CMT disease. A prospective multicenter study was performed, consecutively enrolling 168 CMT patients (104 with CMT1A, 27 with CMT1B, 37 with X-linked CMT) from Italian centers specializing in CMT care. Statistical analysis showed that the 6MWT was highly related with all previously used OMs. Some, but not all, SAM parameters were related to commonly used OMs but may provide more information about quality of life. The current study demonstrated the validity and reliability of the 6MWT and SAM as OMs for CMT. Moreover, SAM provides data that correlate better with quality of life measures, making it useful in future rehabilitation trials. © 2016 EAN.

  17. A study of the 200-metre fast walk test as a possible new assessment tool to predict maximal heart rate and define target heart rate for exercise training of coronary heart disease patients.

    PubMed

    Casillas, Jean-Marie; Joussain, Charles; Gremeaux, Vincent; Hannequin, Armelle; Rapin, Amandine; Laurent, Yves; Benaïm, Charles

    2015-02-01

    To develop a new predictive model of maximal heart rate based on two walking tests at different speeds (comfortable and brisk walking) as an alternative to a cardiopulmonary exercise test during cardiac rehabilitation. Evaluation of a clinical assessment tool. A Cardiac Rehabilitation Department in France. A total of 148 patients (133 men), mean age of 59 ±9 years, at the end of an outpatient cardiac rehabilitation programme. Patients successively performed a 6-minute walk test, a 200 m fast-walk test (200mFWT), and a cardiopulmonary exercise test, with measure of heart rate at the end of each test. An all-possible regression procedure was used to determine the best predictive regression models of maximal heart rate. The best model was compared with the Fox equation in term of predictive error of maximal heart rate using the paired t-test. Results of the two walking tests correlated significantly with maximal heart rate determined during the cardiopulmonary exercise test, whereas anthropometric parameters and resting heart rate did not. The simplified predictive model with the most acceptable mean error was: maximal heart rate = 130 - 0.6 × age + 0.3 × HR200mFWT (R(2) = 0.24). This model was superior to the Fox formula (R(2) = 0.138). The relationship between training target heart rate calculated from measured reserve heart rate and that established using this predictive model was statistically significant (r = 0.528, p < 10(-6)). A formula combining heart rate measured during a safe simple fast walk test and age is more efficient than an equation only including age to predict maximal heart rate and training target heart rate. © The Author(s) 2014.

  18. CT densitovolumetry in children with obliterative bronchiolitis: correlation with clinical scores and pulmonary function test results*,**

    PubMed Central

    Mocelin, Helena; Bueno, Gilberto; Irion, Klaus; Marchiori, Edson; Sarria, Edgar; Watte, Guilherme; Hochhegger, Bruno

    2013-01-01

    OBJECTIVE: To determine whether air trapping (expressed as the percentage of air trapping relative to total lung volume [AT%]) correlates with clinical and functional parameters in children with obliterative bronchiolitis (OB). METHODS: CT scans of 19 children with OB were post-processed for AT% quantification with the use of a fixed threshold of −950 HU (AT%950) and of thresholds selected with the aid of density masks (AT%DM). Patients were divided into three groups by AT% severity. We examined AT% correlations with oxygen saturation (SO2) at rest, six-minute walk distance (6MWD), minimum SO2 during the six-minute walk test (6MWT_SO2), FVC, FEV1, FEV1/FVC, and clinical parameters. RESULTS: The 6MWD was longer in the patients with larger normal lung volumes (r = 0.53). We found that AT%950 showed significant correlations (before and after the exclusion of outliers, respectively) with the clinical score (r = 0.72; 0.80), FVC (r = 0.24; 0.59), FEV1 (r = −0.58; −0.67), and FEV1/FVC (r = −0.53; r = −0.62), as did AT%DM with the clinical score (r = 0.58; r = 0.63), SO2 at rest (r = −0.40; r = −0.61), 6MWT_SO2 (r = −0.24; r = −0.55), FVC (r = −0.44; r = −0.80), FEV1 (r = −0.65; r = −0.71), and FEV1/FVC (r = −0.41; r = −0.52). CONCLUSIONS: Our results show that AT% correlates significantly with clinical scores and pulmonary function test results in children with OB. PMID:24473764

  19. Visual control of walking velocity.

    PubMed

    François, Matthieu; Morice, Antoine H P; Bootsma, Reinoud J; Montagne, Gilles

    2011-06-01

    Even if optical correlates of self-motion velocity have already been identified, their contribution to the control of displacement velocity remains to be established. In this study, we used a virtual reality set-up coupled to a treadmill to test the role of both Global Optic Flow Rate (GOFR) and Edge Rate (ER) in the regulation of walking velocity. Participants were required to walk at a constant velocity, corresponding to their preferred walking velocity, while eye height and texture density were manipulated. This manipulation perturbed the natural relationship between the actual walking velocity and its optical specification by GOFR and ER, respectively. Results revealed that both these sources of information are indeed used by participants to control walking speed, as demonstrated by a slowing down of actual walking velocity when the optical specification of velocity by either GOFR or ER gives rise to an overestimation of actual velocity, and vice versa. Gait analyses showed that these walking velocity adjustments result from simultaneous adaptations in both step length and step duration. The role of visual information in the control of self-motion velocity is discussed in relation with other factors.

  20. Determinants of 6-minute walk distance in patients with idiopathic pulmonary fibrosis undergoing lung transplant evaluation

    PubMed Central

    Rivera-Lebron, Belinda N.; Kreider, Maryl; Lee, James; Kawut, Steven M.

    2016-01-01

    Abstract Little is known about the physiologic determinants of 6-minute walk distance in idiopathic pulmonary fibrosis. We investigated the demographic, pulmonary function, echocardiographic, and hemodynamic determinants of 6-minute walk distance in patients with idiopathic pulmonary fibrosis evaluated for lung transplantation. We performed a cross-sectional analysis of 130 patients with idiopathic pulmonary fibrosis who completed a lung transplantation evaluation at the Hospital of the University of Pennsylvania between 2005 and 2010. Multivariable linear regression analysis was used to generate an explanatory model for 6-minute walk distance. After adjustment for age, sex, race, height, and weight, the presence of right ventricular dilation was associated with a decrease of 50.9 m (95% confidence interval [CI], 8.4–93.3) in 6-minute walk distance (P=0.02). For each 200-mL reduction in forced vital capacity, the walk distance decreased by 15.0 m (95% CI, 9.0–21.1; P<0.001). For every increase of 1 Wood unit in pulmonary vascular resistance, the walk distance decreased by 17.3 m (95% CI, 5.1–29.5; P=0.006). Six-minute walk distance in idiopathic pulmonary fibrosis depends in part on circulatory impairment and the degree of restrictive lung disease. Future trials that target right ventricular morphology, pulmonary vascular resistance, and forced vital capacity may potentially improve exercise capacity in patients with idiopathic pulmonary fibrosis. PMID:27076905

  1. Determinants of 6-minute walk distance in patients with idiopathic pulmonary fibrosis undergoing lung transplant evaluation.

    PubMed

    Porteous, Mary K; Rivera-Lebron, Belinda N; Kreider, Maryl; Lee, James; Kawut, Steven M

    2016-03-01

    Little is known about the physiologic determinants of 6-minute walk distance in idiopathic pulmonary fibrosis. We investigated the demographic, pulmonary function, echocardiographic, and hemodynamic determinants of 6-minute walk distance in patients with idiopathic pulmonary fibrosis evaluated for lung transplantation. We performed a cross-sectional analysis of 130 patients with idiopathic pulmonary fibrosis who completed a lung transplantation evaluation at the Hospital of the University of Pennsylvania between 2005 and 2010. Multivariable linear regression analysis was used to generate an explanatory model for 6-minute walk distance. After adjustment for age, sex, race, height, and weight, the presence of right ventricular dilation was associated with a decrease of 50.9 m (95% confidence interval [CI], 8.4-93.3) in 6-minute walk distance ([Formula: see text]). For each 200-mL reduction in forced vital capacity, the walk distance decreased by 15.0 m (95% CI, 9.0-21.1; [Formula: see text]). For every increase of 1 Wood unit in pulmonary vascular resistance, the walk distance decreased by 17.3 m (95% CI, 5.1-29.5; [Formula: see text]). Six-minute walk distance in idiopathic pulmonary fibrosis depends in part on circulatory impairment and the degree of restrictive lung disease. Future trials that target right ventricular morphology, pulmonary vascular resistance, and forced vital capacity may potentially improve exercise capacity in patients with idiopathic pulmonary fibrosis.

  2. The Walk Poem.

    ERIC Educational Resources Information Center

    Padgett, Ron

    2000-01-01

    Discusses the long history of writing poems about a walk, noting many titles. Notes four basic types of walk poems and includes one by American poet Bill Zavatksy, called "Class Walk With Notebooks After Storm." Offers numerous brief ideas for both the writing and the form of walk poems. (SR)

  3. The Walk Poem.

    ERIC Educational Resources Information Center

    Padgett, Ron

    2000-01-01

    Discusses the long history of writing poems about a walk, noting many titles. Notes four basic types of walk poems and includes one by American poet Bill Zavatksy, called "Class Walk With Notebooks After Storm." Offers numerous brief ideas for both the writing and the form of walk poems. (SR)

  4. Effect of body weight loss on cardiopulmonary function assessed by 6-minute walk test and arterial blood gas analysis in obese dogs.

