Six-minute walking test in children with ESRD: discrimination validity and construct validity |
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Authors: | Tim Takken Raoul Engelbert Monique van Bergen Jaap Groothoff Jeroen Nauta Koen van Hoeck Marc Lilien Paul Helders |
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Affiliation: | (1) Department of Pediatric Physical Therapy & Exercise Physiology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Room KB.02.056, P.O. Box 85090, 3508 AB Utrecht, The Netherlands;(2) University of Applied Sciences Amsterdam, Hogeschool van Amsterdam, Education of Physical Therapy, Amsterdam, The Netherlands;(3) Department of Pediatric Nephrology, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands;(4) Department of Pediatric Nephrology, Sophia’s Children Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands;(5) Department of Pediatric Nephrology, University Hospital Antwerp, Antwerp, Belgium;(6) Department of Pediatric Nephrology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands |
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Abstract: | The six-minute walking test (6MWT) may be a practical test for the evaluation functional exercise capacity in children with end-stage renal disease (ESRD). The aim of this study was to investigate the 6MWT performance in children with ESRD compared to reference values obtained in healthy children and, secondly, to study the relationship between 6MWT performance with anthropometric variables, clinical parameters, aerobic capacity and muscle strength. Twenty patients (13 boys and seven girls; mean age 14.1 ± 3.4 years) on dialysis participated in this study. Anthropometrics were taken in a standardized manner. The 6MWT was performed in a 20-m-long track in a straight hallway. Aerobic fitness was measured using a cycle ergometer test to determine peak oxygen uptake ( textV· textOtext2peak ) left( {mathop {text{V}}limits^cdot {{text{O}}_{text{2peak}}}} right) , peak rate (Wpeak) and ventilatory threshold (VT). Muscle strength was measured using hand-held myometry. Children with ESRD showed a reduced 6MWT performance (83% of predicted, p < 0.0001), irrespective of the reference values used. The strongest predictors of 6MWT performance were haematocrit and height. Regression models explained 59% (haematocrit and height) to 60% (haematocrit) of the variance in 6MWT performance. 6MWT performance was not associated with textV· textOtext2peak {mathop {text{V}}limits^cdot {{text{O}}_{text{2peak}}}} , strength, or other anthropometric variables, but it was significantly associated with haematocrit and height. Children with ESRD scored lower on the 6MWT than healthy children. Based on these results, the 6MWT may be a useful instrument for monitoring clinical status in children with ESRD, however it cannot substitute for other fitness tests, such as a progressive exercise test to measure textV· textOtext2peak {mathop {text{V}}limits^cdot {{text{O}}_{text{2peak}}}} or muscle strength tests. |
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