TY - JOUR
T1 - The 2- and 6-Minute Walk Tests in Neuromuscular Diseases: Effect of Heart Rate Correction on the Learning Effect
AU - Knak, Kirsten Lykke
AU - Andersen, Linda Kahr
AU - Witting, Nanna
AU - Vissing, John
PY - 2018
Y1 - 2018
N2 - Objective: The 2- and 6-minute walk tests are common measures for evaluating walking ability, but reliability is weakened by a well-documented learning effect. Since heart rate is related to workload, any change in walking distance, which is unrelated to change in clinical function, should be reflected in a change in heart rate during walking. Therefore, the aim of the present study was to investigate test-retest reliability of the 2- and 6-minute walk tests with and without heart rate correction.
Methods: Ninety-three adult patients (mean age of 53 years, range; 22-83 years) with 12 different neuromuscular diseases (myotonic dystrophy type 1, limb-girdle muscular dystrophy, facioscapulohumeral muscular dystrophy type 1, Charcot-Marie-Tooth disease, mitochondrial myopathy, Becker muscular dystrophy, spinobulbar muscular atrophy, sporadic inclusion body myositis, spinal muscular atrophy, myotonia congenita Thomsen disease, congenital myopathy, polymyositis) were recruited in the study. One 2- and 6-minute walk test was performed on two occasions, 1-2 weeks apart. Heart rate was monitored by a pulse-watch.
Results: The distance walked increased significantly with repeated 2- and 6-minute walk tests (2-minute walk test increased by 4 ± 9 m and 6-minute walk test by 11 ± 26 m, p<0.001). Heart rate correction eliminated the learning effect in the 6-minute walk test (+0.01 m/heartbeat, p=0.84), but not in the 2-minute walk test (+0.03 m/ heartbeat, p=0.018). The same pattern of heart rate-correction in the 6-minute walk test was observed in all subgroup diagnoses. There was no difference in the learning effect between disease severities.
Conclusion: Both the 2- and 6-minute walk tests are associated with a learning effect. The learning effect is eliminated when correcting for heart rate in the 6-minute walk test, but not in the 2-minute walk test. The results suggest using a heart rate corrected 6-minute walk test to weed out day-to-day variations that are not due to a real change in the patient’s clinical condition.
AB - Objective: The 2- and 6-minute walk tests are common measures for evaluating walking ability, but reliability is weakened by a well-documented learning effect. Since heart rate is related to workload, any change in walking distance, which is unrelated to change in clinical function, should be reflected in a change in heart rate during walking. Therefore, the aim of the present study was to investigate test-retest reliability of the 2- and 6-minute walk tests with and without heart rate correction.
Methods: Ninety-three adult patients (mean age of 53 years, range; 22-83 years) with 12 different neuromuscular diseases (myotonic dystrophy type 1, limb-girdle muscular dystrophy, facioscapulohumeral muscular dystrophy type 1, Charcot-Marie-Tooth disease, mitochondrial myopathy, Becker muscular dystrophy, spinobulbar muscular atrophy, sporadic inclusion body myositis, spinal muscular atrophy, myotonia congenita Thomsen disease, congenital myopathy, polymyositis) were recruited in the study. One 2- and 6-minute walk test was performed on two occasions, 1-2 weeks apart. Heart rate was monitored by a pulse-watch.
Results: The distance walked increased significantly with repeated 2- and 6-minute walk tests (2-minute walk test increased by 4 ± 9 m and 6-minute walk test by 11 ± 26 m, p<0.001). Heart rate correction eliminated the learning effect in the 6-minute walk test (+0.01 m/heartbeat, p=0.84), but not in the 2-minute walk test (+0.03 m/ heartbeat, p=0.018). The same pattern of heart rate-correction in the 6-minute walk test was observed in all subgroup diagnoses. There was no difference in the learning effect between disease severities.
Conclusion: Both the 2- and 6-minute walk tests are associated with a learning effect. The learning effect is eliminated when correcting for heart rate in the 6-minute walk test, but not in the 2-minute walk test. The results suggest using a heart rate corrected 6-minute walk test to weed out day-to-day variations that are not due to a real change in the patient’s clinical condition.
U2 - 10.4172/2329-9096.1000415
DO - 10.4172/2329-9096.1000415
M3 - Journal article
SN - 2329-9096
VL - 5
JO - International Journal of Physical Medicine & Rehabilitation
JF - International Journal of Physical Medicine & Rehabilitation
M1 - 415
ER -