Using the six minute walk test to evaluate walking capacity in patients with stroke
DOI:
https://doi.org/10.5935/0104-7795.20140038Keywords:
Stroke, Hemiplegia, Mobility Limitation, WalkingAbstract
The 6-minute walk test (6MWT) measures the maximum distance that a person can walk in 6 minutes. The test is gaining popularity because it assesses the functional capacity of different patients and is considered a simple, safe, valid, inexpensive, and noninvasive cardiopulmonary test. Objective: The aim of this review was to investigate the applicability of the six-minute walk test in stroke survivors. Method: A literature search of MedLine (PubMed) databases dating from January 1, 2000 to April 16, 2013 was performed. The search terms used were stroke (or cerebrovascular accident or hemiplegia) and walking (mobility limitation). Author number one reviewed the titles and/or abstracts of displayed articles and determined their relevance to this review. Full text copies of relevant articles were obtained. Reference lists were screened for identification of other relevant articles. Only articles written in English were included in this review. Results: The 31 included studies were divided into 9 randomized controlled trials, 2 case-control studies, 5 prospective studies, and 15 cross-sectional studies and involved 1,824 surviving stroke patients, 146 healthy controls, and 38 Multiple Sclerosis patients. Conclusion: The 6MWT is useful in evaluating de functional capacity of patients with stroke, however, it should be used along with other assessment tools to determine the general profile of these patients. More studies are necessary to verify the factors that influence the test results and as a way to supplement them.
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Ng SS, Yu PC, To FP, Chung JS, Cheung TH. Effect of walkway length and turning direction on the distance covered in the 6-minute walk test among adults over 50 years of age: a cross sectional study. Physiotherapy. 2013;99(1):63-70. DOI: http://dx.doi.org/10.1016/j.physio.2011.11.005
Papathanasiou JV, Ilieva E, Marinov B. Six-minute walk test: an effective and necessary tool in modern cardiac rehabilitation. Hellenic J Cardiol. 2013;54(2):126-30.
Witham MD, Sugden JA, Sumukadas D, Dryburgh M, McMurdo ME. A comparison of the Endurance Shuttle Walk test and the Six Minute Walk test for assessment of exercise capacity in older people. Aging Clin Exp Res. 2012;24(2):176-80.
Hsu CH, Glassner C, Foremann AJ, Agarwal R, Benza RJ, Frantz RP, et al. Treadmill testing improves survival prediction models in pulmonar arterial hupertension. Am Heart J. 2011; 162(6):1011-7. DOI: http://dx.doi.org/10.1016/j.ahj.2011.09.015
Rao RS, Singh S, Shama BB, Agawal W, Singh V. Sildenafil imporeves six-minute walk distance in chronica obstrutive pulmonar disease: a randomized, double-blind, placebo-controlled trial. Indian J Chest Dis Allied Sci. 2011; 53(2):81-85.
Adedoyin RA, Adeyanju SA, Balogun MO, Adebayo RA, Akintomide AO, Akinwusi PO. Prediction of functional capacity during six-minute walk among patients with chronic heart failure. Niger J Clin Pract. 2010;13(4):379-81.
Dalgas U, Severinsen K, Overgaard K. Relations between 6 minute walking distance and 10 meter walking speed in patients with multiple sclerosis and stroke. Arch Phys Med Rehabil. 2012;93(7):1167-72. DOI: http://dx.doi.org/10.1016/j.apmr.2012.02.026
Scalzo PA, Flores CR, Marques JR, Robini SCC, Teixeira AL. Impact of changes in balance and walking capacity on the quality of life in patients with Parkinson's disease. Arq Neriopsiquiatr 2012;70(2):119-24. DOI: http://dx.doi.org/10.1590/S0004-282X2012000200009
Wevers LE, Kwakkel G, van de Port IG. Is outdoor use of the six-minute walk test with a global positioning system in stroke patients' own neighbourhoods reproducible and valid? J Rehabil Med. 2011;43(11):1027-31.
