How to Cite
Abstract
The six-minute walk test (6MWT) is a common utility outcome for evaluating exercise capacity in patients with pulmonary diseases. However, there is no existent reference value for Nigerian older adults. This study is therefore aimed at establishing reference values and equations for 45-70 years old Nigerian adults. We consecutively recruited apparently healthy adults into this cross-sectional survey and used standard protocols for 6MWT and anthropometrics. Regression equations were developed based on demographic and anthropomorphic data. These equations were compared to existing prediction equations. One hundred and four participants completed two 6MWT. The average six-minute walk distance (6MWD) was 378 metres; greater in men than women (p<0.001). The 25th and 75th percentiles were 345.10 and 408.18 metres, respectively. The variables that were significantly associated with 6MWD were sex, age and height. We found two explanatory model equations and the model equation for all participants is 6MWD = 297.96 + 47.41 (sex) – 1.001 (age) + 65.214 (height) where female = 0 and male = 1 with explanatory power of 41.3%. Applying other studies’ equations to our population resulted in an underestimation or overestimation of the 6MWD. In conclusion, the average 6MWD in this Nigerian population was 378 metres. Age, height and sex were the most significant predictors of 6MWD and the regression equations explained 41% of the variance in the distance walked. These equations will help to improve evaluation of patients with diseases that affect aerobic capacity.
References
Ajiboye OA, Anigbogu CN, Ajuluchukwu JN, Jaja SI (2014): Prediction equations for 6-minute walk distance in apparently healthy Nigerians. Hong Kong Physiother J 32(2): 65–72.
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002): ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1): 111–117.
Balke B (1963): A simple field test for the assessment of physical fitness. REP 63-6. Rep Civ Aeromed Res Inst US : 1–8.
Balogun MO, Ladipo GO (1989): Cardiovascular responses to maximal treadmill exercise in healthy adult Nigerians. Afr J Med Med Sci 18(2): 109–116.
Bartels B, Groot JF de, Terwee CB (2013): The six-minute walk test in chronic pediatric conditions: a systematic review of measurement properties. Phys Ther 93(4): 529–541.
Ben Saad H, Prefaut C, Tabka Z, Mtir AH, Chemit M, Hassaoune R, Ben Abid T, Zara K, Mercier G, Zbidi A, Hayot M (2009): 6-minute walk distance in healthy North Africans older than 40 years: influence of parity. Respir Med 103(1): 74–84.
Bourahli M-K, Bougrida M, Martani M, Mehdioui H, Ben Saad H (2016): 6-Min walk-test data in healthy North-African subjects aged 16–40years. Egypt J Chest Dis Tuberc 65(1): 349–360.
Britto RR, Probst VS, Andrade AFD de, Samora GAR, Hernandes NA, Marinho PEM, Karsten M, Pitta F, Parreira VF (2013): Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther 17(6): 556–563.
Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM (1982): Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J Clin Res Ed 284(6329): 1607–1608.
Casas A, Vilaro J, Rabinovich R, Mayer A, Barberà JA, Rodriguez-Roisin R, Roca J (2005): Encouraged 6-min walking test indicates maximum sustainable exercise in COPD patients. Chest 128(1): 55–61.
Cooper KH (1968): A means of assessing maximal oxygen intake. Correlation between field and treadmill testing. JAMA 203(3): 201–204.
Fernandes L, Mesquita AM, Vadala R, Dias A (2016): Reference Equation for Six Minute Walk Test in Healthy Western India Population. J Clin Diagn Res JCDR 10(5): CC01–CC04.
G * Power 3.1 manual (2020) https://gpower.hhu.de/fileadmin/redaktion/Fakultaeten/Mathematisch Naturwissenschaftliche_Fakultaet/Psychologie/AAP/gpower/GPowerManual.pdf. Accessed January 8, 2021.
Gremeaux V, Troisgros O, Benaïm S, Hannequin A, Laurent Y, Casillas J-M, Benaïm C (2011): Determining the minimal clinically important difference for the six-minute walk test and the 200-meter fast-walk test during cardiac rehabilitation program in coronary artery disease patients after acute coronary syndrome. Arch Phys Med Rehabil 92(4): 611–619.
Guyatt GH, Pugsley SO, Sullivan MJ, Thompson PJ, Berman L, Jones NL, Fallen EL, Taylor DW (1984): Effect of encouragement on walking test performance. Thorax 39(11): 818–822.