    PubMed

    Manens, J; Ricci, R; Damoiseaux, C; Gault, S; Contiero, B; Diez, M; Clercx, C

    2014-01-01

    Few studies show the detrimental effect of canine obesity on cardiopulmonary function (CPF). The 6-Minute Walk Test (6MWT) is a noninvasive exercise test easy to perform in clinical settings. The aim of this study was to investigate the effect of obesity and body weight loss (BWL) on CPF assessed by the 6MWT and arterial blood gas analysis. Six experimental Beagles and 9 privately owned obese dogs were enrolled in a diet-induced BWL program. Arterial blood gas analysis and 6MWT were repeated in obese subjects (BCS 8-9/9), in the middle of BWL (overweight, BCS 6-7/9), and in lean dogs (BCS 5/9). Heart rate (HRp) and oxygen saturation (SpO2 ) were measured by pulse oximetry before the 6MWT, at midtest, and during a 5-minute recovery period. Twelve dogs completed the BWL program (initial BW, 27.3 ± 2.9 kg; final BW, 20.85 ± 2.9, lsmeans ± SE, P ≤ .001). BWL caused a significant increase in 6MWT walked distance (WD; obese: 509 ± 35 m; overweight: 575 ± 36 m; lean: 589 ± 36 m; P ≤ .05). Resting arterial blood gas results were not influenced by BWL. Including all time points, obese dogs showed higher HRp and lower SpO2 compared to overweight and lean dogs. SpO2 at the end of the walk was significantly lower in obese dogs. Obesity negatively affects 6MWT performances in dogs. The 6MWT may be used to demonstrate the efficacy of BWL to improve CPF and quality of life in obese dogs. Although BWL induced significant improvement of cardiopulmonary parameters before ideal BW, WD improved until the end of the BWL program. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  5. Fire-Walking

    ERIC Educational Resources Information Center

    Willey, David

    2010-01-01

    This article gives a brief history of fire-walking and then deals with the physics behind fire-walking. The author has performed approximately 50 fire-walks, took the data for the world's hottest fire-walk and was, at one time, a world record holder for the longest fire-walk (www.dwilley.com/HDATLTW/Record_Making_Firewalks.html). He currently…

  6. Fire-Walking

    ERIC Educational Resources Information Center

    Willey, David

    2010-01-01

    This article gives a brief history of fire-walking and then deals with the physics behind fire-walking. The author has performed approximately 50 fire-walks, took the data for the world's hottest fire-walk and was, at one time, a world record holder for the longest fire-walk (www.dwilley.com/HDATLTW/Record_Making_Firewalks.html). He currently…

  7. Effects of Muscle Strength and Balance Control on Sit-to-Walk and Turn Durations in the Timed Up and Go Test.

    PubMed

    Chen, Tzurei; Chou, Li-Shan

    2017-04-30

    To examine the association of muscle strength and balance control with the amount of time taken to perform sit-to-walk (STW) or turning components of the Timed Up and Go (TUG) test in older adults. Correlations; multiple regression models. General community. Older adults (N=60) age >70 years recruited from the community. Not applicable. Muscle strength, balance control, and TUG test performance time. Muscle strength was quantified by peak joint moments during the isometric maximal voluntary contraction test for bilateral hip abductors, knee extensors, and ankle plantar flexors. Balance control was assessed with the Berg Balance Scale, Fullerton Advanced Balance Scale, and center of mass and ankle inclination angle derived during the TUG test performance. We found that balance control measures were significantly associated with both STW and turning durations even after controlling for muscle strength and other confounders (STW duration: P<.001, turning duration: P=.001). Adding strength to the regression model was found to significantly improve its prediction of STW duration (F change =5.945, P=.018), but not turning duration (F change =1.03, P=.14). Our findings suggest that poor balance control is an important factor that contributes to longer STW and turning durations on the TUG test. Furthermore, strength has a higher association with STW than turning duration. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Pulmonary rehabilitation in patients with bronchiectasis: pulmonary function, arterial blood gases, and the 6-minute walk test.

    PubMed

    van Zeller, Mafalda; Mota, Patrícia Caetano; Amorim, Adelina; Viana, Paulo; Martins, Paula; Gaspar, Luís; Hespanhol, Venceslau; Gomes, Isabel

    2012-01-01

    Information regarding the effects of pulmonary rehabilitation (PR) on pulmonary function (PF), arterial blood gases (ABG), and 6-minute walk distance (6MWD) in patients with bronchiectasis is scant in the literature. To evaluate the effects of PR on these indices in this population, a retrospective evaluation of those who attended PR from 2007 to 2010, was made. Pulmonary rehabilitation lasted a mean of 12 weeks and included cycle ergometer exercise for 30 minutes, 3 times per week, with additional upper limbs and quadriceps training. PF, ABG, and 6MWD were evaluated before and after PR to determine the potential influence of gender, exacerbations, underlying cause of bronchiectasis, severity of obstruction, and colonization with bacteria. Forty-one patients (48.8% males; median age, 54 years) were included; 25 had severe obstruction and 19 were colonized with bacteria. Following PR, no significant changes were detected in PF or ABG. Median 6MWD before PR was 425 m and post-PR was 450 m (P = .431). Outcomes did not show any interaction with gender, colonization, or exacerbations. However, patients with idiopathic bronchiectasis did show a significant improvement in forced vital capacity in percent of predicted and residual volume after PR (P = .016 and .048, respectively). Patients with severe obstruction showed a statistically significant decrease in percent of predicted residual volume (P = .025). There appears to be a beneficial impact of PR on PF in certain groups of patients with bronchiectasis. In addition, PR indications and protocols for patients with bronchiectasis may need to be adapted to accommodate specific patients, so that expressive exercise capacity improvement can be achieved.

  9. Ventilatory and Metabolic Response in the Incremental Shuttle and 6-Min Walking Tests Measured by Telemetry in Obese Patients Prior to Bariatric Surgery.

    PubMed

    Oliver, Nicole; Onofre, Tatiana; Carlos, Renata; Barbosa, Juliana; Godoy, Eudes; Pereira, Eliane; Guerra, Ricardo O; Bruno, Selma

    2015-09-01

    Low cardiopulmonary fitness, measured by oxygen uptake peak (VO 2pk), is associated with postoperative complications and mortality. Obese people have difficulty in performing the cardiopulmonary exercise test, which requires maximal exertion. The incremental shuttle walking test (ISWT) and 6-min walking test (6MWT) have been used to assess cardiorespiratory capacity, mortality, and complications in the postoperative phase. However, the physiological response elicited by these tests in obese people is unknown. This study analyzed and compared cardiopulmonary fitness (oxygen uptake [VO2] and CO2 output [VCO2]) in the ISWT and 6MWT in obese adults using a telemetry system. Fifteen obese patients (10 women; mean age 39.4 ± 10.1 years; mean body mass index 43.5 ± 6.8 kg/m(2)) with normal forced vital capacity (% FVC 93.7) performed the 6MWT and ISWT in the field in this cross-sectional study. Metabolic (VO 2pk, VCO2) and respiratory (minute ventilation; VE) variables were recorded using telemetry. Obese patients performed the ISWT with an incremental and exponential cardiopulmonary response, with higher VO 2pk (15.4 ± 2.9 ml/kg/min), VCO2 (1.7 ± 0.7 l/min), and VE (51.4 ± 21.3 l/min) than the 6MWT (VO 2pk = 13.2 ± 2.59 ml/kg/min, VCO2 = 1.4 ± 0.6 l/min; VE = 41.2 ± 16.6 l/min (all p < 0.01). They also demonstrated more effort intensity, assessed by VO2, (p = 0.006) and heart rate (p = 0.04) in the ISWT than the 6MWT. In the 6MWT, patients showed a fast rise in ventilatory and metabolic response, reaching a plateau. The ISWT test generated superior metabolic and ventilatory stress than the 6MWT and may be more suitable for assessing cardiopulmonary fitness than self-paced tests.

  10. The Effectiveness of Thai Exercise with Traditional Massage on the Pain, Walking Ability and QOL of Older People with Knee Osteoarthritis: A Randomized Controlled Trial in the Community

    PubMed Central

    Peungsuwan, Punnee; Sermcheep, Phawinee; Harnmontree, Papatsara; Eungpinichpong, Wichai; Puntumetakul, Rungthip; Chatchawan, Uraiwan; Yamauchi, Junichiro

    2014-01-01

    [Purpose] This study investigated the effectiveness of a class- and home-based exercise with massage between Thai traditional and standardized physical therapy (TPT and SPT) in older people with knee osteoarthritis (KOA). [Subjects and Methods] Thirty-one subjects with KOA (aged 50–85 years) in two selected villages were randomly assigned into the TPT or SPT programs. Seventeen TPT subjects received Thai exercise with traditional massage, and 14 SPT individuals performed strengthening exercise with Swedish massage. Both programs consisted of a class with supervision plus home self-care for 8 weeks; the subjects then managed home self-care for 1 year. [Results] After 2 months, the six-minute walk test (6MWT), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and SF-36 testing showed significant improvement in both groups, but the improvement of the TPT group was greater. After 1year, only the score for the 6MWT was greater in the TPT group than in the SPT group. [Conclusion] The TPT program yielded better results for the 6MWT, but, both programs had beneficial effects on the pain, function, and QOL of middle-aged and older patients with KOA in the community setting. PMID:24567694

  11. 6-Min walk-test data in severe obstructive-sleep-apnea-hypopnea-syndrome (OSAHS) under continuous-positive-airway-pressure (CPAP) treatment.

    PubMed

    Ben Saad, Helmi; Ben Hassen, Ikram; Ghannouchi, Ines; Latiri, Imed; Rouatbi, Sonia; Escourrou, Pierre; Ben Salem, Halima; Benzarti, Mohamed; Abdelghani, Ahmed

    2015-05-01

    Few studies have evaluated the functional capacity of severe OSAHS. To assess their functional capacity, identify their 6-min walking-distance (6MWD) influencing factors and compare their data with those of two control-groups. Sixty (42 males) clinically consecutive stable patients with severe OSAHS under CPAP were included. Clinical, Epworth questionnaire, anthropometric, polysomnographic, plethysmographic and 6-min walk-test (6MWT) data were collected. Univariate and multivariate analyses were used to identify the 6MWD influencing factors. Data of a subgroup of severe OSAHS aged ≥40 Yrs (n = 49) were compared with those of non-obese (n = 174) and obese (n = 55) groups. The means ± SD of age and apnea-hypopnea-index were, respectively, 49 ± 10 Yr and 62 ± 18/h. The profile of OSAHS patients carrying the 6MWT, was as follows: at the end of the 6MWT, 31% and 25% had, respectively, a high dyspnea (>5/10, visual analogue scale) and a low heart-rate (<60% of-maximal-predicted), 13% had an abnormal 6MWD ( 5 points and 3% stopped the walk. The factors that significantly influenced the 6MWD, explaining 80% of its variability, are included in the following equation: 6MWD (m) = 29.66 × first-second-forced-expiratory-volume (L) - 4.19 × Body-mass-index (kg/m(2)) - 51.89 × arterial-hypertension (0. No; 1. Yes) + 263.53 × Height (m) + 2.63 × average oxy-sat during sleep (%) - 51.06 × Diuretic-use (0. No; 1. Yes) - 20.68 × Dyspnea (NYHA) (0. No; 1. Yes) - 38.09 × Anemia (0. No; 1. Yes) + 5.79 × Resting oxy-sat (%) - 586.25. Compared with non-obese and obese groups, the subgroup of OSAHS has a significantly lower 6MWD [100 ± 9%, 100 ± 8% and 83 ± 12%, respectively). Severe OSAHS may play a role in reducing the functional capacity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Does long-distance walking improve or deteriorate walking stability of transtibial amputees?

    PubMed

    Wong, Duo Wai-Chi; Lam, Wing Kai; Yeung, L F; Lee, Winson C C

    2015-10-01

    Falls are common in transtibial amputees which are linked to their poor stability. While amputees are encouraged to walk more, they are more vulnerable to fatigue which leads to even poorer walking stability. The objective of this study was to evaluate the dynamic stability of amputees after long-distance walking. Six male unilateral transtibial amputees (age: 53 (SD: 8.8); height: 170cm (SD: 3.4); weight: 75kg (SD: 4.7)) performed two sessions (30minutes each) of treadmill walking, separated by a short period of gait tests. Gait tests were performed before the walking (baseline) and after each session of treadmill walking. Gait parameters and their variability across repeated steps at each of the three conditions were computed. There were no significant differences in walking speed, step length, stance time, time of occurrence, and magnitude of peak angular velocities of the knee and hip joint (P>0.05). However, variability of knee and hip angular velocity after 30-minute walking was significantly higher than the baseline (P<0.05) and after a total of 60-minute walking (P<0.05). The variability of lateral sway velocity after 30-minute walking was significantly higher than the baseline (P<0.05). The significant increase in variability after 30-minute walking could indicate poorer walking stability when fatigue was developed, while the significant reduction after 60-minute walking might indicate the ability of amputees to restore their walking stability after further continuous walking. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Accelerometer-determined physical activity and walking capacity in persons with Down syndrome, Williams syndrome and Prader-Willi syndrome.