Tseng BY, Kluding P. The relationship between fatigue, aerobic fitness, and motor control in people with chronic stroke: a pilot study. J Geriatr Phys Ther. 2009;32(3):97-102. DOI: http://dx.doi.org/10.1519/00139143-200932030-00003
Kang HK, Kim Y, Chung Y, Hwang S. Effects of treadmill training with optic flow on balance and gait in individuals following stroke: randomized controlled trials. Clin Rehabil. 2012;26(3):246-55. DOI: http://dx.doi.org/10.1177/0269215511419383
Lam JM, Globas C, Cerny J, Hertler B, Uludag K, Forrester LW, et al. Predictores of response to treadmill exercise stroke. Neurorehabil Neural Repair. 2010;24(6):567-74. DOI: http://dx.doi.org/10.1177/1545968310364059
Mayo NE, Mackay-Lyons MJ, Scott SC, Moriello C, Brophy J. A randomized trial of two home based exercise programmes to improve functional walking post-stroke. Clin Rehabil. 2013;27(7):659-71. DOI: http://dx.doi.org/10.1177/0269215513476312
Monticone M, Ambrosini E, Ferrante S, Colombo R. 'Regent Suit' training improves recovery of motor and daily living activities in subjects with subacute stroke: a randomized controlled trial. Clin Rehabil. 2013;27(9):792-802. DOI: http://dx.doi.org/10.1177/0269215513478228
Globas C, Becker C, Cerny J, Lam JM, Lindemann U, Forrester LW, et al. Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized control trial. Neurorehabil Neural Repair. 2012;26(1):85-95. DOI: http://dx.doi.org/10.1177/1545968311418675
Brock K, Haase G, Rothacher G, Cotton S. 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. Clin Rehabil. 2011;25(10):903-12. DOI: http://dx.doi.org/10.1177/0269215511406557
Kuys SS, Brauer SG, Ada L. Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: a pilot randomized trial. Clin Rehabil. 2011;25(4):316-26. DOI: http://dx.doi.org/10.1177/0269215510382928
Langhammer B, Stanghelle JK. Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke. Clin Rehabil. 2010;24(1):46-54. DOI: http://dx.doi.org/10.1177/0269215509343328
Blennerhassett J, Dite W. Additional task-related practice improves mobility and upper limb function early after stroke: a randomised controlled trial. Aust J Physiother. 2004;50(4):219-24. DOI: http://dx.doi.org/10.1016/S0004-9514(14)60111-2
Rose DK, Behrman AL, Nadeau SE, Martin AD, Schofield RS, Tilson JK, et al. Does exercise tolerance testing at 60 days poststroke predict rehabilitation performance? Arch Phys Med Rehabil. 2013;94(7):1223-9.
Carroll SL, Greig CA, Lewis SJ, McMurdo ME, Sniehotta FF, Johnston M, et al. The use of pedometers in stroke survivors: are they feasible and how well do they detect steps? Arch Phys Med Rehabil. 2012;93(3):466-70.
Mehrholz J, Wagner K, Rutte K, Meissner D, Pohl M. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88(10):1314-9. DOI: http://dx.doi.org/10.1016/j.apmr.2007.06.764
Simpson LA, Miller WC, Eng JJ. Effect of stroke on fall rate, location and predictors: a prospective comparison of older adults with and without stroke. PLoS One. 2011;6(4):e19431. DOI: http://dx.doi.org/10.1371/journal.pone.0019431
Iosa M, Morone G, Fusco A, Pratesi L, Bragoni M, Coiro P, et al. Effects of walking endurance reduction on gait stability in patients with stroke.Stroke Res Treat. 2012;2012:810415. DOI: http://dx.doi.org/10.1155/2012/810415
van Bloemendaal M, Kokkeler AM, van de Port IG. The shuttle walk test: a new approach to functional walking capacity measurements for patients after stroke? Arch Phys Med Rehabil. 2012;93(1):163-6.
