Self-selected walking velocity for functional ambulation in patients with end-stage emphysema

Area of Science:

• Pulmonary Medicine
• Rehabilitation Science
• Geriatric Medicine

Background:

• Chronic obstructive pulmonary disease (COPD) significantly impacts daily activities, particularly ambulation.
• Functional ambulation in end-stage emphysema patients remains poorly defined, affecting community independence.
• Self-selected walking velocity (SSWV) is a key metric for assessing mobility and functional capacity.

Purpose of the Study:

• To evaluate functional ambulation and self-selected walking velocity (SSWV) in patients with end-stage emphysema.
• To determine the relationship between SSWV during a 6-minute walk (6 MW) and a timed get up and go (GUG) test.
• To assess if patients with end-stage emphysema meet criteria for independent community ambulation.

Main Methods:

• Fifty-nine end-stage emphysema patients underwent a 6-minute walk (6 MW) and a timed get up and go (GUG) test.
• Self-selected walking velocity (SSWV) was calculated using data from the 6 MW and GUG tests.
• Estimated energy expenditure was determined using American College of Sports Medicine formulas.

Main Results:

• No significant gender differences were observed in 6 MW distance, rest time, walk time, or SSWV.
• Mean SSWV was 42.2 m/min (1.6 mph) during the 6 MW and 41.8 m/min (1.6 mph) during the GUG test.
• Patients' SSWV and distance walked were significantly below the thresholds required for independent community ambulation.

Conclusions:

• Patients with end-stage emphysema exhibit impaired ambulation, evidenced by reduced walking distance and velocity.
• The study population did not meet the established criteria for independent community ambulation (332 m at 80 m/min).
• Calculating SSWV from 6 MW tests, including rest and walk times, is essential for interpreting functional independence in this population.