    PubMed

    Nordstrøm, Marianne; Hansen, Bjørge Herman; Paus, Benedicte; Kolset, Svein Olav

    2013-12-01

    In this study we describe by use of accelerometers the total physical activity (PA), intensity pattern and walking capacity in 87 persons age 16-45 years with Down syndrome (DS), Williams syndrome (WS) and Prader-Willi syndrome (PWS). Participants were recruited from all over Norway, and lived either with their parents or in community residences with support. On average the participants generated 294 counts per minute (cpm) or 6712 steps per day, with most of the day spent in sedentary activity, 522 min/day, followed by 212 min/day in light PA, 71 min/day in lifestyle activity and 27 min/day in moderate-to-vigorous physical activity (MVPA). Inactivity was prevalent, as only 12% meet the current Nordic recommendations for PA. When compared, no differences for total physical activity or time in MVPA were observed between the three groups. However, participant with DS spent a mean of 73 min/day less and 43 min/day less in sedentary activities compared to participants with PWS and WS, respectively, (p=0.011, 95% CI: -10.9; -80.1). In addition the DS-group spent a mean of 66 min/day more in light PA than the PWS-group and 41 min/day more than the WS-group, (p<0.001, 95% CI: 29.3; 79.7). Participants with PWS spent on average 30 min/day less in lifestyle activities compared to both participants with DS and WS, (p<0.001, 95% CI: -14.2; -45.4). No association between total PA and BMI were observed. Males were more active than females across all diagnoses. Males accumulated on average 85 counts per minutes more than females, (p=0.002, 95% CI: 33.3; 136.7), 2137 more steps per day, (p=0.002, 95% CI: 778; 3496). The mean walking capacity during six-minutes was 507 m (SD 112 m) for males and 466 m (SD 88 m) for females. Distance walked during testing decreased with 33.6 m when comparing normal or underweight participants to overweight participants, and 78.1 m when comparing overweight to obese participants (p<0.001 95% CI: -40.4; -85.8). When adjusted for BMI no differences in

  14. An impaired health related muscular fitness contributes to a reduced walking capacity in patients with schizophrenia: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Patients with schizophrenia report muscle weakness. The relation of this muscle weakness with performing daily life activities such as walking is however not yet studied. The aim of this study was to quantify walking capacity and health related muscular fitness in patients with schizophrenia compared with age-, gender and body mass index (BMI)-matched healthy controls. Secondly, we identified variables that could explain the variability in walking capacity and in health related muscular fitness in patients with schizophrenia. Methods A total of 100 patients with schizophrenia and 40 healthy volunteers were initially screened. Eighty patients with schizophrenia (36.8±10.0 years) and the 40 age-, gender- and body mass index (BMI)-matched healthy volunteers (37.1±10.3 years) were finally included. All participants performed a standing broad jump test (SBJ) and a six-minute walk test (6MWT) and filled out the International Physical Activity Questionnaire. Patients additionally had a fasting metabolic laboratory screening and were assessed for psychiatric symptoms. Results Patients with schizophrenia did have lower 6MWT (17.9%, p<0.001) [effect size (ES)=−1.01] and SBJ (14.1%, p<0.001) (ES=−0.57) scores. Patients were also less physically active (1291.0±1201.8 metabolic equivalent-minutes/week versus 2463.1±1365.3, p<0.001) (ES=−0.91) than controls. Schizophrenia patients with metabolic syndrome (MetS) (35%) had a 23.9% lower (p<0.001) SBJ-score and 22.4% (p<0.001) lower 6MWT-score than those without MetS. In multiple regression analysis, 71.8% of the variance in 6MWT was explained by muscular fitness, BMI, presence of MetS and physical activity participation, while 53.9% of the variance in SBJ-score was explained by age, illness duration, BMI and physical activity participation. Conclusions The walking capacity and health-related muscular fitness are impaired in patients with schizophrenia and both should be a major focus in daily clinical practice

  15. The Not-so-Random Drunkard's Walk

    ERIC Educational Resources Information Center

    Ehrhardt, George

    2013-01-01

    This dataset contains the results of a quasi-experiment, testing Karl Pearson's "drunkard's walk" analogy for an abstract random walk. Inspired by the alternate hypothesis that drunkards stumble to the side of their dominant hand, it includes data on intoxicated test subjects walking a 10' line. Variables include: the…

  16. The Not-so-Random Drunkard's Walk

    ERIC Educational Resources Information Center

    Ehrhardt, George

    2013-01-01

    This dataset contains the results of a quasi-experiment, testing Karl Pearson's "drunkard's walk" analogy for an abstract random walk. Inspired by the alternate hypothesis that drunkards stumble to the side of their dominant hand, it includes data on intoxicated test subjects walking a 10' line. Variables include: the…

  17. Cell phones change the way we walk.

    PubMed

    Lamberg, Eric M; Muratori, Lisa M

    2012-04-01

    Cell phone use among pedestrians leads to increased cognitive distraction, reduced situation awareness and increases in unsafe behavior. Performing a dual-task, such as talking or texting with a cell phone while walking, may interfere with working memory and result in walking errors. At baseline, thirty-three participants visually located a target 8m ahead; then vision was occluded and they were instructed to walk to the remembered target. One week later participants were assigned to either walk, walk while talking on a cell phone, or walk while texting on a cell phone toward the target with vision occluded. Duration and final location of the heel were noted. Linear distance traveled, lateral angular deviation from the start line, and gait velocity were derived. Changes from baseline to testing were analyzed with paired t-tests. Participants engaged in cell phone use presented with significant reductions in gait velocity (texting: 33% reduction, p=0.01; talking: 16% reduction, p=0.02). Moreover, participants who were texting while walking demonstrated a 61% increase in lateral deviation (p=0.04) and 13% increase in linear distance traveled (p=0.03). These results suggest that the dual-task of walking while using a cell phone impacts executive function and working memory and influences gait to such a degree that it may compromise safety. Importantly, comparison of the two cell phone conditions demonstrates texting creates a significantly greater interference effect on walking than talking on a cell phone.

  18. Effects of a "test in-train out" walking program versus supervised standard rehabilitation in chronic stroke patients: a feasibility and pilot randomized study.

    PubMed

    Malagoni, Anna M; Cavazza, Stefano; Ferraresi, Giovanni; Grassi, Guido; Felisatti, Michele; Lamberti, Nicola; Basaglia, Nino; Manfredini, Fabio

    2016-06-01

    The loss of normal ambulatory function after stroke, besides causing disability, leads to progressive deconditioning and exposes patients to increased risk of cardiovascular diseases and recurrent stroke. Conventional rehabilitation is mainly limited to the subacute period after stroke. Effective, safe and sustainable interventions for patients and healthcare system, including the long-term, should be identified. To verify the feasibility, safety and preliminary efficacy of an original home-based rehabilitation model compared to a standard supervised program in chronic hemiplegic stroke survivors. Pilot, two-arm, parallel group, randomized, controlled clinical trial. Community-dwelling poststroke patient/Hospital. Twelve chronic hemiplegic stroke patients (age=66.5±11.9 years, males, N.=9). Participants were randomly assigned for a 10-week period to a structured home-based exercise program (N.=6) and a standard supervised group-setting program (N.=6). The feasibility outcomes included adherence to interventions, retention rate and safety. Satisfaction was also evaluated by the Client Satisfaction Questionnaire. Efficacy was assessed by the 6-minute walk test, Timed Up and Go and Stair Climb tests. The impact on Quality-of-life was estimated using the physical activity domain of the Short Form-36 questionnaire. Operators' time consuming was also calculated. Adherence was 91% in the home-based exercise group and 92% in the standard supervised group. The retention rate was 100%, with no adverse events reported and high satisfaction scores for both interventions. 6-minute walk test and physical activity domain significantly increased in both groups (P=0.03). Timed Up and Go improved in both groups, significantly for the home-based exercise group (P=0.03) while Stair Climb remained stable. Time required to operators to implement the home-based exercise program was 15 hours vs. 30 hours for the standard supervised one. In a sample of hemiplegic chronic stroke patients

  19. Gait or Walking Problems

    MedlinePlus

    Gait or Walking Problems the basic facts multiple sclerosis Many people with MS will experience difficulty with walking, which is also called ambulation. The term “gait” refers more specifically to the manner ...

  20. Toe Walking in Children

    MedlinePlus

    ... concern. Toe walking is sometimes the result of cerebral palsy, muscular dystrophy or another generalized disease of nerve ... can prevent the heel from touching the ground. Cerebral palsy. Toe walking can be caused by cerebral palsy — ...

  1. The 6-Minute-Walk Distance Test as a Chronic Obstructive Pulmonary Disease Stratification Tool. Insights from the COPD Biomarker Qualification Consortium.

    PubMed

    Celli, Bartolome; Tetzlaff, Kay; Criner, Gerard; Polkey, Michael I; Sciurba, Frank; Casaburi, Richard; Tal-Singer, Ruth; Kawata, Ariane; Merrill, Debora; Rennard, Stephen

    2016-12-15

    The 6-minute-walk distance (6MWD) test predicts mortality in chronic obstructive pulmonary disease (COPD). Whether variability in study type (observational vs. interventional) or region performed limits use of the test as a stratification tool or outcome measure for therapeutic trials is unclear. To analyze the original data from several large observational studies and from randomized clinical trials with bronchodilators to support the qualification of the 6MWD test as a drug development tool in COPD. Original data from 14,497 patients with COPD from six observational (n = 9,641) and five interventional (n = 4,856) studies larger than 100 patients and longer than 6 months in duration were included. The geographical, anthropometrics, FEV1, dyspnea, comorbidities, and health status scores were measured. Associations between 6MWD and mortality, hospitalizations, and exacerbations adjusted by study type, age, and sex were evaluated. Thresholds for outcome prediction were calculated using receiver operating curves. The change in 6MWD after inhaled bronchodilator treatment and surgical lung volume reduction were analyzed to evaluate the responsiveness of the test as an outcome measure. The 6MWD was significantly lower in nonsurvivors, those hospitalized, or who exacerbated compared with those without events at 6, 12, and greater than 12 months. At these time points, the 6MWD receiver operating characteristic curve-area under the curve to predict mortality was 0.71, 0.70, and 0.68 and for hospitalizations was 0.61, 0.60, and 0.59, respectively. After treatment, the 6MWD was not different between placebo and bronchodilators but increased after surgical lung volume reduction compared with medical therapy. Variation across study types (observational or therapeutic) or regions did not confound the ability of 6MWD to predict outcome. The 6MWD test can be used to stratify patients with COPD for clinical trials and interventions aimed at modifying exacerbations

  2. Are 30 minutes of rest between two incremental shuttle walking tests enough for cardiovascular variables and perceived exertion to return to baseline values?

