Can the 6-minute walking test evaluate all patients with respiratory disease?

Authors

  • Marta R. Q. Pimentel Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Yves Raphael Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Luciane V. B. Nascimento Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Rogério Rufino Pneumology Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Adalgisa Maiworm Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Kenia Maynard da Silva Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Cláudia Henrique da Costa Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

DOI:

https://doi.org/10.12957/bjhbs.2019.53507

Abstract

The 6-minute walking test (6MWT) is a submaximal test
used as a clinical indicator of functional capacity in patients
with pulmonary disease. However, is has not been defined
whether the parameters obtained in the 6MWT are similar
in two groups of interstitial lung diseases (ILD), systemic sclerosis
(SSc) and idiopathic pulmonary fibrosis (IPF), and what
are the differences when compared to patients with chronic
obstructive pulmonary disease (COPD). This is a comparative
cross-sectional study of 6MWT data, with the inclusion of 32
patients with SSc, 32 with IPF and 50 with COPD. All patients
underwent the 6MWT and a respiratory function test. Patients
with ILD did not present significant differences when compared
with each other. However, when compared to patients
with COPD, the ILD group showed greater distance walked
(ILD = 404.6 ± 1.09m, COPD = 352.4 ± 10.80m; p = 0.0033) and
predicted percentage above 100% (ILD = 113.5 ± 3.72%, COPD
= 84.36 ± 4.81%; p <0.0001). Both groups showed a drop in
blood oxygen saturation (SaO2) at the end of the test, but the
difference between the measured values before and after the
6MWT was more significant in the ILD group (ILD = 10.33 ±
01.09%, COPD = 4.60 ± 12.37%; p <0.0001). The data suggest
that, differently from COPD patients, the main parameter to
be evaluated during the 6MWT in the ILD group could be the
drop in saturation and not the distance walked.


Keywords: COPD; Lung diseases, Interstitial; Respiratory
Function Tests; Walk Test; Walking.

Author Biographies

Marta R. Q. Pimentel, Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Yves Raphael, Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Luciane V. B. Nascimento, Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Respiratory Department, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Rogério Rufino, Pneumology Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Pneumology Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro,
Brazil.

Adalgisa Maiworm, Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Respiratory Department, University Hospital of Rio de Janeiro
State University, Rio de Janeiro State University, Rio de Janeiro,
Brazil.

Kenia Maynard da Silva, Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Cláudia Henrique da Costa, Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Respiratory Department, University Hospital of Rio de Janeiro State University, Rio de Janeiro State University, Rio de Janeiro, Brazil.

References

Denton CP. Advances in pathogenesis and treatment of systemic

sclerosis. Clin Med. 2016;16(1):55–60.

Cappelli S, Bellando Randone S, Camiciottoli G, et al. Interstitial

lung disease in systemic sclerosis: where do we stand? Eur

Respir Rev. 2015 Sep;24(137):411–9.

Rubio-Rivas M, Royo C, Simeón CP, Corbella X, et al. Mortality

and survival in systemic sclerosis: systematic review and meta-

analysis. Semin Arthritis Rheum. 2014 Oct;44(2):208–19.

Sgalla G, Biffi A, Richeldi L. Idiopathic pulmonary fibrosis:

Diagnosis, epidemiology and natural history. Respirology. 2016

Apr;21(3):427–37.

Baddini-Martinez J, Baldi BG, Costa CH da, et al. Update on

diagnosis and treatment of idiopathic pulmonary fibrosis. J

Bras Pneumol. 2015 Sep;41(5):454–66.

Crisafulli E, Torres A. COPD 2017: A Year in Review. COPD:

Journal of Chronic Obstructive Pulmonary Disease. 2018;1–5.

Celli BR, MacNee W, Agusti A, et al. Standards for the diagnosis

and treatment of patients with COPD: a summary of the

ATS/ERS position paper. Eur Respir J. 2004;23(6):932–46.

da Costa CH, da Silva KM, Maiworm A, et al. Can we use the

-minute step test instead of the 6-minute walking test? An

observational study. Physiotherapy. 2017;103(1):48–52.

Rostagno C. 6MWT Predicts Survival Better Than CPET in

Patients with Stable Cardiomyopathy. Br J Med Med Res.

;2(3):386–95.

van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification

criteria for systemic sclerosis: an American College of

Rheumatology/European League against Rheumatism collaborative

initiative. Arthritis Rheum. 2013 Nov;65(11):2737–47.

Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/

ALAT statement: idiopathic pulmonary fibrosis: evidence-based

guidelines for diagnosis and management. Am J Respir Crit

Care Med. 2011 Mar 15;183(6):788–824.

‘Global Strategy for the Diagnosis, Management, and Prevention

of Chronic Obstructive Lung Disease 2017 Report: GOLD

Executive Summary.’ Vogelmeier CF, Criner GJ, Martinez

FJ, et al. Eur Respir J 2017; 49: 1700214. Eur Respir J.

;49(6):1750214.

ATS Committee on Proficiency Standards for Clinical Pulmonary

Function Laboratories. ATS statement: guidelines for the

six-minute walk test. Am J Respir Crit Care Med. 2002 Jul

;166(1):111–7.

The Borg Rating of Perceived Exertion (RPE) Scale. In: Care of

the Obese in Advanced Practice Nursing.

Enright PL, Sherrill DL. Reference Equations for the Six-Minute

Walk in Healthy Adults. Am J Respir Crit Care Med.

;158(5):1384–7.

Crisafulli E, Iattoni A, Venturelli E, et al. Predicting Walking-Induced

Oxygen Desaturations in COPD Patients: A Statistical

Model. Respir Care. 2013;58(9):1495–503.

Waatevik M, Johannessen A, Real FG, et al. Oxygen desaturation

in 6-min walk test is a risk factor for adverse outcomes in

COPD. Eur Respir J. 2016;48(1):82–91.

Godfrey S, Bluestone R, Higgs BE. Lung function and

the response to exercise in systemic sclerosis. Thorax.

;24(4):427–34.

Park JH, Jegal Y, Shim TS, et al. Hypoxemia and arrhythmia

during daily activities and six-minute walk test in fibrotic interstitial

lung diseases. J Korean Med Sci. 2011 Mar;26(3):372–8.

Buch MH, Denton CP, Furst DE, et al. Submaximal exercise

testing in the assessment of interstitial lung disease secondary

to systemic sclerosis: reproducibility and correlations of the

-min walk test. Ann Rheum Dis. 2007 Feb;66(2):169–73.

Lederer DJ, Arcasoy SM, Wilt JS, et al. Six-minute-walk

distance predicts waiting list survival in idiopathic pulmonary fibrosis.

Am J Respir Crit Care Med. 2006 Sep 15;174(6):659–64.

Manali ED, Lyberopoulos P, Triantafillidou C, et al. MRC chronic

Dyspnea Scale: Relationships with cardiopulmonary exercise

testing and 6-minute walk test in idiopathic pulmonary fibrosis

patients: a prospective study. BMC Pulm Med. 2010 May

;10:32.

Verma G, Marras T, Chowdhury N, et al. Health-related quality

of life and 6 min walk distance in patients with idiopathic pulmonary

fibrosis. Can Respir J. 2011 Sep;18(5):283–7.

Schoindre Y, Meune C, Dinh-Xuan AT, et al. Lack of specificity

of the 6-minute walk test as an outcome measure for patients

with systemic sclerosis. J Rheumatol. 2009 Jul;36(7):1481–5.

Caminati A, Bianchi A, Cassandro R, et al. Walking distance on

-MWT is a prognostic factor in idiopathic pulmonary fibrosis.

Respir Med. 2009 Jan;103(1):117–23.

Flaherty KR, Andrei A-C, Murray S, et al. Idiopathic pulmonary

fibrosis: prognostic value of changes in physiology and

six-minute-walk test. Am J Respir Crit Care Med. 2006 Oct

;174(7):803–9.

Rasekaba T, Lee AL, Naughton MT, et al. The six-minute walk

test: a useful metric for the cardiopulmonary patient. Intern

Med J. 2009 Aug;39(8):495–501.

Villalba WO, Sampaio-Barros PD, Pereira MC, et al. Six-minute

walk test for the evaluation of pulmonary disease severity in

scleroderma patients. Chest. 2007 Jan;131(1):217–22.

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Published

2019-12-04

How to Cite

Pimentel, M. R. Q., Raphael, Y., Nascimento, L. V. B., Rufino, R., Maiworm, A., da Silva, K. M., & da Costa, C. H. (2019). Can the 6-minute walking test evaluate all patients with respiratory disease?. Brazilian Journal of Health and Biomedical Sciences, 18(2), 136–146. https://doi.org/10.12957/bjhbs.2019.53507

Issue

Vol. 18 No. 2 (2019)

Section

Original Papers

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