Halliday SJ, Wang L, Yu C, Vickers BP, Newman JH, Fremont RD, Huerta LE, Brittain EL, Hemnes AR (2020): Six-minute walk distance in healthy young adults. Respir Med 165: 105933.
Heresi GA, Dweik RA (2011): Strengths and limitations of the six-minute-walk test: a model biomarker study in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 183(9): 1122–1124.
Iwama AM, Andrade GN, Shima P, Tanni SE, Godoy I, Dourado VZ (2009): The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects. Braz J Med Biol Res 42(11): 1080–1085.
Kim AL, Kwon JC, Park I, Kim JN, Kim JM, Jeong BN, Yu SK, Lee BK, Kim YJ (2014): Reference equations for the six-minute walk distance in healthy korean adults, aged 22-59 years. Tuberc Respir Dis 76(6): 269–275.
Klepper SE, Muir N (2011): Reference values on the 6-minute walk test for children living in the United States. Pediatr Phys Ther Off Publ Sect Pediatr Am Phys Ther Assoc 23(1): 32–40.
Mbada CE, Jaiyeola OA, Johnson OE, Dada OO, Ogundele AO, Awotidebe TO, Akinwande OA (2015): Reference Values for Six Minute Walk Distance in Apparently Healthy Young Nigerian Adults (Age 18-35 Years). Int J Sports Sci 5(1): 19–26.
McGavin CR, Gupta SP, McHardy GJ (1976): Twelve-minute walking test for assessing disability in chronic bronchitis. Br Med J 1(6013): 822–823.
Oliveira MJ, Marçôa R, Moutinho J, Oliveira P, Ladeira I, Lima R, Guimarães M (2019): Reference equations for the 6-minute walk distance in healthy Portuguese subjects 18-70 years old. Pulmonology 25(2): 83–89.
Pitta F, Troosters T, Spruit MA, Probst VS, Decramer M, Gosselink R (2005): Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 171(9): 972–977.
Poh H, Eastwood PR, Cecins NM, Ho KT, Jenkins SC (2006): Six-minute walk distance in healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations. Respirol Carlton Vic 11(2): 211–216.
Polkey MI, Spruit MA, Edwards LD, Watkins ML, Pinto-Plata V, Vestbo J, Calverley PMA, Tal-Singer R, Agustí A, Bakke PS, Coxson HO, Lomas DA, et al. (2013): Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization. Am J Respir Crit Care Med 187(4): 382–386.
Shoemaker MJ, Curtis AB, Vangsnes E, Dickinson MG (2013): Clinically meaningful change estimates for the six-minute walk test and daily activity in individuals with chronic heart failure. Cardiopulm Phys Ther J 24(3): 21–29.
Tsang RCC (2005): Reference Values for 6-Minute Walk Test and Hand-Grip Strength in Healthy Hong Kong Chinese Adults. Hong Kong Physiother J 23(1): 6–12.
Ubuane PO, Animasahun BA, Ajiboye OA, Kayode-Awe MO, Ajayi OA, Njokanma FO (2018): The historical evolution of the six-minute walk test as a measure of functional exercise capacity: a narrative review. J Xiangya Med 3(0).
Zhang Q, Lu H, Pan S, Lin Y, Zhou K, Wang L (2017): 6MWT Performance and its Correlations with VO₂ and Handgrip Strength in Home-Dwelling Mid-Aged and Older Chinese. Int J Environ Res Public Health 14(5).
Zou H, Zhang J, Chen X, Wang Y, Lin W, Lin J, Chen H, Pan J (2017a): Reference Equations for the Six-Minute Walk Distance in the Healthy Chinese Han Population, Aged 18-30 Years. BMC Pulm Med 17(1): 119.
Zou H, Zhang J, Zou Y, Chen X, Wang Y, Chen H, Ye F, Yu H (2020): Six-minute walking distance in healthy Chinese people older than 60 years. BMC Pulm Med 20(1): 177.
Zou H, Zhu X, Zhang J, Wang Y, Wu X, Liu F, Xie X, Chen X (2017b): Reference equations for the six-minute walk distance in the healthy Chinese population aged 18-59 years. PloS One 12(9): e0184669.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 African Journal of Biomedical Research