    PubMed Central

    Ribeiro, Laís R. G.; Mesquita, Rafael B.; Vidotto, Laís S.; Merli, Myriam F.; Carvalho, Débora R.; de Castro, Larissa A.; Probst, Vanessa S.

    2015-01-01

    Objective: To verify whether 30 minutes of rest between two incremental shuttle walking tests (ISWT) are enough for cardiovascular variables and perceived exertion to return to baseline values in healthy subjects in a broad age range. Method: The maximal exercise capacity of 334 apparently healthy subjects (age ≥18) was evaluated using the ISWT. The test was performed twice with 30 minutes of rest in between. Heart rate (HR), arterial blood pressure (ABP), dyspnea, and leg fatigue were evaluated before and after each test. Subjects were allocated to 6 groups according to their age: G1: 18-29 years; G2: 30-39 years; G3: 40-49 years; G4: 50-59 years; G5: 60-69 years and G6: ≥70 years. Results: All groups had a good performance in the ISWT (median >90% of the predicted distance). The initial HR (HRi) of the second ISWT was higher than the first ISWT in the total sample (p<0.0001), as well as in all groups (p<0.0001). No difference was observed in the behavior of ABP (systolic and diastolic) and dyspnea between the two tests, but this difference occurred for leg fatigue (greater before the second ISWT) in G1 (p<0.05). Most subjects (58%) performed better in the second test. Conclusion: 30 minutes of rest between two ISWTs are not enough for all cardiovascular variables and perceived exertion to return to baseline values. However, this period appears to be sufficient for blood pressure and performance to recover in most subjects. PMID:25789556

  3. [Chronic obstructive pulmonary disease: evaluation of exercise tolerance using three different exercise tests].

    PubMed

    Montes de Oca, M; Ortega Balza, M; Lezama, J; López, J M

    2001-02-01

    The clinical usefulness of simple exercise tests in patients with chronic obstructive pulmonary disease (COPD) continues to give rise to debate. Questions remain about whether these tests assess maximum effort or only exercise tolerance (submaximal effort). To determine the levels of stress reached during the six-minute walking (6MW) test and stair climbing (SC) test and their relation to maximum aerobic capacity, 50 patients with COPD (FEV1 49 +/- 19%) were studied. Data collected included spirometric variables and VO2, heart rate (HR), ventilatory response and dyspnea during the progressive effort ergometric cycle (PEEC) test. Two 6MW and SC tests were completed on two separate days, with distance, number of steps, HR and dyspnea recorded. HR was higher during the PEEC test. Among the simple tests, SC caused a faster HR than did the 6MW test. Likewise, a significant linear relation was observed between VO2/kgpeak during the 6MW test (r2 = 0.27; p < 0.05) and the SC test (r2 = 0.33; p < 0.01). We therefore conclude that exercise tolerance in patients with COPD can be evaluated using simple stress tests. The SC test is probably the best simple way to determine maximum functional capacity, whereas the 6MW test can be reserved for measurement of exercise tolerance.

  4. On alternating quantum walks

    NASA Astrophysics Data System (ADS)

    Rousseva, Jenia; Kovchegov, Yevgeniy

    2017-03-01

    We study an inhomogeneous quantum walk on a line that evolves according to alternating coins, each a rotation matrix. For the quantum walk with the coin alternating between clockwise and counterclockwise rotations by the same angle, we derive a closed form solution for the propagation of probabilities, and provide its asymptotic approximation via the method of stationary phase. Finally, we observe that for a x03c0;/4 angle, this alternating rotation walk will replicate the renown Hadamard walk.

  5. 76 FR 65362 - Energy Conservation Program: Compliance Date Regarding the Test Procedures for Walk-In Coolers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-21

    ... test procedures will be mandatory for making representations of energy usage or energy efficiency... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY 10 CFR Parts 429 and 431 RIN 1904-AC58 Energy Conservation Program: Compliance Date Regarding the...

  6. 76 FR 48745 - Energy Conservation Program: Compliance Date Regarding the Test Procedures for Walk-In Coolers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... final rule stated that the test procedures will be mandatory for making representations of energy usage... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY 10 CFR Parts 429 and 431 RIN 1904-AC58 Energy Conservation Program: Compliance Date Regarding the...

  7. Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test

    PubMed Central

    Mene-Afejuku, Tuoyo O; Balogun, Michael O; Akintomide, Anthony O; Adebayo, Rasaaq A

    2017-01-01

    Background Hypertensive heart failure (HHF) is associated with a poor prognosis. There is paucity of data in Nigeria on prognosis among HHF patients elucidating the role of 24-hour Holter electrocardiogram (ECG) in concert with other risk factors. Objective The aim of this study was to determine the prognostic utility of 24-hour Holter ECG, the 6-minute walk test (6-MWT), echocardiography, clinical and laboratory parameters among HHF patients. Methods A total of 113 HHF patients were recruited and followed up for 6 months. Thirteen of these patients were lost to follow-up, and as a result only 100 HHF patients were analyzed. All the patients underwent baseline laboratory tests, echocardiography, 24-hour Holter ECG and the 6-MWT. HHF patients were analyzed as “mortality vs alive” and as “events vs no-events” based on the outcome at the end of 6 months. Events was defined as HHF patients who were rehospitalized for heart failure (HF), had prolonged hospital stay or died. No-events group was defined as HHF patients who did not meet the criteria for the events group. Results HHF patients in the mortality group (n = 7) had significantly higher serum urea (5.71 ± 2.07 mmol/L vs 3.93 ± 1.45 mmol/L, p = 0.003) than that in those alive. After logistic regression, high serum urea conferred increased mortality risk (p = 0.035). Significant premature ventricular complexes (PVCs) on 24-hour Holter ECG following logistic regression were also significantly higher (p = 0.015) in the mortality group than in the “alive” group (n = 93) at the end of the 6-month follow-up period. The 6-minute walk distance (6-MWD) was least among the HHF patients who died (167.26 m ± 85.24 m). However, following logistic regression, the 6-MWT was not significant (p = 0.777) for predicting adverse outcomes among HHF patients. Patients in the events group (n = 41) had significantly higher New York Heart Association (NYHA) class (p = 0.001), Holter-detected ventricular tachycardia (VT; p

  8. Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test.

    PubMed

    Mene-Afejuku, Tuoyo O; Balogun, Michael O; Akintomide, Anthony O; Adebayo, Rasaaq A

    2017-01-01

    Hypertensive heart failure (HHF) is associated with a poor prognosis. There is paucity of data in Nigeria on prognosis among HHF patients elucidating the role of 24-hour Holter electrocardiogram (ECG) in concert with other risk factors. The aim of this study was to determine the prognostic utility of 24-hour Holter ECG, the 6-minute walk test (6-MWT), echocardiography, clinical and laboratory parameters among HHF patients. A total of 113 HHF patients were recruited and followed up for 6 months. Thirteen of these patients were lost to follow-up, and as a result only 100 HHF patients were analyzed. All the patients underwent baseline laboratory tests, echocardiography, 24-hour Holter ECG and the 6-MWT. HHF patients were analyzed as "mortality vs alive" and as "events vs no-events" based on the outcome at the end of 6 months. Events was defined as HHF patients who were rehospitalized for heart failure (HF), had prolonged hospital stay or died. No-events group was defined as HHF patients who did not meet the criteria for the events group. HHF patients in the mortality group (n = 7) had significantly higher serum urea (5.71 ± 2.07 mmol/L vs 3.93 ± 1.45 mmol/L, p = 0.003) than that in those alive. After logistic regression, high serum urea conferred increased mortality risk (p = 0.035). Significant premature ventricular complexes (PVCs) on 24-hour Holter ECG following logistic regression were also significantly higher (p = 0.015) in the mortality group than in the "alive" group (n = 93) at the end of the 6-month follow-up period. The 6-minute walk distance (6-MWD) was least among the HHF patients who died (167.26 m ± 85.24 m). However, following logistic regression, the 6-MWT was not significant (p = 0.777) for predicting adverse outcomes among HHF patients. Patients in the events group (n = 41) had significantly higher New York Heart Association (NYHA) class (p = 0.001), Holter-detected ventricular tachycardia (VT; p = 0.009), Holter-detected atrial fibrillation (AF

  9. Walk This Way

    ERIC Educational Resources Information Center

    Mason, Nick

    2007-01-01

    A generation ago, it was part of growing up for all kids when they biked or walked to school. But in the last 30 years, heavier traffic, wider roads and more dangerous intersections have made it riskier for students walking or pedaling. Today, fewer than 15 percent of kids bike or walk to school compared with more than 50 percent in 1969. In the…

  10. Walk This Way

    ERIC Educational Resources Information Center

    Mason, Nick

    2007-01-01

    A generation ago, it was part of growing up for all kids when they biked or walked to school. But in the last 30 years, heavier traffic, wider roads and more dangerous intersections have made it riskier for students walking or pedaling. Today, fewer than 15 percent of kids bike or walk to school compared with more than 50 percent in 1969. In the…

  11. Quantum walk computation

    SciTech Connect

    Kendon, Viv

    2014-12-04

    Quantum versions of random walks have diverse applications that are motivating experimental implementations as well as theoretical studies. Recent results showing quantum walks are “universal for quantum computation” relate to algorithms, to be run on quantum computers. We consider whether an experimental implementation of a quantum walk could provide useful computation before we have a universal quantum computer.

  12. Walking Wellness. Student Workbook.

    ERIC Educational Resources Information Center

    Sweetgall, Robert; Neeves, Robert

    This comprehensive student text and workbook, for grades four through eight, contains 16 workshop units focusing on walking field trips, aerobic pacing concepts, walking techniques, nutrition, weight control and healthy life-style planning. Co-ordinated homework assignments are included. The appendixes include 10 tips for walking, a calorie chart,…

  13. Walking Wellness. Student Workbook.

    ERIC Educational Resources Information Center

    Sweetgall, Robert; Neeves, Robert

    This comprehensive student text and workbook, for grades four through eight, contains 16 workshop units focusing on walking field trips, aerobic pacing concepts, walking techniques, nutrition, weight control and healthy life-style planning. Co-ordinated homework assignments are included. The appendixes include 10 tips for walking, a calorie chart,…

  14. Relationship between performances of 10-time-repeated sit-to-stand and maximal walking tests in non-disabled older women.

