Normative values in healthy adults for the 6-minute and 2-minute walk tests in Belgium and Vietnam: implications for clinical practice

Authors

  • Duy Thanh Nguyen Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam; Faculty of Motricity Sciences, Université Libre de Bruxelles, Belgium
  • Massimo Penta Institute of NeuroScience, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Arsalis, Glabais, Belgium
  • Claire Questienne Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
  • Johanne Garbusinski Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
  • Chinh Van Nguyen Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
  • Chloé Sauvage Faculty of Motricity Sciences, Université Libre de Bruxelles, Belgium; Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium

DOI:

https://doi.org/10.2340/jrm.v56.18628

Keywords:

Reference values, Rehabilitation, Walk test, healthy subjects, geographic variability

Abstract

Objective: To establish reference values for the 6-minute walk test (6MWT) and 2-minute walk test (2MWT) distances, to investigate the correlation between these 2 tests, and to establish prediction equations for these distances in healthy populations of Belgium and Vietnam.

Design: Cross-sectional study.

Subjects and methods: The 6MWT and 2MWT were administered to a convenience sample of 239 Belgian and 303 Vietnamese participants between the ages of 18 and 80 years.

Results: The mean (standard deviation; SD) 2MWT distances were 215 (32.8) m for Belgian participants and 156 (25.5) m for Vietnamese participants. The mean (SD) 6MWT distances were 625 (90.7) m for Belgian participants and 449 (70.4) m for Vietnamese participants. The Pearson correlation coefficient between the 2 tests was 0.901 (p < 0.001) for Belgian participants and 0.871 (p < 0.001) for Vietnamese participants. Age and sex were the 2 most important predictors of walking distance, followed by body mass index for Belgium and height for Vietnam. The adjusted R² ranged from 0.31 to 0.49 across 4 predictive equations.

Conclusion: These results can be used to determine the presence of walking performance deficits and to guide future studies. The 2MWT is suggested as a useful and convenient alternative to the 6MWT for assessing walking performance in clinical practice.

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References

Butland R, Pang J, Gross E, Woodcock A, Geddes D. Two-, six-, and 12-minute walking tests in respiratory disease. BMJ 1982; 284: 1607-1608.

https://doi.org/10.1136/bmj.284.6329.1607 DOI: https://doi.org/10.1136/bmj.284.6329.1607

Enright PL. The six-minute walk test. Respir Care 2003; 48: 783-785.

https://doi.org/10.1164/ajrccm.167.9.950 DOI: https://doi.org/10.1164/ajrccm.167.9.950

Macchiavelli A, Giffone A, Ferrarello F, Paci M. Reliability of the six-minute walk test in individuals with stroke: systematic review and meta-analysis. Neurol Sci 2020; 42: 81-87.

https://doi.org/10.1007/s10072-020-04829-0 DOI: https://doi.org/10.1007/s10072-020-04829-0

Andersen LK, Knak KL, Witting N, Vissing J. Two-and 6-minute walk tests assess walking capability equally in neuromuscular diseases. Neurology 2016; 86: 442-445.

https://doi.org/10.1212/WNL.0000000000002332 DOI: https://doi.org/10.1212/WNL.0000000000002332

Scalzitti DA, Harwood KJ, Maring JR, Leach SJ, Ruckert EA, Costello E. Validation of the 2-minute walk test with the 6-minute walk test and other functional measures in persons with multiple sclerosis. Int J MS Care 2018; 20: 158-163.

https://doi.org/10.7224/1537-2073.2017-046 DOI: https://doi.org/10.7224/1537-2073.2017-046

Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev 2005; 42: 103-107.

https://doi.org/10.1682/JRRD.2003.11.0171 DOI: https://doi.org/10.1682/JRRD.2003.11.0171

Reid L, Thomson P, Besemann M, Dudek N. Going places: does the two-minute walk test predict the six-minute walk test in lower extremity amputees? J Rehabil Med 2015; 47: 256-261.

https://doi.org/10.2340/16501977-1916 DOI: https://doi.org/10.2340/16501977-1916

Salbach NM, O'Brien KK, Brooks D, Irvin E, Martino R, Takhar P, et al. Reference values for standardized tests of walking speed and distance: a systematic review. Gait Posture 2015; 41: 341-360.

https://doi.org/10.1016/j.gaitpost.2014.10.002 DOI: https://doi.org/10.1016/j.gaitpost.2014.10.002

Selman JP, de Camargo AA, Santos J, Lanza FC, Dal Corso S. Reference equation for the 2-minute walk test in adults and the elderly. Respir Care 2014; 59: 525-530.

