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Comparison of Six-Minute Walk Test and Modified Bruce Treadmill Test in Paediatric Patients With Severe Burns: A
Alen Palackic1, Stephanie Abazie2, Ingrid Parry3
1Department of Surgery; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. alpalack@utmb.edu.
Insights
The Modified Bruce treadmill test significantly challenges the cardiorespiratory system more than the six-minute walk test in pediatric burn patients. The Modified Bruce treadmill test is preferred for assessing cardiovascular capacity when feasible.
Area of Science:
- Cardiology
- Pediatric Rehabilitation
- Burn Care
Background:
- Pediatric patients with severe burns often experience reduced functional capacity.
- Assessing cardiorespiratory fitness is crucial for rehabilitation and recovery in this population.
- Standardized exercise tests are used to evaluate functional capacity, but their applicability in burn survivors needs evaluation.
Purpose of the Study:
- To compare the effectiveness of the six-minute walk test (6MWT) and the Modified Bruce treadmill test (MBTT) in assessing cardiorespiratory function in pediatric patients with severe burns.
- To determine which test provides a more comprehensive measure of cardiovascular challenge and functional capacity in this specific patient group.
Main Methods:
- A randomized crossover design was employed with 67 pediatric patients (aged 7-17 years) with severe burns.
- Participants underwent both the 6MWT and MBTT in a randomized order.
- Primary outcome was maximal heart rate; secondary outcomes included distance walked, rate of perceived exertion (RPE) using Borg's CR-10 scale, and maximal oxygen uptake (VO2).
Main Results:
- Thirty-eight patients completed both tests.
- The MBTT elicited significantly higher maximal heart rates (148 ± 24 bpm) compared to the 6MWT (135 ± 19 bpm; p ≤ 0.05), with weak correlation (R² = 0.14).
- The MBTT also resulted in significantly greater distances covered (439 ± 181 m vs. 294 ± 124 m; p ≤ 0.05) and a maximal RPE of 10, compared to a mean RPE of 3 for the 6MWT.
Conclusions:
- The Modified Bruce treadmill test provides a significantly greater cardiorespiratory challenge than the six-minute walk test in pediatric burn patients, indicated by higher heart rates and perceived exertion.
- The MBTT is recommended for assessing maximal cardiovascular functional capacity when clinically appropriate.
- The 6MWT remains a feasible option for evaluating submaximal functional capacity and may be more practical in certain clinical settings for this population.
Objective:
To compare the six-minute walk test and the Modified Bruce treadmill test in paediatric patients with severe burns.
Subjects:
A total of 67 children, aged 7-17 years, with severe burns.
Methods:
Participants were assigned to perform the six-minute walk test and the Modified Bruce treadmill test in randomized order on discharge from acute burn care. Primary outcome measure was heart rate. Secondary outcome measures were distance walked, Borg's CR-10 rate of perceived exertion, and maximal oxygen uptake (VO2).
Results:
A total of 67 participants were enrolled. Thirty-eight patients completed both tests. The mean six-minute walk test maximum heart rate was 135 ± 19 bpm (range 97-180 bpm) and the mean Modified Bruce treadmill test maximum heart rate was 148 ± 24 bpm (range 100-197 bpm; p ≤ 0.05), with a weak positive correlation of R² = 0.14. The mean six-minute walk test maximum distance was 294 ± 124 m (range 55 to 522 m) while the mean Modified Bruce treadmill test maximum distance was 439 ± 181 m (range 53 to 976 m; p ≤ 0.05), with no correlation of R² = 0.006. The mean RPE CR-10 score for the six-minute walk test was 3 ± 2.5 (range 0-10) vs a mean RPE CR-10 score of 10 ± 0 for the Modified Bruce treadmill test.
Conclusion:
The Modified Bruce treadmill test challenges the cardiorespiratory system significantly more than the six-minute walk test, as reflected by maximum heart rate measurements, and the perception of effort (i.e. rate of perceived exertion) by the patient. When possible, the Modified Bruce treadmill test should be used to assess cardiovascular functional capacity. However, the six-minute walk test may be more clinically feasible for use with paediatric patients with burns, and provides information about submaximal functional exercise capacity.