    PubMed

    Yanagawa, Naoko; Shimomitsu, Teruichi; Kawanishi, Masashi; Fukunaga, Tetsuo; Kanehisa, Hiroaki

    2016-06-27

    Sit-to-stand (STS) test is extensively used to assess the functionality of the lower body in elderly people. This study aimed to examine how the score of STS can be associated with that of maximal walking (MW) tests through a cross-sectional as well as longitudinal analysis for non-disabled older women. Times taken for a 10-time-repeated STS (STS time) and 5-m MW (MW time) were determined before (pre) and after (post) a 3-month body mass-based exercise program in 154 non-disabled women aged 60 to 79 years. In addition to the time scores, STS and MW power indexes (STS-PI and MW-PI, respectively) were calculated using the following equations: STS-PI = (body height - 0.4) × body mass × 10/STS time and MW-PI = body mass × 5/MW time. At pre- and post-intervention, STS-PI was significantly correlated to MW-PI, with higher correlation coefficients (r = 0.545-0.567, P < 0.0001) than those between the two time scores (r = 0.271-0.309, P < 0.001). The intervention significantly improved STS-time (13.6 ± 3.2 s at pre to 9.4 ± 1.8 s at post, P < 0.0001), MW time (2.4 ± 0.3 s to 2.2 ± 0.3 s, P < 0.0001), STS-PI (46.5 ± 12.5 to 65.7 ± 12.7, P < 0.0001), and MW-PI (112.1 ± 20.2 to 124.2 ± 24.4, P < 0.0001). There were significant correlations between the changes of STS and MW times (r = 0.281, P < 0.001) and between those of STS-PI and MW-PI (r = 0.366, P < 0.0001). In elderly women, the performance of sit-to-stand task and its training-induced gain are associated with those of the maximal walking task. In addition, the current results indicated that translation of the performance scores of the sit-to-stand and maximal walking tasks to power indexes may be a useful approach for examining the association between the two tasks.

  15. Predictors of Walking Performance and Walking Capacity in People with Lumbar Spinal Stenosis, Low Back Pain and Asymptomatic Controls

    PubMed Central

    Tomkins-Lane, Christy C.; Holz, Sara Christensen; Yamakawa, KS; Phalke, Vaishali V.; Quint, Doug J.; Miner, Jennifer; Haig, Andrew J.

    2011-01-01

    Objective Examine predictors of community walking performance and walking capacity in lumbar spinal stenosis (LSS), compared to individuals with low back pain and asymptomatic controls. Design Retrospective analysis. Setting University Spine Program. Participants 126 participants (50 LSS, 44 low back pain and 32 asymptomatic controls), aged 55–80 yrs. Interventions Not applicable. Main Outcome Measure(s) 7-day community walking distance measured by pedometer (walking performance) and a 15 minute walking test (walking capacity). All participants had a lumbosacral MRI, electrodiagnostic testing, and a history and physical examination including history of pain and neurologic symptoms, straight leg raise test, tests for directional symptoms, reflexes, strength, and nerve tension signs. The study questionnaire included demographic information, history of back/leg pain, questions about walking, exercise frequency, and pain level, as well as the standardized Quebec Back Pain Disability Scale. Results BMI, pain, age and female sex predicted walking performance (r2 = 0.41) and walking capacity (r2=0.41). The diagnosis of LSS itself had no clear relationship with either walking variable. Compared to the asymptomatic group, LSS participants had significantly lower values for all walking parameters, with the exception of stride length, while there was no significant difference between the LSS and low back pain groups. Conclusions BMI, pain, female sex, and age predict walking performance and capacity in people with LSS, low back pain, and asymptomatic controls. While pain was the strongest predictor of walking capacity, BMI was the strongest predictor of walking performance. Average pain, rather than leg pain was predictive of walking. Obesity and pain are modifiable predictors of walking deficits that could be targets for future intervention studies aimed at increasing walking performance and capacity in both the low back pain and LSS populations. PMID:22365377

  16. Accelerometry is associated with walking mobility, not physical activity, in persons with multiple sclerosis.

    PubMed

    Weikert, Madeline; Suh, Yoojin; Lane, Abbi; Sandroff, Brian; Dlugonski, Deirdre; Fernhall, Bo; Motl, Robert W

    2012-06-01

    Accelerometers are seemingly a criterion standard of real-life walking mobility and this is supported by assumptions and empirical data. This application would be strengthened by including objective measures of walking mobility along with a matched control sample for verifying specificity versus generality in accelerometer output. We compared associations among accelerometer output, walking mobility, and physical activity between persons with multiple sclerosis (MS) and controls without a neurological disorder. Sixty-six persons (33 MS, 33 matched controls) completed a battery of questionnaires, performed the six-minute walk (6MW) and timed-up-and-go (TUG), and wore an accelerometer for a 7-day period. After this period, participants completed the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and International Physical Activity Questionnaire (IPAQ). Accelerometer output was significantly correlated with only mobility measures (6MW, ρ=.78; TUG, ρ=-.68) in MS, whereas it correlated with both mobility (6MW, ρ=.58; TUG, ρ=-.49) and physical activity (GLTEQ, ρ=.56; IPAQ, ρ=.53) measures in controls. Regression analysis indicated that only 6MW explained variance in accelerometer output in MS (β=.65, R(2)=.43). These findings support the possibility that accelerometers primarily and specifically measure real-life walking mobility, not physical activity, in persons with MS.

  17. Effects of Exercise Training versus Attention on Plasma B-type Natriuretic Peptide, 6-Minute Walk Test and Quality of Life in Individuals with Heart Failure

    PubMed Central

    Norman, Joseph F.; Pozehl, Bunny J.; Duncan, Kathleen A.; Hertzog, Melody A.; Krueger, Steven K.

    2012-01-01

    Purpose The purpose of this study was to compare an Exercise Training Group (EX) with an Attention-Control Group (AT-C) to more specifically assess the impact of exercise training on individuals with heart failure (HF). Methods Forty-two individuals with HF were randomized to AT-C or EX that met with the same frequency and format of investigator interaction. Baseline, 12- and 24-week measurements of B-type naturetic peptide (BNP), 6-minute walk test (6-MWT), and the Kansas City Cardiomyopathy Questionnaire (KCCQ) were obtained. Results BNP tended to increase in the AT-C while remaining stable in the EX over time. A clinically significant increase in 6-MWT was demonstrated by the EX but not the AT-C. The EX achieved a clinically significant change on the KCCQ at 12 weeks, with further improvement by 24 weeks, while the AT-C demonstrated a clinically significant change at 24 weeks. Conclusions Attention alone was inadequate to positively impact BNP levels or 6-MWT distances, but did have a positive impact on quality of life after 24 weeks. Although exercise offers enhanced benefits, individuals with HF unable to participate in an exercise program may still gain quality of life benefits from participation in a peer-support group that discusses topics pertinent to HF. PMID:23304096

  18. Testing for the presence and source of nonstationarity in United States energy efficiency: Time trends, hysteresis or random walk?

    NASA Astrophysics Data System (ADS)

    McArdle, Paul Francis

    This research tests for the presence and source of non-stationarity in U.S. aggregate energy efficiency for the 1900-1991 period. An outlier/intervention model is used to test for the presence of a unit-root in aggregate energy efficiency against the alternative hypothesis of a segmented/broken trend. A decomposed energy price model is also used to test if hysteresis in energy efficiency results from an asymmetrical response to energy price changes. The analysis revealed four distinct stages in aggregate energy efficiency during the 20th century: (1) the 1900-1920 period characterized by highly volatile decreases in energy efficiency caused by rapid industrialization and transition to a fossil-fueled economy; (2) the 1920-1949 period distinguished by a persistent increase in energy efficiency as the economy became adept at harnessing fossil energy; (3) the 1949-1972 period when energy efficiency remained stable within a narrow range; and (4) the 1973-1991 period when energy efficiency improved dramatically in response to the two oil prices shocks of the 1970s. Key modeling results include the following: (1) energy efficiency follows a unit-root process even when the effects of intervention outliers are taken into consideration, indicating that the unit-root hypothesis cannot be rejected against an alternative of a segmented/broken trend; (2) a major source of non-stationarity in energy efficiency is hysteresis induced by non-reverting changes in energy efficiency, in turn caused by dramatic increases in energy prices; and (3) although a strong negative trend appears to have occurred in aggregate energy intensity since 1920, it seems to be the result of energy price increases, rather than a general downward trend. An important economic implication of the analysis is that energy price increases appear to impact energy efficiency, while energy price decreases appear to have much less effect. This finding is consistent with much of the economic literature in this area

  19. Association between Modified Shuttle Walk Test and cardiorespiratory fitness in overweight/obese adults with primary hypertension: EXERDIET-HTA study.

    PubMed

    Jurio-Iriarte, Borja; Gorostegi-Anduaga, Ilargi; Aispuru, G Rodrigo; Pérez-Asenjo, Javier; Brubaker, Peter H; Maldonado-Martín, Sara

    2017-02-07

    The aims of the study were to evaluate the relationship between Modified Shuttle Walk Test (MSWT) with peak oxygen uptake (V˙O2peak) in overweight/obese people with primary hypertension (HTN) and to develop an equation for the MSWT to predict V˙O2peak. Participants (N = 256, 53.9 ± 8.1 years old) with HTN and overweight/obesity performed a cardiorespiratory exercise test to peak exertion on an upright bicycle ergometer using an incremental ramp protocol and the 15-level MSWT. The formula of Singh et al was used as a template to predict V˙O2peak, and a new equation was generated from the measured V˙O2peak-MSWT relationship in this investigation. The correlation between measured and predicted V˙O2peak for Singh et al equation was moderate (r = 0.60, P < .001) with a standard error of the estimate (SEE) of 4.92 mL·kg(-1) minute(-1), SEE% = 21%. The correlation between MSWT and measured V˙O2peak as well as for the new equation was strong (r = 0.72, P < .001) with a SEE of 4.35 mL·kg(-1) minute(-1), SEE% = 19%. These results indicate that MSWT does not accurately predict functional capacity in overweight/obese people with HTN and questions the validity of using this test to evaluate exercise intolerance. A more accurate determination from a new equation in the current study incorporating more variables from MSWT to estimate V˙O2peak has been performed but still results in substantial error.

  20. The self-perception of dyspnoea threshold during the 6-min walk test: a good alternative to estimate the ventilatory threshold in chronic obstructive pulmonary disease.

    PubMed

    Couillard, Annabelle; Tremey, Emilie; Prefaut, Christian; Varray, Alain; Heraud, Nelly

    2016-12-01

    To determine and/or adjust exercise training intensity for patients when the cardiopulmonary exercise test is not accessible, the determination of dyspnoea threshold (defined as the onset of self-perceived breathing discomfort) during the 6-min walk test (6MWT) could be a good alternative. The aim of this study was to evaluate the feasibility and reproducibility of self-perceived dyspnoea threshold and to determine whether a useful equation to estimate ventilatory threshold from self-perceived dyspnoea threshold could be derived. A total of 82 patients were included and performed two 6MWTs, during which they raised a hand to signal self-perceived dyspnoea threshold. The reproducibility in terms of heart rate (HR) was analysed. On a subsample of patients (n=27), a stepwise regression analysis was carried out to obtain a predictive equation of HR at ventilatory threshold measured during a cardiopulmonary exercise test estimated from HR at self-perceived dyspnoea threshold, age and forced expiratory volume in 1 s. Overall, 80% of patients could identify self-perceived dyspnoea threshold during the 6MWT. Self-perceived dyspnoea threshold was reproducibly expressed in HR (coefficient of variation=2.8%). A stepwise regression analysis enabled estimation of HR at ventilatory threshold from HR at self-perceived dyspnoea threshold, age and forced expiratory volume in 1 s (adjusted r=0.79, r=0.63, and relative standard deviation=9.8 bpm). This study shows that a majority of patients with chronic obstructive pulmonary disease can identify a self-perceived dyspnoea threshold during the 6MWT. This HR at the dyspnoea threshold is highly reproducible and enable estimation of the HR at the ventilatory threshold.