https://doi.org/10.4187/respcare.02649 DOI: https://doi.org/10.4187/respcare.02649

Bohannon RW, Wang Y-C, Gershon RC. Two-minute walk test performance by adults 18 to 85 years: normative values, reliability, and responsiveness. Arch Phys Med Rehabil 2015; 96: 472-477.

https://doi.org/10.1016/j.apmr.2014.10.006 DOI: https://doi.org/10.1016/j.apmr.2014.10.006

Tveter AT, Dagfinrud H, Moseng T, Holm I. Health-related physical fitness measures: reference values and reference equations for use in clinical practice. Arch Phys Med Rehabil 2014; 95: 1366-1373.

https://doi.org/10.1016/j.apmr.2014.02.016 DOI: https://doi.org/10.1016/j.apmr.2014.02.016

Oliveira MJ, Marçôa R, Moutinho J, Oliveira P, Ladeira I, Lima R, et al. Reference equations for the 6-minute walk distance in healthy Portuguese subjects 18-70 years old. Pulmonology 2019; 25: 83-89.

https://doi.org/10.1016/j.pulmoe.2018.04.003 DOI: https://doi.org/10.1016/j.pulmoe.2018.04.003

Tsang RC. Reference values for 6-minute walk test and hand-grip strength in healthy Hong Kong Chinese adults. Hong Kong Physiother J 2005; 23: 6-12.

https://doi.org/10.1016/S1013-7025(09)70053-3 DOI: https://doi.org/10.1016/S1013-7025(09)70053-3

El-Sobkey SB. Influence of physical activity level on Saudi reference values of 6-minute walk test. MEJSR 2013; 16: 164-171.

https://doi.org/10.1016/j.jsha.2013.03.158 DOI: https://doi.org/10.1016/j.jsha.2013.03.158

Thaweewannakij T, Wilaichit S, Chuchot R, Yuenyong Y, Saengsuwan J, Siritaratiwat W, et al. Reference values of physical performance in Thai elderly people who are functioning well and dwelling in the community. Phys Ther 2013; 93: 1312-1320.

https://doi.org/10.2522/ptj.20120411 DOI: https://doi.org/10.2522/ptj.20120411

Priya TK, Verma S. A study to determine the reference values for two minute walk distance in healthy Indian adults. IJPR 2015; 3: 1208-1214.

https://doi.org/10.16965/ijpr.2015.178 DOI: https://doi.org/10.16965/ijpr.2015.178

Zhang J, Chen X, Huang S, Wang Y, Lin W, Zhou R, et al. Two-minute walk test: Reference equations for healthy adults in China. PLoS One 2018; 13: e0201988.

https://doi.org/10.1371/journal.pone.0201988 DOI: https://doi.org/10.1371/journal.pone.0201988

Zou H, Zhu X, Zhang J, Wang Y, Wu X, Liu F, et al. Reference equations for the six-minute walk distance in the healthy Chinese population aged 18-59 years. PLoS One 2017; 12: e0184669.

https://doi.org/10.1371/journal.pone.0184669 DOI: https://doi.org/10.1371/journal.pone.0184669

Camarri B, Eastwood PR, Cecins NM, Thompson PJ, Jenkins S. Six minute walk distance in healthy subjects aged 55-75 years. Respir Med 2006; 100: 658-665.

https://doi.org/10.1016/j.rmed.2005.08.003 DOI: https://doi.org/10.1016/j.rmed.2005.08.003

Jenkins S, Cecins N, Camarri B, Williams C, Thompson P, Eastwood P. Regression equations to predict 6-minute walk distance in middle-aged and elderly adults. Physiother Theory Pract 2009; 25: 516-522. DOI: https://doi.org/10.1080/09593980802664711

https://doi.org/10.3109/09593980802664711 DOI: https://doi.org/10.3109/09593980802664711

Saad HB, Prefaut C, Tabka Z, Mtir AH, Chemit M, Hassaoune R, et al. 6-minute walk distance in healthy North Africans older than 40 years: influence of parity. Respir Med 2009; 103: 74-84

https://doi.org/10.1016/j.rmed.2008.07.023 DOI: https://doi.org/10.1016/j.rmed.2008.07.023

Poh H, Eastwood PR, Cecins NM, Ho KT, Jenkins SC. Six-minute walk distance in healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations. Respirology 2006; 11: 211-216.

https://doi.org/10.1111/j.1440-1843.2006.00820.x DOI: https://doi.org/10.1111/j.1440-1843.2006.00820.x

