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Published on: June 16, 2016
Self-selected walking velocity for functional ambulation in patients with end-stage emphysema
K Menard-Rothe1, D C Sobush, M Bousamra
1Department of Cardiopulmonary Rehabilitation, Froedtert Memorial Lutheran Hospital, Wauwatosa, Wisconsin, USA.
Purpose:
Considerable attention has been given to ambulation and dyspnea in the population with chronic obstructive pulmonary disease; however, previous studies leave the question of what constitutes functional ambulation in this population unanswered. This article examines ambulation for functional independence in the community for patients with-end-stage emphysema based on their self-selected walking velocity (SSWV) during a 6-minute walk (6 MW) and a timed get up and go (GUG) test.
Methods:
Fifty-nine patients (28 women, 31 men; mean age of 65.1 +/- 7.2 years) referred for lung transplantation or lung volume reduction surgery (mean forced expiratory volume in 1 second [FEV1] of 0.60 +/- 0.20 L; mean FEV1 as percent of predicted [FEV1%] of 22.7 +/- 8.7%) each had a 6 MW and GUG test performed on the same day. Calculations for SSWV and estimated energy expenditure were determined using the horizontal walking formula by the American College of Sports Medicine.
Results:
No statistically significant gender differences were identified for distance walked (235.1 +/- 92.0 m), rest time taken (33.2 +/- 58.5 seconds), actual walk time (5.5 +/- 1.0 minutes), or SSWV (42.2 +/- 13.9 m/min or 1.6 +/- 0.5 miles per hour) during the 6 MW. Men tended to walk farther and faster but rested more. The SSWV during the GUG test was similar (mean 41.8 +/- 10.9 m/min or 1.6 +/- 0.4 miles per hour) to the SSWV during the 6 MW. Estimated energy expenditure was approximately 1.6 to 3.4 metabolic equivalents (METS; mean 2.3 +/- 0.5 METS).
Conclusion:
The literature defines independent community ambulation as the ability to walk at least 332 m at a near-normal velocity of approximately 80 m/min. This study population was significantly impaired for both distance and the velocity required to ambulate independently in the community. Documentation of both rest time and walk time taken during a 6 MW test will enable SSWV to be calculated and interpreted as it relates to independent community ambulation.
