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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Six-minute walk test in obese children and adolescents: reproducibility and validity
Gunilla Morinder1, Eva Mattsson, Clara Sollander
1Department of Neurobiology, National Childhood Obesity Centre, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden. gunilla.morinder@karolinska.se
Insights
The six-minute walk test (6MWT) demonstrates good reproducibility and validity in obese children, showing they walk 86% of the distance of normal-weight peers. Significant changes in 6MWD must exceed 68 meters.
Area of Science:
- Pediatric Exercise Science
- Clinical Exercise Physiology
- Obesity Research
Background:
- The six-minute walk test (6MWT) is increasingly utilized in clinical settings.
- Assessing walking capacity in obese pediatric populations is crucial for monitoring health and intervention effectiveness.
Purpose of the Study:
- To evaluate the reproducibility of the 6MWT in obese children and adolescents.
- To describe the walking capacity of obese children and compare it to normal-weight children.
- To examine the correlation between 6MWT distance and estimated maximal oxygen uptake (VO2max).
Main Methods:
- Test-retest design used to assess reproducibility in 49 obese children.
- Comparative design involving 250 obese and 97 normal-weight children for known group validity.
- Obese children also underwent sub-maximal bicycle ergometry to estimate VO2max.
Main Results:
- The 6MWT exhibited good reproducibility with an intraclass correlation coefficient (ICC) of 0.84 and a measurement error of 24m.
- Obese children walked significantly shorter distances (571m) compared to normal-weight children (663m), averaging 86% of the normal-weight distance.
- A low correlation (r=0.34) was found between 6MWD and estimated VO2max in obese children.
Conclusions:
- The 6MWT is a reproducible and valid measure for assessing walking capacity in obese children and adolescents.
- A change of over 68 meters is required for statistically significant individual outcome evaluation.
- The 6MWT cannot replace bicycle ergometry for assessing cardiorespiratory fitness (VO2max) in this population.
Background And Purpose:
The six-minute walk test (6MWT) is increasingly used in clinical practice. The aims of this study were to determine the reproducibility of the 6MWT in obese children and adolescents, to describe walking capacity in this population and compare the results with values from normal-weight children (known group validity), and, finally, to describe the correlation between distance walked and estimated maximum oxygen uptake (VO(2)max).
Methods:
Reproducibility was determined by a test-retest design and known group validity by a comparative design. The 6MWT was first test-retested in 49 obese children (30 boys, 19 girls, 8-16 years, body mass index [BMI] 24.9-52.1 kg?m(-2)). Then, for validation, 250 obese children (126 boys, 124 girls, 8-16 years, BMI 23.2-57 kg/m(2)) and 97 normal-weight children (48 boys, 49 girls, 8-16 years, BMI 13.3-23.2 kg.m(-2)) performed the 6MWT. The obese children also performed a sub-maximal bicycle ergometry test.
Results:
In the test-retest, the obese children walked 571 m the first test and 57 m the second (p = 0.578). The measurement error (S(w)) was 24 m, coefficient of variation (CV): 4.3% and the intraclass correlation (ICC1:1): 0.84. Repeatability was 68 m, and limits of agreement were +71 and -65 m. In comparison mean (standard deviation), six-minute walk distance (6MWD) in the obese children was 571 m (65.5), and in the normal-weight children, 663 m (61.1) (p < 0.001). The correlation between 6MWD and estimated VO(2)max (r = 0.34) was low.
Conclusions:
The 6MWT showed good reproducibility and known group validity, and can be recommended for use in clinical practice in the studied population. To evaluate individual outcomes after intervention, the 6MWD needs to change by >68 m to be statistically significant. The 6MWD performed by obese children averaged 86% of the distance normal-weight children walked. In obese children, the correlation between 6MWD and estimated VO(2)max was low, hence the 6MWT cannot substitute a bicycle ergometry test.
