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Development and comparison of reference equations for the six-minute walk test in Spanish healthy adults aged 45-85 years
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E Gimeno-Santos1,2,3,4,
Corresponding author
elena.gimeno@isglobal.org

Contact details for the corresponding author: Carrer Doctor Aiguader, 88, 08003 Barcelona, Spain
, J Vilaró5, A Arbilllaga-Etxarri6, B Herrero-Cortina7,8, MA Ramon3,9,10, A Balañá Corberó11, JC Fernández-Domínguez12,13, C Zárate-Tejero10, A Barberan-Garcia4, T Del Corral15, B Jiménez-Reguera16, A López17, D López-Fernández18,19, P Madrid Treves20, R Martinez-Alejos21,22, G Muñoz23,24, A Ríos-Cortés25,26, K Ruiz-López27, San Miguel-Pagola M8, N Sánchez-Cayado28,29..., B Valeiro30, MC Valenza31, G Valenza31, AB Varas32, S Córdoba33, A Vega28, M Linares16, Eva María Madrid25,26, S Souto17, Montserrat Vendrell23, Judith Garcia-Aymerich1,2,3Ver más
1 Barcelona of Global Health Institute (ISGlobal), Barcelona, Spain
2 Universitat Pompeu Fabra (UPF), Barcelona, Spain
3 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
4 Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
5 Facultat Ciències de la Salut Blanquerna, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, Spain
6 Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Science, Faculty of Health Science Deusto, Donostia-San Sebastián, Spain
7 Precision Medicine in Respiratory Diseases Group. Instituto de investigacion Sanitaria de Aragon, Spain
8 Universidad San Jorge, Zaragoza, Spain
9 Pneumology Department, Vall d’Hebron University Hospital, Barcelona, Spain
10 Physical Therapy Department, Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Barcelona, Spain
11 Servicio de Neumología Hospital del Mar – PSMAR, Barcelona, Spain
12 Nursing and Physiotherapy Department, University of the Balearic Islands, Palma, Spain
13 Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
15 Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM); IdISSC, Madrid, Spain
16 Departamento de Fisioterapia, Facultad de Medicina, Universidad CEU San Pablo, CEU Universities, Madrid, Spain
17 Facultad de Fisioterapia, Universidad de A Coruña, Spain
18 Faculty of Health Science. University of Las Palmas de Gran Canaria (ULPGC), Gran Canaria, Spain
19 Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, Spain
20 Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain
21 Montpellier University Training School of Physiotherapy, Montpellier, Francia
22 Kernel Biomedical, Rouen, Francia
23 Department of Pneumology, Dr Josep Trueta University Hospital. Bronchiectasis Group, Girona Biomedical Research Institute, Girona, Spain
24 Department of Physical Therapy, EUSES & ENTI. University of Girona and University of Barcelona, Girona, Spain
25 Santa Lucia’s University Hospital, Cartagena, Spain
26 Department of Physiotherapy, University of Murcia, Spain
27 Hospital Universitario Son Espases, Palma, Spain
28 Hospital Universitario Central de Asturias, Oviedo, Spain
29 Departamento de Cirugía y Especialidades Médico Quirúrgicas, Área de Fisioterapia. Universidad de Oviedo, Oviedo, Spain
30 Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
31 Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain
32 Escuela Universitaria de Fisioterapia de la ONCE. Universidad Autónoma de Madrid, Madrid, Spain
33 Centro de recuperación de personas con discapacidad física (CRMF). Instituto de Mayores y Servicios Sociales (IMSERSO), Cádiz, Spain
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Abstract

Objectives: (i) to develop sex-specific reference equations to predict distance walked (6MWD) in the 6-minute walk test (6MWT), in healthy subjects aged 45-85 years, from different geographic areas of Spain; and (ii) to compare developed equations with previously published in a large sample of COPD patients.

Methods: First, a cross-sectional multicentre sample of randomly selected healthy subjects from 17 Spanish hospitals and universities performed two 6MWT. Linear regression and fractional polynomial modelling were used to develop the equations. Second, the developed equations were applied to 715 COPD patients from Spanish primary care centres and hospitals, and the % predicted 6MWD obtained was compared with previously published equations using Dunnett’s multiple comparisons test.

Results: 568 healthy subjects were included (51% females, mean (SD) age 62 (11) years), walked a 6MWD of 615 (113) and 557 (93) meters in males and females, respectively. The developed equations included age, weight and height, and explained 43% and 51% of the 6MWD variance for males and females, respectively. In the COPD sample (n=715, 14% females, 68 (9) years, FEV1 61 (18) % predicted, 6MWD 464 (97) meters), only 1 out of 9 previously published equations for males, and 6 out of 9 for females predicted 6MWD values similar to those of the newly developed Spanish reference equations.

Conclusions: The newly developed reference equations provide a more valid prediction of 6MWD in Spanish adults with COPD compared to previously published equations. We suggest their use in future research and clinical practice for the Spanish adult population.

Keywords:
epidemiology
field test
6-minute walk test
exercise capacity
reference equation
healthy adults
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