Casanova C, Celli B, Barria P, Casas A, Cote C, De Torres J, et al. The 6-min walk distance in healthy subjects: reference standards from seven countries. Eur Respir J 2011; 37: 150-156.

https://doi.org/10.1183/09031936.00194909 DOI: https://doi.org/10.1183/09031936.00194909

Mirza FT, Jenkins S, Justine M, Cecins N, Hill K. Regression equations to estimate the 2-min walk distance in an adult Asian population aged 40-75 years. Respirology 2018; 23: 674-680.

https://doi.org/10.1111/resp.13262 DOI: https://doi.org/10.1111/resp.13262

ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111-117.

https://doi.org/10.1164/ajrccm.166.1.at1102 DOI: https://doi.org/10.1164/ajrccm.166.1.at1102

Eiser N, Willsher D, Dore C. Reliability, repeatability and sensitivity to change of externally and self-paced walking tests in COPD patients. Respir Med 2003; 97: 407-414.

https://doi.org/10.1053/rmed.2002.1462 DOI: https://doi.org/10.1053/rmed.2002.1462

Wu G, Sanderson B, Bittner V. The 6-minute walk test: how important is the learning effect? Am Heart J 2003; 146: 129-133.

https://doi.org/10.1016/S0002-8703(03)00119-4 DOI: https://doi.org/10.1016/S0002-8703(03)00119-4

Portney LG, Watkins MP. Foundations of clinical research: applications to practice: Pearson/Prentice Hall Upper Saddle River, NJ; 2009.

https://doi.org/10.1016/S0039-6257(02)00362-4 DOI: https://doi.org/10.1016/S0039-6257(02)00362-4

Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 2010; 19: 539-549.

https://doi.org/10.1007/s11136-010-9606-8 DOI: https://doi.org/10.1007/s11136-010-9606-8

Alameri H, Al-Majed S, Al-Howaikan A. Six-min walk test in a healthy adult Arab population. Respir Med 2009; 103: 1041-1046.

https://doi.org/10.1016/j.rmed.2009.01.012 DOI: https://doi.org/10.1016/j.rmed.2009.01.012

Werkman A, Deurenberg-Yap M, Schmidt G, Deurenberg P. A comparison between composition and density of the fat-free mass of young adult Singaporean Chinese and Dutch Caucasians. Ann Nutr Metab 2000; 44: 235-242.

https://doi.org/10.1159/000046690 DOI: https://doi.org/10.1159/000046690

Bohannon RW, Bubela D, Magasi S, McCreath H, Wang Y-C, Reuben D, et al. Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six-Minute Walk Test. BMC Res Notes 2014; 7: 1-6.

https://doi.org/10.1186/1756-0500-7-269 DOI: https://doi.org/10.1186/1756-0500-7-269

Zhang J, Zou Y, Wang Z, Chen X, Pan J, Yu H, et al. Two-minute walk distance reference equations for middle-aged and elderly Chinese individuals with obesity. PLoS One 2022; 17: e0273550.

https://doi.org/10.1371/journal.pone.0273550 DOI: https://doi.org/10.1371/journal.pone.0273550

Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee I-M, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. 2011; 43: 1334-1359.

https://doi.org/10.1249/MSS.0b013e318213fefb DOI: https://doi.org/10.1249/MSS.0b013e318213fefb

Rütten A, Ziemainz H, Schena F, Stahl T, Stiggelbout M, Auweele YV, et al. Using different physical activity measurements in eight European countries. Results of the European Physical Activity Surveillance System (EUPASS) time series survey. Public Health Nutr 2003; 6: 371-376.

https://doi.org/10.1079/PHN2002450 DOI: https://doi.org/10.1079/PHN2002450

Tran DV, Lee AH, Au TB, Nguyen CT, Hoang DV. Reliability and validity of the International Physical Activity Questionnaire-Short Form for older adults in Vietnam. Health Promot J Austr 2013; 24: 126-131.

https://doi.org/10.1071/HE13012 DOI: https://doi.org/10.1071/HE13012

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Published

2024-03-19

How to Cite

Nguyen , D. T., Penta, M., Questienne, C., Garbusinski, J., Nguyen, C. V., & Sauvage, C. (2024). Normative values in healthy adults for the 6-minute and 2-minute walk tests in Belgium and Vietnam: implications for clinical practice. Journal of Rehabilitation Medicine, 56, jrm18628. https://doi.org/10.2340/jrm.v56.18628

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Vol. 56 (2024)

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Original Report

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Copyright (c) 2024 Duy Thanh Nguyen , Massimo Penta, Claire Questienne, Johanne Garbusinski, Chinh Van Nguyen, Chloé Sauvage

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