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Utility of the 6-Min Walk Test for Assessing Physical Performance in Pediatric Heart Transplant Recipients
Heidi Mäenpää1, Tiina Ojala2, Juuso Tainio3
1Department of Rehabilitation, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland and University of Helsinki, Helsinki, Finland.
Insights
The 6-minute walk test (6MWT) effectively assesses physical performance capacity in pediatric heart transplant recipients. Annual 6MWT is recommended for monitoring and motivating these young patients.
Area of Science:
- Pediatric Cardiology
- Rehabilitation Medicine
- Transplant Science
Background:
- Pediatric heart transplant (HT) recipients often exhibit suboptimal physical performance capacity (PPC).
- Longitudinal monitoring of PPC in these patients is crucial but lacks standardized methods.
- This study aimed to identify a simple, reliable tool for assessing PPC in pediatric HT survivors.
Purpose of the Study:
- To evaluate the correlation between the 6-minute walk test (6MWT) and a comprehensive physical performance test set in pediatric heart transplant recipients.
- To determine if the 6MWT can serve as a simple follow-up tool for assessing physical performance capacity (PPC).
- To explore the association between clinical parameters and PPC in this population.
Main Methods:
- A cohort of 15 pediatric heart transplant recipients and 392 historical controls were assessed.
- Physical performance capacity was measured using the 6-minute walk test (6MWT) and a six-component physical performance test set.
- Tests assessed muscle endurance, strength, speed, and flexibility.
Main Results:
- Controls demonstrated superior performance in most physical tests compared to HT recipients, except for leg lift and sit-and-reach.
- The 6MWT distance showed strong correlations with various components of the physical performance test set, including repeated squatting (rs=0.851) and total PPC (rs=0.873).
- No significant associations were found between indexed 6MWT results or total PPC and tested clinical parameters.
Conclusions:
- The 6-minute walk test (6MWT) is a suitable and effective method for the longitudinal follow-up of physical performance capacity in pediatric heart transplant recipients.
- Annual performance of the 6MWT is recommended for this population.
- The 6MWT can be utilized to motivate pediatric heart transplant recipients to increase their physical activity levels.
Background:
Physical performance capacity (PPC) of pediatric heart transplant (HT) recipients is reportedly low to normal, and longitudinal follow-up of these patients is recommended. However, no recommendation for a follow-up method is available. In this study, the correlation between the 6-min walk test (6MWT), various clinical parameters, and a physical performance test set was evaluated to develop a simple follow-up tool for PPC.
Methods:
Fifteen pediatric HT patients and 392 historical controls were tested at a median age of 15.4 years. PPC was tested with a 6MWT and a physical performance test set consisting of six different components assessing muscle endurance, strength, speed, and flexibility.
Results:
Controls outperformed recipients across all test domains except the leg lift and sit-and-reach test. The 6MWT distance correlated well with the physical performance test set results; the correlations were with leg lift (rs = 0.622, p = <0.05), repeated squatting (rs = 0.851, p = <0.001, sit-up (rs = 0.738, p = <0.05), back extension (rs = 0.747, p ≤ 0.001), and total physical performance capacity (rs = 0.873, p = <0.001). Indexed 6MWT results or total physical performance capacity set had no statistically significant associations with any of the clinical parameters tested.
Conclusion:
Our study supports recent findings suggesting that the 6MWT is a suitable method for longitudinal follow-up in children with HT. We recommend performing the 6MWT annually in these patients, to be used to motivate and encourage them to enhance their physical activity.