Rand D, Eng JJ, Tang PF, Jeng JS, Hung C. How active are people with stroke?: use of accelerometers to assess physical activity. Stroke. 2009;40(1):163-8. DOI: http://dx.doi.org/10.1161/STROKEAHA.108.523621
Blennerhassett JM, Dite W, Ramage ER, Richmond ME. Changes in balance and walking from stroke rehabilitation to the community: a follow-up observational study. Arch Phys Med Rehabil. 2012;93(10):1782-7. DOI: http://dx.doi.org/10.1016/j.apmr.2012.04.005
Schmid AA, Van Puymbroeck M, Altenburger PA, Dierks TA, Miller KK, Damush TM, et al. Balance and balance self-efficacy are associated with activity and participation after stroke: a cross-sectional study in people with chronic stroke. Arch Phys Med Rehabil. 2012;93(6):1101-7. DOI: http://dx.doi.org/10.1016/j.apmr.2012.01.020
Ng SS, Hui-Chan CW. Contribution of ankle dorsiflexor strength to walking endurance in people with spastic hemiplegia after stroke. Arch Phys Med Rehabil. 2012;93(6):1046-51. DOI: http://dx.doi.org/10.1016/j.apmr.2011.12.016
Liu J, Drutz C, Kumar R, McVicar L, Weinberger R, Brooks D, et al. Use of the six-minute walk test poststroke: is there a practice effect? Arch Phys Med Rehabil. 2008;89(9):1686-92.
Sibley KM, Tang A, Patterson KK, Brooks D, McIlroy WE. Changes in spatiotemporal gait variables over time during a test of functional capacity after stroke. J Neuroeng Rehabil. 2009;6:27. DOI: http://dx.doi.org/10.1186/1743-0003-6-27
Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev. 2005;42(1):103-7.
Severinsen K, Jakobsen JK, Overgaard K, Andersen H. Normalized muscle strength, aerobic capacity, and walking performance in chronic stroke: a population-based study on the potential for endurance and resistance training. Arch Phys Med Rehabil. 2011;92(10):1663-8. DOI: http://dx.doi.org/10.1016/j.apmr.2011.04.022
Pang MY, Eng JJ, Dawson AS. Relationship between ambulatory capacity and cardiorespiratory fitness in chronic stroke: influence of stroke-specific impairments. Chest. 2005;127(2):495-501. DOI: http://dx.doi.org/10.1378/chest.127.2.495
Muren MA, Hütler M, Hooper J. Functional capacity and health-related quality of life in individuals post stroke. Top Stroke Rehabil. 2008;15(1):51-8. DOI: http://dx.doi.org/10.1310/tsr1501-51
Kluding P, Gajewski B. Lower-extremity strength differences predict activity limitations in people with chronic stroke. Phys Ther. 2009;89(1):73-81. DOI: http://dx.doi.org/10.2522/ptj.20070234
Ng SS, Tsang WW, Cheung TH, Chung JS, To FP, Yu PC. Walkway length, but not turning direction, determines the six-minute walk test distance in individuals with stroke. Arch Phys Med Rehabil. 2011;92(5):806-11. DOI: http://dx.doi.org/10.1016/j.apmr.2010.10.033
Scrivener K, Sherrington C, Schurr K. A systematic review of the responsiveness of lower limb physical performance measures in inpatient care after stroke. BMC Neurol. 2013;13:4. DOI: http://dx.doi.org/10.1186/1471-2377-13-4
Bland MD, Sturmoski A, Whitson M, Connor LT, Fucetola R, Huskey T, et al. Arch Phys Med Rehabil. 2012;93(8):1441-7.
Sarker SJ, Rudd AG, Douiri A, Wolfe CD. Comparison of 2 extended activities of daily living scales with the Barthel Index and predictors of their outcomes: cohort study within the South London Stroke Register (SLSR). Stroke. 2012;43(5):1362-9. DOI: http://dx.doi.org/10.1161/STROKEAHA.111.645234
Nijboer T, van de Port I, Schepers V, Post M, Visser-Meily A. Predicting functional outcome after stroke: the influence of neglect on basic activities in daily living. Front Hum Neurosci. 2013;7:182. DOI: http://dx.doi.org/10.3389/fnhum.2013.00182
Fulk GD, Echternach JL, Nof L, O'Sullivan S. Clinometric properties of the six-minute walk test in individuals undergoing rehabilitation poststroke. Physiother Theory Pract. 2008;24(3):195-204 DOI: http://dx.doi.org/10.1080/09593980701588284
Kollen B, van de Port I, Lindeman E, Twisk J, Kwakkel G. Predicting improvement in gait after stroke: a longitudinal prospective study. Stroke. 2005;36(12):2676-80. DOI: http://dx.doi.org/10.1161/01.STR.0000190839.29234.50
Duncan P, Richards L, Wallace D, Stoker-Yates J, Pohl P, Luchies C, et al. A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke. 1998;29(10):2055-60. DOI: http://dx.doi.org/10.1161/01.STR.29.10.2055
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