  1. Psychometric properties of the 30-m walking test in patients with degenerative cervical myelopathy: results from two prospective multicenter cohort studies.

    PubMed

    Bohm, Parker E; Fehlings, Michael G; Kopjar, Branko; Tetreault, Lindsay A; Vaccaro, Alexander R; Anderson, Karen K; Arnold, Paul M

    2017-02-01

    The timed 30-m walking test (30MWT) is used in clinical practice and in research to objectively quantify gait impairment. The psychometric properties of 30MWT have not yet been rigorously evaluated. This study aimed to determine test-retest reliability, divergent and convergent validity, and responsiveness to change of the 30MWT in patients with degenerative cervical myelopathy (DCM). A retrospective observational study was carried out. The sample consisted of patients with symptomatic DCM enrolled in the AOSpine North America or AOSpine International cervical spondylotic myelopathy studies at 26 sites. Modified Japanese Orthopaedic Association scale (mJOA), Nurick scale, 30MWT, Neck Disability Index (NDI), and Short-Form-36 (SF-36v2) physical component score (PCS) and mental component score (MCS) were the outcome measures. Data from two prospective multicenter cohort myelopathy studies were merged. Each patient was evaluated at baseline and 6 months postoperatively. Of 757 total patients, 682 (90.09%) attempted to perform the 30MWT at baseline. Of these 682 patients, 602 (88.12%) performed the 30MWT at baseline. One patient was excluded, leaving601 in the analysis. At baseline, 81 of 682 (11.88%) patients were unable to perform the test, and their mJOA, NDI, and SF-36v2 PCS scores were lower compared with those who performed the test at baseline. In patients who performed the 30MWT at baseline, there was very high correlation among the three baseline 30MWT measurements (r=0.9569-0.9919). The 30MWT demonstrated good convergent and divergent validity. It was moderately correlated with the Nurick (r=0.4932), mJOA (r=-0.4424), and SF-36v2 PCS (r=-0.3537) (convergent validity) and poorly correlated with the NDI (r=0.2107) and SF-36v2 MCS (r=-0.1984) (divergent validity). Overall, the 30MWT was not responsive to change (standardized response mean [SRM]=0.30). However, for patients who had a baseline time above the median value of 29 seconds, the SRM was 0.45. The 30MWT

  2. Test monkeys anesthetized by routine procedure

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Test monkeys are safely anesthetized for five minutes by confining them for less than six minutes in enclosures containing a controlled volume of ether. Thus the monkeys can be properly and safely positioned on test couches and fitted with electrodes or other devices prior to physiological tests.

  3. Walk Score®

    PubMed Central

    Brown, Scott C.; Pantin, Hilda; Lombard, Joanna; Toro, Matthew; Huang, Shi; Plater-Zyberk, Elizabeth; Perrino, Tatiana; Perez-Gomez, Gianna; Barrera-Allen, Lloyd; Szapocznik, José

    2013-01-01

    Background Walk Score® is a nationally and publicly available metric of neighborhood walkability based on proximity to amenities (e.g., retail, food, schools). However, few studies have examined the relationship of Walk Score to walking behavior. Purpose To examine the relationship of Walk Score to walking behavior in a sample of recent Cuban immigrants, who overwhelmingly report little choice in their selection of neighborhood built environments when they arrive in the U.S. Methods Participants were 391 recent healthy Cuban immigrants (M age=37.1 years) recruited within 90 days of arrival in the U.S., and assessed within 4 months of arrival (M=41.0 days in the U.S.), who resided throughout Miami-Dade County FL. Data on participants’ addresses, walking and sociodemographics were collected prospectively from 2008 to 2010. Analyses conducted in 2011 examined the relationship of Walk Score for each participant’s residential address in the U.S. to purposive walking, controlling for age, gender, education, BMI, days in the U.S., and habitual physical activity level in Cuba. Results For each 10-point increase in Walk Score, adjusting for covariates, there was a significant 19% increase in the likelihood of purposive walking, a 26% increase in the likelihood of meeting physical activity recommendations by walking, and 27% more minutes walked in the previous week. Conclusions Results suggest that Walk Score is associated with walking in a sample of recent immigrants who initially had little choice in where they lived in the U.S. These results support existing guidelines indicating that mixed land use (such as parks and restaurants near homes) should be included when designing walkable communities. PMID:23867028

  4. Increasing Walking in the Hartsfield-Jackson Atlanta International Airport: The Walk to Fly Study.

    PubMed

    Fulton, Janet E; Frederick, Ginny M; Paul, Prabasaj; Omura, John D; Carlson, Susan A; Dorn, Joan M

    2017-07-01

    To test the effectiveness of a point-of-decision intervention to prompt walking, versus motorized transport, in a large metropolitan airport. We installed point-of-decision prompt signage at 4 locations in the airport transportation mall at Hartsfield-Jackson Atlanta International Airport (Atlanta, GA) at the connecting corridor between airport concourses. Six ceiling-mounted infrared sensors counted travelers entering and exiting the study location. We collected traveler counts from June 2013 to May 2016 when construction was present and absent (preintervention period: June 2013-September 2014; postintervention period: September 2014-May 2016). We used a model that incorporated weekly walking variation to estimate the intervention effect on walking. There was an 11.0% to 16.7% relative increase in walking in the absence of airport construction where 580 to 810 more travelers per day chose to walk. Through May 2016, travelers completed 390 000 additional walking trips. The Walk to Fly study demonstrated a significant and sustained increase in the number of airport travelers choosing to walk. Providing signage about options to walk in busy locations where reasonable walking options are available may improve population levels of physical activity and therefore improve public health.

  5. The effects of sensory loss and walking speed on the orbital dynamic stability of human walking.

    PubMed

    Dingwell, Jonathan B; Kang, Hyun Gu; Marin, Laura C

    2007-01-01

    Peripheral sensory feedback is believed to contribute significantly to maintaining walking stability. Patients with diabetic peripheral neuropathy have a greatly increased risk of falling. Previously, we demonstrated that slower walking speeds in neuropathic patients lead to improved local dynamic stability. However, all subjects exhibited significant local instability during walking, even though no subject fell or stumbled during testing. The present study was conducted to determine if and how significant changes in peripheral sensation and walking speed affect orbital stability during walking. Trunk and lower extremity kinematics were examined from two prior experiments that compared patients with significant neuropathy to healthy controls and walking at multiple different speeds in young healthy subjects. Maximum Floquet multipliers were computed for each time series to quantify the orbital stability of these movements. All subjects exhibited orbitally stable walking kinematics, even though these same kinematics were previously shown to be locally unstable. Differences in orbital stability between neuropathic and control subjects were small and, with the exception of knee joint movements (p=0.001), not statistically significant (0.380p0.946). Differences in knee orbital stability were not mediated by differences in walking speed. This was supported by our finding that although orbital stability improved slightly with slower walking speeds, the correlations between walking speed and orbital stability were generally weak (r(2)16.7%). Thus, neuropathic patients do not gain improved orbital stability as a result of slowing down and do not experience any loss of orbital stability because of their sensory deficits.

  6. Reliability, Agreement and Minimal Detectable Change of the Timed Up & Go and the 10-Meter Walk Tests in Older Patients with COPD.

    PubMed

    Marques, Alda; Cruz, Joana; Quina, Sara; Regêncio, Maria; Jácome, Cristina

    2016-06-01

    This study aimed to determine the interrater and intrarater reliability and agreement and the minimal detectable change (MDC) of the Timed Up & Go (TUG) test and the 10-Meter Walk Test (10MWT) in older patients with Chronic Obstructive Pulmonary Disease (COPD). Patients (≥ 60 years old) living in the community were asked to attend 2 sessions with 48-72-hour interval. In session 1, participants completed the TUG and 10MWT twice (2 trials) and were assessed by 2 raters. In session 2, they repeated the tests twice and were assessed by 1 rater. Interrater and intrarater reliability were calculated for the exact scores (using data from trial 1) and mean scores (mean of 2 trials) using Intraclass Correlation Coefficients (ICC2,1 and ICC2,2, respectively). Interrater and intrarater agreement were explored with the Bland & Altman method. The MDC95 was calculated from the standard error of measurement. Sixty participants (72.43 ± 6.90 years old) completed session 1 and 41 participants session 2. Excellent ICC values were found for the TUG test (interrater: ICC2,1 = 0.997 ICC2,2 = 0.999; intrarater: ICC2,1 = 0.921 ICC2,2 = 0.964) and 10MWT (interrater: ICC2,1 = 0.992 ICC2,2 = 0.997; intrarater: ICC2,1 = 0.903 ICC2,2 = 0.946). Good interrater and intrarater agreement was also found for both tests. The MDC95 was 2.68 s and 1.84 s for the TUG and 0.40 m/s and 0.30 m/s for the 10MWT considering the exact and mean scores, respectively. Findings suggest that the TUG test and the 10MWT are reliable and have acceptable measurement error. Therefore, these measures may be used to assess functional balance (TUG) and gait (10MWT) deficits in older patients with COPD.

