Six-minute walk distance in healthy young adults

• Published in: Respiratory medicine Vol. 165; p. 105933
• Main Authors: Halliday, Stephen J., Wang, Li, Yu, Chang, Vickers, Brian P., Newman, John H., Fremont, Richard D., Huerta, Luis E., Brittain, Evan L., Hemnes, Anna R.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2020; Elsevier Limited
• Subjects: Adolescent; Adult; Age; Cardiorespiratory fitness; Cohort Studies; Exercise; Exercise test; Exercise Test - methods; Female; Gender; Healthy Volunteers; Heart rate; Heart Rate - physiology; Humans; Male; Middle Aged; Neuromuscular diseases; Older people; Oxygen saturation; Physical fitness; Physical training; Predictive Value of Tests; Reference Values; Regression Analysis; Respiratory function; Respiratory Function Tests - methods; Smartphones; Thorax; Variables; Walk Test; Walking - physiology; Young Adult; Young adults; United States > US; ATS; ERS; Cardiorespiratory fitness; IQR; Exercise test; 6MWD; 6MWT; Reference values; US; COPD
• ISSN: 0954-6111; 1532-3064; 1532-3064
• DOI: 10.1016/j.rmed.2020.105933

The 6-min walk test (6MWT) is a commonly used clinical assessment of exercise capacity in patients with cardiopulmonary or neuromuscular disease, but normal values are lacking for young adults, who are frequent subjects of testing. In a two-center study, 272 young adults, ages 18–50, underwent American Thoracic Society protocolized 6-min walk testing, and 56 underwent repeat testing. A linear regression model was developed based on anthropomorphic data. This model was compared to existing prediction equations. Median 6MWD for the cohort was 637 m (IQR 584–686 m) and was not significantly impacted by age. This is in contrast to existing equations extrapolated from older subjects that predict increasing 6MWD in younger subjects. We found weak correlation of 6MWD with height, weight, BMI, and resting heart rate. Heart rate at completion correlated most strongly with 6MWD (rho 0.53 p < 0.0001). Repeat 6MWD was surprisingly variable, with a median difference between tests of 32.5 ± 31.9 m. Established reference equations performed poorly in this population, largely because age has much less effect on 6MWD in this group than in older adults. Established reference equations should be reconfigured to include data from young adults, as age has minimal effect on 6MWD in this population. Heart rate response may be a valuable measure of effort in normal subjects. Six-minute walk distance, as with pulmonary function and exercise testing, should have predictive equations across the spectrum of age to allow for accurate assessment of exercise limitation. •Current reference equations for 6-min walk distance (6MWD) dramatically over-estimate 6MWD in healthy young adults.•Age has minimal impact on walking speed in healthy young adults.•Reference equations for 6MWD should be revised to include broader demographics.