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Influence of step length on 6-minute walk test performance in patients with chronic heart failure
Garyfallia K Pepera1, Gavin R Sandercock, Rebecca Sloan
1Department of Biological Sciences, University of Essex, Colchester, UK. hilary.gunn100@plymouth.ac.uk
Insights
Patients with chronic heart failure (CHF) exhibit reduced step length and walking speed during the 6-minute walking test (6MWT). These altered gait mechanics may limit exercise capacity in individuals with CHF.
Area of Science:
- Cardiology
- Exercise Physiology
- Gait Analysis
Background:
- Chronic heart failure (CHF) significantly impacts patients' functional capacity.
- The 6-minute walking test (6MWT) is a standard measure of exercise tolerance in CHF.
- Gait parameters like step length and walking speed are crucial determinants of walking performance.
Purpose of the Study:
- To examine the influence of gait parameters, specifically step length and walking speed, during the 6MWT in patients with CHF.
- To compare gait parameters between patients with CHF and healthy controls during the 6MWT.
Main Methods:
- An observational study conducted in a specialist heart failure clinic.
- Participants included patients with CHF and age-matched healthy controls.
- Gait parameters (step length, walking speed) were measured minute-by-minute during a standardized 6MWT protocol.
Main Results:
- Patients with CHF demonstrated significantly shorter step length and slower walking speed compared to healthy controls within the first five minutes of the 6MWT.
- No significant minute-by-minute changes in step length or walking speed were observed in the CHF group during the test.
- Body mass index was identified as a key predictor of 6MWT performance in patients with CHF.
Conclusions:
- Patients with CHF exhibit impaired gait mechanics, characterized by reduced step length and walking speed, during the 6MWT.
- These altered gait characteristics are likely contributors to the limited exercise capacity observed in individuals with CHF.
- Further research into gait interventions may be beneficial for improving functional outcomes in CHF patients.
Objective:
To investigate the influence of gait parameters including step length and walking speed during performance of the 6-minute walking test (6MWT) in patients with chronic heart failure (CHF).
Design:
Observational study.
Setting:
Specialist heart failure clinic.
Participants:
Patients with CHF and aged-matched, apparently healthy controls.
Interventions:
Each patient and control performed a 6MWT following a standardised protocol in a 15m corridor. The number of steps (defined as step from left foot to right foot) taken every 15m was counted, and reported as minute-by-minute changes in 6MWT performance. In addition, minute-by-minute changes in time taken to complete 15m and mean walking speed throughout the test were calculated.
Main Outcome Measures:
Walking speed and step length.
Results:
Thirty patients with CHF {87% males; mean age 75 [standard deviation (SD) 8] years} and 10 healthy controls [80% males; mean age 77 (SD 11) years] undertook the 6MWT. For the CHF group, the mean distance walked was 309 (SD 48)m and the peak Borg score was 12 (SD 1). For the controls, the mean distance walked was 334 (SD 138)m and the peak Borg score was 12 (SD 1). Patients with CHF showed no significant minute-by-minute changes in step length or walking speed over the course of the 6MWT. In the first 5minutes, healthy controls had a longer step length and faster walking speed than patients with CHF [step length: mean difference in the first minute was 0.03m, 95% confidence interval (CI) of the difference 0.01 to 0.05m; P=0.02; walking speed: mean difference in the first minute 0.04m/second, 95% CI of the difference 0.02 to 0.07m/second; P=0.01]. A multiple linear regression analysis demonstrated that body mass index (P=0.02) was the most important predictor of 6MWT performance.
Conclusion:
Patients with CHF have a shorter step length and walk more slowly than controls during the 6MWT. Altered gait mechanics may contribute to limited exercise capacity in patients with CHF.
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