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Six-minute walk test in patients with Down syndrome: validity and reproducibility
Jeroen C Vis1, Hanneke Thoonsen, Marielle G Duffels
1Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands. j.c.vis@amc.uva.nl
Objectives:
To examine the validity of the six-minute walk test (6MWT) as a tool to evaluate functional exercise performance in patients with Down syndrome (DS).
Design:
Comparison of the six-minute walk distance (6MWD) in 2 distinct groups of DS patients: with and without severe cardiac disease. To test reproducibility, a group of patients with DS performed the 6MWT twice.
Setting:
Tertiary referral centers for patients with congenital heart defects and outpatient clinics for people with intellectual disabilities.
Participants:
Adult patients with DS with (n=29) and without (n=52) severe cardiac disease categorized by cardiac echocardiography.
Interventions:
Not applicable.
Main Outcome Measure:
Distance walked on the 6MWT.
Results:
The mean 6MWD in the group with severe cardiac disease was 289+/-104 m and in the group without severe cardiac disease 280+/-104 m (P=.70). Older age, female sex, and severe level of intellectual disability were all found to be independently and significantly correlated with a lower 6MWD (r=.67, P<.001). The paired 6MWD was not significantly different (310+/-88 m vs 317+/-85 m; P=.40) in patients who performed the 6MWT twice. The coefficient of variation was 11%.
Conclusions:
The 6MWD between the 2 groups was not significantly different. However, the walking distance inversely correlated with the level of intellectual disability. Therefore, the 6MWT is not a valid test to examine cardiac restriction in adult patients with DS.