  7. Individualized Prediction of Changes in 6-Minute Walk Distance for Patients with Duchenne Muscular Dystrophy

    PubMed Central

    Goemans, Nathalie; vanden Hauwe, Marleen; Signorovitch, James; Swallow, Elyse; Song, Jinlin

    2016-01-01

    Background Deficits in ambulatory function progress at heterogeneous rates among individuals with Duchenne muscular dystrophy (DMD). The resulting inherent variability in ambulatory outcomes has complicated the design of drug efficacy trials and clouded the interpretation of trial results. We developed a prediction model for 1-year change in the six minute walk distance (6MWD) among DMD patients, and compared its predictive value to that of commonly used prognostic factors (age, baseline 6MWD, and steroid use). Methods Natural history data were collected from DMD patients at routine follow up visits approximately every 6 months over the course of 2–5 years. Assessments included ambulatory function and steroid use. The annualized change in 6MWD (Δ6MWD) was studied between all pairs of visits separated by 8–16 months. Prediction models were developed using multivariable regression for repeated measures, and evaluated using cross-validation. Results Among n = 191 follow-up intervals (n = 39 boys), mean starting age was 9.4 years, mean starting 6MWD was 351.8 meters, and 75% had received steroids for at least one year. Over the subsequent 8–16 months, mean Δ6MWD was -37.0 meters with a standard deviation (SD) of 93.7 meters. Predictions based on a composite of age, baseline 6MWD, and steroid use explained 28% of variation in Δ6MWD (R2 = 0.28, residual SD = 79.4 meters). A broadened prognostic model, adding timed 10-meter walk/run, 4-stair climb, and rise from supine, as well as height and weight, significantly improved prediction, explaining 59% of variation in Δ6MWD after cross-validation (R2 = 0.59, residual SD = 59.7 meters). Conclusions A prognostic model incorporating timed function tests significantly improved prediction of 1-year changes in 6MWD. Explained variation was more than doubled compared to predictions based only on age, baseline 6MWD, and steroid use. There is significant potential for composite prognostic models to inform DMD clinical trials

  8. A natural walking monitor for pulmonary patients using mobile phones.

    PubMed

    Juen, Joshua; Cheng, Qian; Schatz, Bruce

    2015-07-01

    Mobile devices have the potential to continuously monitor health by collecting movement data including walking speed during natural walking. Natural walking is walking without artificial speed constraints present in both treadmill and nurse-assisted walking. Fitness trackers have become popular which record steps taken and distance, typically using a fixed stride length. While useful for everyday purposes, medical monitoring requires precise accuracy and testing on real patients with a scientifically valid measure. Walking speed is closely linked to morbidity in patients and widely used for medical assessment via measured walking. The 6-min walk test (6MWT) is a standard assessment for chronic obstructive pulmonary disease and congestive heart failure. Current generation smartphone hardware contains similar sensor chips as in medical devices and popular fitness devices. We developed a middleware software, MoveSense, which runs on standalone smartphones while providing comparable readings to medical accelerometers. We evaluate six machine learning methods to obtain gait speed during natural walking training models to predict natural walking speed and distance during a 6MWT with 28 pulmonary patients and ten subjects without pulmonary condition. We also compare our model's accuracy to popular fitness devices. Our universally trained support vector machine models produce 6MWT distance with 3.23% error during a controlled 6MWT and 11.2% during natural free walking. Furthermore, our model attains 7.9% error when tested on five subjects for distance estimation compared to the 50-400% error seen in fitness devices during natural walking.

  9. Sex-specific predictive power of 6-minute walk test in chronic heart failure is not enhanced using percent achieved of published reference equations.

    PubMed

    Frankenstein, Lutz; Zugck, Christian; Nelles, Manfred; Schellberg, Dieter; Katus, Hugo; Remppis, Andrew

    2008-04-01

    The 6-minute walk test (6MWT) is an established prognostic tool in chronic heart failure. The strong influence of height, weight, age, and sex on 6MWT distance may be accounted for by using percentage achieved of predicted value rather than uncorrected 6MWT values. The study included 1069 patients (862 men) with a mean age 55.2 +/- 11.7 years and mean left ventricular ejection fraction of 29% +/- 10%, attending the heart failure clinic of the University of Heidelberg between 1995 and 2005. The predictive power and accuracy of 6MWT and achieved percentage values according to all available published equations for mortality and mortality or transplant combined were tested separately for each sex. The percentage values varied largely between equations. For all equations, women in New York Heart Association (NYHA) functional class I had higher values than men. Although the 6MWT significantly discriminated all NYHA classes for both sexes, only 1 equation discriminated all NYHA classes. No significant differences in the area under the receiver operating-characteristic curve were noted between achieved percentage values and 6MWT. Despite strong univariate significance, achieved percentage values did not retain multivariate significance. The 6MWT was independent from N-terminal brain natriuretic propeptide, NYHA, left ventricular ejection fraction, and peak oxygen uptake. We confirmed 6MWT to be a strong and independent risk predictor for both sexes. Because the prognostic power of 6MWT is not enhanced using percentage achieved of published reference equations, we suggest recalibration of these reference values rather than discarding this approach.

  10. Community walking speed, sedentary or lying down time, and mortality in peripheral artery disease.

    PubMed

    McDermott, Mary M; Guralnik, Jack M; Ferrucci, Luigi; Tian, Lu; Kibbe, Melina R; Greenland, Philip; Green, David; Liu, Kiang; Zhao, Lihui; Wilkins, John T; Huffman, Mark D; Shah, Sanjiv J; Liao, Yihua; Gao, Ying; Lloyd-Jones, Donald M; Criqui, Michael H

    2016-04-01

    We studied whether slower community walking speed and whether greater time spent lying down or sleeping were associated with higher mortality in people with lower extremity peripheral artery disease (PAD). Participants with an ankle-brachial index (ABI) < 0.90 were identified from Chicago medical centers. At baseline, participants reported their usual walking speed outside their home and the number of hours they spent lying down or sleeping per day. Cause of death was adjudicated using death certificates and medical record review. Analyses were adjusted for age, sex, race, comorbidities, ABI, and other confounders. Of 1314 PAD participants, 189 (14.4%) died, including 63 cardiovascular disease (CVD) deaths. Mean follow-up was 34.9 months ± 18.1. Relative to average or normal pace (2-3 miles/hour), slower walking speed was associated with greater CVD mortality: no walking at all: hazard ratio (HR) = 4.17, 95% confidence interval (CI) = 1.46-11.89; casual strolling (0-2 miles/hour): HR = 2.24, 95% CI = 1.16-4.32; brisk or striding (>3 miles/hour): HR = 0.55, 95% CI = 0.07-4.30. These associations were not significant after additional adjustment for the six-minute walk. Relative to sleeping or lying down for 8-9 hours, fewer or greater hours sleeping or lying down were associated with higher CVD mortality: 4-7 hours: HR = 2.08, 95% CI = 1.06-4.05; 10-11 hours: HR = 4.07, 95% CI = 1.86-8.89; ⩾ 12 hours: HR = 3.75, 95% CI = 1.47-9.62. These associations were maintained after adjustment for the six-minute walk. In conclusion, slower walking speed outside the home and less than 8 hours or more than 9 hours lying down per day are potentially modifiable behaviors associated with increased CVD mortality in patients with PAD. © The Author(s) 2016.

  11. Locomotor sequence learning in visually guided walking.

    PubMed

    Choi, Julia T; Jensen, Peter; Nielsen, Jens Bo

    2016-04-01

    Voluntary limb modifications must be integrated with basic walking patterns during visually guided walking. In this study we tested whether voluntary gait modifications can become more automatic with practice. We challenged walking control by presenting visual stepping targets that instructed subjects to modify step length from one trial to the next. Our sequence learning paradigm is derived from the serial reaction-time (SRT) task that has been used in upper limb studies. Both random and ordered sequences of step lengths were used to measure sequence-specific and sequence-nonspecific learning during walking. In addition, we determined how age (i.e., healthy young adults vs. children) and biomechanical factors (i.e., walking speed) affected the rate and magnitude of locomotor sequence learning. The results showed that healthy young adults (age 24 ± 5 yr,n= 20) could learn a specific sequence of step lengths over 300 training steps. Younger children (age 6-10 yr,n= 8) had lower baseline performance, but their magnitude and rate of sequence learning were the same compared with those of older children (11-16 yr,n= 10) and healthy adults. In addition, learning capacity may be more limited at faster walking speeds. To our knowledge, this is the first study to demonstrate that spatial sequence learning can be integrated with a highly automatic task such as walking. These findings suggest that adults and children use implicit knowledge about the sequence to plan and execute leg movement during visually guided walking.

  12. Submaximal exercise in individuals with stroke: Test-retest reliability and concurrent validity with VO2max

    PubMed Central

    Eng, Janice J; Dawson, Andrew S; Chu, Kelly

    2011-01-01

    Objective The purpose of this study was to establish the test-retest reliability and concurrent validity with maximal oxygen uptake (VO2max) for three submaximal exercise tests in individuals with chronic stroke: 1) submaximal treadmill test, 2) submaximal cycle ergometer test and 3) six minute walk test (6MWT). Design Prospective study using a convenient sample Setting Freestanding tertiary rehabilitation centre Participants 12 community-dwelling individuals who have had a stroke with moderate motor deficits; volunteer sample Main Outcome Measures Heart rate (HR), blood pressure (BP) and oxygen uptake (VO2) were assessed during the exercise tests. Results Test-retest reliability was good to excellent for the exercise tests (maximal and submaximal tests). VO2 for all submaximal measures related to VO2max (r=0.66 to 0.80). Neither the 6MWT distance, self-selected gait speed or hemodynamic measures related to VO2max. Conclusion The VO2 measures of the submaximal exercise tests had excellent reliability and good concurrent validity with VO2max. Submaximal exercise tests may be one potential method of monitoring effects of interventions following a screening test (e.g., symptom-limited graded exercise test, dobutamine stress echocardiograph). PMID:14970978

  13. Walking on music.

    PubMed

    Styns, Frederik; van Noorden, Leon; Moelants, Dirk; Leman, Marc

    2007-10-01

    The present study focuses on the intricate relationship between human body movement and music, in particular on how music may influence the way humans walk. In an experiment, participants were asked to synchronize their walking tempo with the tempo of musical and metronome stimuli. The walking tempo and walking speed were measured. The tempi of the stimuli varied between 50 and 190 beats per minute. The data revealed that people walk faster on music than on metronome stimuli and that walking on music can be modeled as a resonance phenomenon that is related to the perceptual resonance phenomenon as described by Van Noorden and Moelants (Van Noorden, L., & Moelants, D. (1999). Resonance in the perception of musical pulse. Journal of New Music Research, 28, 43-66).

  14. Stability of walking frames.

    PubMed

    Deathe, A B; Pardo, R D; Winter, D A; Hayes, K C; Russell-Smyth, J

    1996-02-01

    Biomechanical tools were used to assess stability for 11 patients who, following the surgical amputation of one lower limb, required the assistance of a walking frame to ambulate. The Walker Tipping Index (WTI), as derived from the forces applied to the walking frame, was developed specifically for this study to examine the relationship between stability and walking frame height during ambulation. However, the WTI may be useful as a criterion of stability to assist clinicians in their evaluation of walker use in a variety of patient populations. Walker stability was examined as subjects, wearing their prostheses, completed 30-sec walking trials in each of the normal, high, and low walking frame height conditions. Adjusting the height of the walker to one setting (3 cm) above or below normal appears to redistribute the load of walking between the upper and lower extremities without adversely affecting stability.

