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Reference values and equations for the 6-minute walk distance of Nigerian children aged 6-11 years: A cross-sectional
Peter Odion Ubuane1, Olufunke Adewumi Ajiboye2, Motunrayo Oluwabukola Adekunle1
1Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria.
Insights
This study established reference standards for the 6-minute walk test (6MWT) in Nigerian school-aged children. The findings provide crucial data for assessing functional capacity in this population, addressing a gap in current pediatric 6MWT norms.
Area of Science:
- Pediatric functional assessment
- Exercise physiology
- Public health
Background:
- The 6-minute walk test (6MWT) quantifies functional capacity in chronic disorders.
- Existing 6MWT reference standards lack data from Nigerian school-aged children.
- This limits the test's utility in this specific demographic.
Purpose of the Study:
- To develop normative values and predictive equations for the 6-minute walk distance (6MWD) in Nigerian school-aged children.
- Establish reliable reference data for pediatric functional capacity assessment in Nigeria.
Main Methods:
- A cross-sectional study involving healthy Nigerian children aged 6-11 years in Lagos.
- Participants completed the 6MWT on a 20-m course.
- Data collected included 6MWD, demographics, anthropometrics, and physiological responses (heart rate, SpO2, blood pressure, RPE).
Main Results:
- 627 children participated, with boys walking significantly farther than girls (16m difference, p=0.002).
- A regression model predicted 6MWD based on age, sex, change in heart rate, and change in systolic blood pressure (R²=0.25).
- Previously published reference equations tended to overestimate the 6MWD for Nigerian children.
Conclusions:
- New reference standards for the 6MWD in Nigerian school-aged children have been established.
- These standards contribute to global pediatric 6MWT normative data.
- The findings are valuable for functional evaluations of Nigerian children with chronic disorders.
Background:
The 6-minute walk test (6MWT), a simple, reliable, and valid test that uses the distance walked in 6 minute walk distance (6MWD) to quantify functional capacity, is widely used in the management of chronic disorders. However, the absence of reference standards from sub-Saharan African, including Nigerian, school-aged children limits its utility in this age group.
Objectives:
To develop normative values and equations for the 6MWD of school-aged Nigerian children.
Methods:
In a cross-sectional study, healthy children aged 6-11 years in Lagos, Nigeria, completed the 6MWT on 20-m-long straight outdoor courses in their schools. The primary outcome was the 6MWD in meters while potential predictors included demographic (age, sex), anthropometric (height, weight, chest circumference, leg length) and physiologic variables (pre-walk, immediate post-walk, and fifth min-post-walk heart rate [HR], oxygen saturation [SpO2 ], systolic blood pressure [SBP], diastolic blood pressure [DBP], and rating of perceived exertion [RPE]; and the difference between pre-walk and post-walk HR [∆HR], SpO2 [∆SpO2 ], SBP [∆SBP], DBP [∆DBP], and RPE [∆RPE]).
Results:
Overall, 627 pupils (52.1% girls) walked 504.6 ± 66.6 m (95% CI: 499.4, 509.8; range: 326.6-673.0 m); 16 m longer in boys (p = 0.002). A stepwise linear regression model yielded: 6MWD (m) = 347.9 + 14(Ageyears ) + 1.6 (∆HRbeats/min ) + 17.6(Sexmale=1, female=0 ) + 1.2(∆SBPmmHg ); R2 = 0.25. Previously published reference equations mostly over-estimated Nigerian children's 6MWD.
Conclusion:
These reference standards add to the global normative data on pediatric 6MWT and may be useful for the functional evaluation of Nigerian school-aged children with chronic childhood disorders.
