Related Experiment Video
Updated: May 4, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Six-minute walk test: reference values and prediction equation in healthy boys aged 5 to 12 years
Nathalie Goemans1, Katrijn Klingels2, Marleen van den Hauwe1
1Department of Child Neurology, University Hospitals Leuven, Leuven, Belgium.
Insights
This study generated normative data for the six-minute walk test (6MWT) in healthy boys aged 5-12 years. Refitted prediction equations improve ambulatory capacity assessment in Duchenne muscular dystrophy (DMD) clinical trials.
Area of Science:
- Pediatrics
- Neuromuscular Disorders
- Clinical Trials Methodology
Background:
- The six-minute walk test (6MWT) is a key outcome measure in Duchenne muscular dystrophy (DMD) clinical trials.
- Generating normative data is crucial for accurately interpreting 6MWT results in pediatric populations.
Purpose of the Study:
- To establish normative data for the 6MWT in healthy boys aged 5-12 years.
- To examine the relationship between 6MWT performance and anthropometric/myometric variables.
- To compare existing prediction equations with newly generated data and refine them for DMD trials.
Main Methods:
- Conducted the 6MWT on 442 healthy boys (ages 5-12) using a standardized protocol.
- Measured maximal voluntary isometric contractions of knee flexors and extensors using a hand-held myometer.
- Developed age- and height-related percentile curves for 6MWD and analyzed correlations.
Main Results:
- Six-minute walk distance (6MWD) significantly increased with age, with the steepest gains between 5-8 years.
- Correlations between 6MWD and anthropometric/myometric variables were fair to good, primarily in younger boys (5-8 years).
- Existing equations (Geiger, Ben Saad) overestimated 6MWD; the Geiger equation was refitted to the study population.
Conclusions:
- Age- and height-based percentile curves offer a valuable tool for assessing ambulatory function in boys.
- The refitted Geiger equation provides a more accurate prediction model for ambulatory capacity in DMD clinical trials.
- Understanding correlations with physical measures aids in interpreting 6MWT results in pediatric populations.
Objective:
This study aimed to (1) generate normative data in healthy boys aged 5-12 years for the six-minute walk test (6MWT), an outcome measure currently used in clinical trials in Duchenne muscular dystrophy (DMD), (2) to describe the relation with anthropometric variables and myometry, and (3) to compare our data with published equations.
Methods:
The 6MWT was conducted in 442 boys according to a standardized protocol, as currently used in clinical trials in DMD. Maximal voluntary isometric contractions for knee flexion and extension were recorded with a hand-held myometer.
Results:
The 6MWD increased significantly with age, from 478.0 ± 44.1 m at age 5, to 650.0 ± 76.8 m at age 12, with the steepest increase between 5 and 8 years. Age- and height related percentile curves of the 6MWD were developed. Correlations with anthropometric variables were fair to good (age r = 0.60, height r = 0.57, weight r = 0.44). Myometric variables (knee flexors and extensors) showed correlations of 0.46 and 0.50 respectively. When dividing into two age categories (5-8 years, 9-12 years), these magnitudes of correlations only applied to the younger age group. Additionally, predicted values were calculated according to available reference equations (Geiger and Ben Saad), indicating an overestimation by those equations. Finally, the Geiger equation was refitted to our population.
Conclusion:
The percentile curves according to age and height provide a useful tool in the assessment of ambulatory capacity in boys aged 5 to 12 years. Significant correlations with anthropometric variables and myometry were only found in the 5-8 years age group. The Geiger prediction equation, currently used to assess ambulatory capacity in DMD was refitted to obtain a more accurate prediction model based on a large sample with a homogenous distribution across the age categories 5 to 12 years and applying the methodology as currently used in clinical trials in DMD.