  15. Reduced Gravity Walking Simulator

    NASA Technical Reports Server (NTRS)

    1963-01-01

    A test subject being suited up for studies on the Reduced Gravity Walking Simulator located in the hanger at Langley Research Center. The initial version of this simulator was located inside the hanger. Later a larger version would be located at the Lunar Landing Facility. The purpose of this simulator was to study the subject while walking, jumping or running. Researchers conducted studies of various factors such as fatigue limit, energy expenditure, and speed of locomotion. Francis B. Smith wrote in his paper 'Simulators For Manned Space Research,' 'I would like to conclude this talk with a discussion of a device for simulating lunar gravity which is very effective and yet which is so simple that its cost is in the order of a few thousand dollars at most, rather than hundreds of thousands. With a little ingenuity, one could almost build this type simulator in his backyard for children to play on. The principle is ...if a test subject is suspended in a sling so that his body axis makes an angle of 9 1/2 degrees with the horizontal and if he then 'stands' on a platform perpendicular to his body axis, the component of the earth's gravity forcing him toward the platform is one times the sine of 9 1/2 degrees or approximately 1/6 of the earth's normal gravity field. That is, a 180 pound astronaut 'standing' on the platform would exert a force of only 30 pounds - the same as if he were standing upright on the lunar surface.' Published in James R. Hansen, Spaceflight Revolution: NASA Langley Research Center From Sputnik to Apollo, NASA SP-4308; Francis B. Smith, 'Simulators For Manned Space Research,' Paper for 1966 IEEE International Convention, New York, NY, March 21-25, 1966.

  16. Between-rater reliability of the 6-minute walk test, berg balance scale, and handheld dynamometry in people with multiple sclerosis.

    PubMed

    Toomey, Elaine; Coote, Susan

    2013-01-01

    This study investigated the between-rater reliability of the Berg Balance Scale (BBS), 6-Minute Walk test (6MW), and handheld dynamometry (HHD) in people with multiple sclerosis (MS). Previous studies that examined BBS and 6MW reliability in people with MS have not used more than two raters, or analyzed different mobility levels separately. The reliability of HHD has not been previously reported for people with MS. In this study, five physical therapists assessed eight people with MS using the BBS, 6MW, and HHD, resulting in 12 pairs of data. Data were analyzed using intraclass correlation coefficients (ICCs), Spearman correlation coefficients (SCCs), and Bland and Altman methods. The results suggest excellent agreement for the BBS (SCC = 0.95, mean difference between raters [d̄] = 2.08, standard error of measurement [SEM] = 1.77) and 6MW (ICC = 0.98, d̄ = 5.22 m, SEM = 24.76 m) when all mobility levels are analyzed together. Reliability is lower in less mobile people with MS (BBS SCC = 0.6, d̄ = -1.83; 6MW ICC = 0.95, d̄ = 20.04 m). Although the ICC and SCC results for HHD suggest good-to-excellent reliability (0.65-0.85), d̄ ranges up to 17.83 N, with SEM values as high as 40.95 N. While the small sample size is a limitation of this study, the preliminary evidence suggests strong agreement between raters for the BBS and 6MW and decreased agreement between raters for people with greater mobility problems. The mean differences between raters for HHD are probably too high for it to be applied in clinical practice.

  17. Treadmill walking is not equivalent to overground walking for the study of walking smoothness and rhythmicity in older adults.

    PubMed

    Row Lazzarini, Brandi S; Kataras, Theodore J

    2016-05-01

    Treadmills are appealing for gait studies, but some gait mechanics are disrupted during treadmill walking. The purpose of this study was to examine the effects of speed and treadmill walking on walking smoothness and rhythmicity of 40 men and women between the ages of 70-96 years. Gait smoothness was examined during overground (OG) and treadmill (TM) walking by calculating the harmonic ratio from linear accelerations measured at the level of the lumbar spine. Rhythmicity was quantified as the stride time standard deviation. TM walking was performed at two speeds: a speed matching the natural OG walk speed (TM-OG), and a preferred TM speed (PTM). A dual-task OG condition (OG-DT) was evaluated to determine if TM walking posed a similar cognitive challenge. Statistical analysis included a one-way Analysis of Variance with Bonferroni corrected post hoc comparisons and the Wilcoxon signed rank test for non-normally distributed variables. Average PTM speed was slower than OG. Compared to OG, those who could reach the TM-OG speed (74.3% of sample) exhibited improved ML smoothness and rhythmicity, and the slower PTM caused worsened vertical and AP smoothness, but did not affect rhythmicity. PTM disrupted smoothness and rhythmicity differently than the OG-DT condition, likely due to reduced speed. The use of treadmills for gait smoothness and rhythmicity studies in older adults is problematic; some participants will not achieve OG speed during TM walking, walking at the TM-OG speed artificially improves rhythmicity and ML smoothness, and walking at the slower PTM speed worsens vertical and AP gait smoothness.

  18. Virtually Abelian quantum walks

    NASA Astrophysics Data System (ADS)

    Mauro D'Ariano, Giacomo; Erba, Marco; Perinotti, Paolo; Tosini, Alessandro

    2017-01-01

    We study discrete-time quantum walks on Cayley graphs of non-Abelian groups, focusing on the easiest case of virtually Abelian groups. We present a technique to reduce the quantum walk to an equivalent one on an Abelian group with coin system having larger dimension. This method allows one to extend the notion of wave-vector to the virtually Abelian case and study analytically the walk dynamics. We apply the technique in the case of two quantum walks on virtually Abelian groups with planar Cayley graphs, finding the exact solution in terms of dispersion relation.

  19. The relationship of the 6-min walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease.

    PubMed

    Cahalin, L; Pappagianopoulos, P; Prevost, S; Wain, J; Ginns, L

    1995-08-01

    To assess the relationship of distance ambulated during the 6-min walk test (6'WT) to maximal oxygen consumption (VO2 max). Multivariate analysis of patient characteristics to VO2 max. Pre-lung transplant evaluation. 60 patients (22 men, 38 women; mean age, 44 years) with end-stage lung disease (mean FEV1 and forced vital capacity of 0.97 and 1.93, respectively). The 6'WT was performed on a level hallway surface, and VO2 max was obtained during maximal cycle ergometry exercise testing with respiratory gas analysis. Multivariate analysis of patient characteristics (age, sex, weight, FEV1, FVC, diffusing capacity for carbon monoxide (DCO), 6'WT distance ambulated, number of rests per 6'WT, and the maximal heart rate, blood pressure, rate-pressure product, respiratory rate, oxygen saturation, rating of perceived exertion, and amount of supplemental oxygen used during the 6'WT) was performed on two groups of 30 patients each (group A or B) who were randomly assigned to either group by a process of random selection using a computer-generated random numbers program. Distance ambulated was the strongest independent predictor of VO2 max (r = 0.73; p < 0.0001) in both groups, and adding age, weight, and pulmonary function test results (FVC, FEV1, and DCO) to the regression equation increased the correlation coefficient to 0.83. Because of the significant correlation of distance ambulated during the 6'WT to VO2 max, the prediction equation obtained from the multivariate analysis of group A, VO2 max = 0.006 x distance (feet) +3.38, was used to estimate the VO2 max of the group B patients. No significant difference was observed between the estimated (x +/- SD = 8.9 +/- 2.4 mL/kg/min) and observed (x +/- SD = 9.4 +/- 3.8 mL/kg/min) VO2 max (mean difference, 0.5 mL/kg/min; SD of the difference = 2.88). The distance ambulated during a 6'WT can predict VO2 max in patients with end-stage lung disease. The addition of several patient characteristics can increase the ability to

  20. 013. Complementary role of 6-minutes walking test (6MWT) in the assessment of functional status of patients with chronic obstructive pulmonary disease (COPD)

    PubMed Central

    Mathioudakis, Alexander G.; Evangelopoulou, Efstathia I.; Karapiperis, Georgios C.; Perros, Elias I.; Simou, Georgia; Kiritsi, Evridiki; Chatzimavridou-Grigoriadou, Victoria; Mathioudakis, Georgios A.

    2015-01-01

    Background Despite its limited repeatability, spirometry is the most widely used method of assessment of the pulmonary ventilation. However, it is not a safe measure of the functional reserve of chronic obstructive pulmonary disease (COPD) patients with multiple comorbidities. Consequently, a stress test that would include cardiovascular and neuromuscular variables would be a useful complimentary test. Objective The aim of this observational study was to investigate the correlation between FEV1 and 6MWT, in patients with stable COPD (mean FEV1% pred =43.9%, SD =15.3). Methods 174 male ex-smokers with stable COPD, with a mean age of 63±6.7 years, mean height of 171.4 and weight of 73.9 were included and grouped according to their GOLD severity staging. A control group consisting of 87 healthy volunteers (mean age: 64±6.2, height: 175.2 and weight: 70.5) was also included. All the patient and controls had spirometry before and after bronchodilatation, on a daily scaled turbine spirometer, and 6MWT, on a 10-meter straight corridor. Elapsed distance (eD), haemoglobin saturation (Sats) and heart rate (HR) were continuously monitored during the 6MWT. All the data of our study were imported in an excel sheet for statistical analysis. Results Among the main results of our study, FEV1 decrease by year of age was less pronounced among healthy volunteers (21 mL/year, r2=0.4) compared to COPD patients (53 mL/year, r2=0.06). Similarly, volunteers had a significantly lower decrease by year of age in eD (2.3 m/year, r2=0.4) compared to COPD patients (7.7 m/year, r2=0.7). A more pronounced decrease of eD by year of age was recognized in patients with later COPD stages, while weight was more significantly correlated to eD compared to age. Post-bronchodilatation FEV1 was correlated to eD in COPD patients (r2=0.7); for each 1% decrease in the FEV1, COPD patients also lose approximately 7 m of walking distance in 6MWT. Conclusions 6MWT is a reliable measure of COPD progression and

  1. Analgesic effects of lidocaine, morphine and diclofenac on movement-induced nociception, as assessed by the Knee-Bend and CatWalk tests in a rat model of osteoarthritis.

    PubMed

    Ferreira-Gomes, Joana; Adães, Sara; Mendonça, Marcelo; Castro-Lopes, José Manuel

    2012-06-01

    Pain is the major symptom of osteoarthritis (OA) and the main reason for patients seeking medical care, but its treatment is not optimal. Animal studies are necessary to elucidate mechanisms underlying OA-induced pain and assess analgesics' efficacy. Previously, we showed that the Knee-Bend test and dynamic weight bearing by the CatWalk test are clinically relevant methods for assessing movement-induced nociception in the mono-iodoacetate (MIA) OA model. Using the same tests, in the present study we investigate the effects of lidocaine (5 mg, 10% solution, intra-articular), morphine (6 mg/kg, subcutaneous) and diclofenac (30 mg/kg per os) on nociceptive behavior in OA animals, on days 3 and 20 of OA evolution. Morphine reduced nociceptive behavior in both tests at both time-points. Lidocaine also decreased nociceptive behavior in both tests on day 3, but on day 20 only reduced the Knee-Bend score. Diclofenac was highly effective in both tests on day 3, while on day 20 it induced a less pronounced decrease in the Knee-Bend score and was ineffective in the CatWalk test. The results showed that the Knee-Bend and CatWalk tests are reliable alternative methods for evaluating movement-induced nociception in OA animals, and measure nociception in a clinically relevant way, since an analgesic profile similar to the one described in humans was observed. Therefore, these tests might be important as good predictors of drug efficacy. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. How might we increase physical activity through dog walking?: A comprehensive review of dog walking correlates.