2013

http://informahealthcare.com/idsISSN 0963-8288 print/ISSN 1464-5165 online

Disabil Rehabil, 2013; 35(18): 1586–1587! 2013 Informa UK Ltd. DOI: 10.3109/09638288.2012.742576

LETTER TO THE EDITOR

Six-minute walking test in children

Roberta Boucault1,2, Marcelo Fernandes2,3, and Vitor Oliveira Carvalho1,2

1Instituto do Coracao do Hospital das Clınicas da Faculdade de Medicina da USP Sao Paulo, Brazil, 2The GREAT Group (GRupo de Estudos em

ATividade fısica) Sao Paulo, Brazil, and 3Curso de Fisioterapia, Universidade Presbiteriana Mackenzie Barueri, Sao Paulo, Brazil

� Implications for Rehabilitation

� Six-minute walking test.� The six-minute walking test is safe and widely performed in the world because of its easy

implementation and low cost.� Many countries have established normal values to the six-minute walking test in healthy

children.� However, the applicability of this test also gains popularity among children with other disease

conditions.

Keywords

Children, exercise, physiotherapy, six-minutewalking test

History

Received 8 October 2012Accepted 18 October 2012Published online 8 January 2013

The six-minute walking test is, conceptually, a submaximal test.It is safe and widely performed in the world because of its easyimplementation and low cost. Moreover, this test may reflect theactivities of daily life, since they are performed on a submaximaleffort [1,2].

Because of high clinical relevance and applicability, manycountries have established normal values to the six-minutewalking test in healthy children, such as China, Austria, UK,Thailand, North Africa, India, the USA and Brazil [2–9].However, the applicability of the six-minute walking test alsogains popularity among children with other diseaseconditions [10].

The study by Vanhelst et al. [11] aimed to assess the validityand reproducibility of the six-minute walking test in young obeseand developed an equation to predict oxygen consumption. Thisstudy is very interesting and adds important information about thesix-minute walking test in young obese. Moreover, this studyopens a discussion regarding objective markers of physical fitnessin this population.

Interestingly, in the study of Vanhelst et al. [11], obeseyoungsters walked an average distance of 689.40 m. However,studies in several countries with healthy children with normalBody Mass Index had lower values of walked distance (Table 1),except in North Africa [6]. They reported that the obese childrenperformed the six-minute walking test after a year of health andwell-being program. It is possible that the difference in walkeddistance between the study of Vanhelst et al. [11] (689 m) and theaverage of studies worldwide (605 m) have been influenced by theprogram of health and wellness. The equation presented by them

is very relevant in clinical practice and can be a reference forfuture studies involving this population, such as epidemiologicalstudies and studies for children with metabolic syndrome.

Declaration of interest

The authors report no conflicts of interest. The authors alone areresponsible for the content and writing of this article.

References

1. Solway S, Brooks D, Lacoose Y, Thomas S. A qualitative systematicoverview of the measured properties of functional walk tests used incardiorespiratory domain. Chest 2001;119:256–70.

2. Li AM, Yin J, Au JT, et al. Standard reference for the six-minute-walk test in healthy children aged 7 to 16 years. Am J Respir CritCare Med 2007;176:174–80.

3. Geiger R, Strasak A, Treml B, et al. Six-minute walk test in childrenand adolescents. J Pediatr 2007;150:395–9.

Address for correspondence: Vitor Oliveira Carvalho, Instituto doCoracao do Hospital das Clınicas da Faculdade de Medicina dauniversidade de sao paulo, Av. Dr Eneas de Carvalho Aguiar, 44 Servicode Cirurgia Cardıaca Pediatrica, Bloco 2, 2 Andar, Sao Paulo 05403-900,Brazil. Tel: þ55 11 26615399. E-mail: vitor.carvalho@usp.br

Table 1. Characteristics of the studies around the world.

Study Country n Age BMI

Walked

distance

(m)

Li et al. [2] China 1445 7–16 18.4 (�3.4) 664 (�65)

Geiger et al. [3] Austria 528 3–18 17.36 (�2.48) 624 (�74)

Lammers et al. [4] UK 328 4–11 16.9 (�2.6) 470 (�59)

Tonklang et al. [5] Thailand 739 9–12 17.83 (�0.1) 677 (�62)

Saad et al. [6] North

Africa

200 6–12 18.5 (�2.06) 700 (�73)

D’silva et al. [7] India 400 7–12 14.77 (�0.75) 608 (�166)

Klepper et al. [8] USA 100 7–11 18.52 (6.50)a 518.5 (�73)

Priesnitz et al. [9] Brazil 188 6–12 18.5 (�3.0) 579 (�68)

World avarage 17.59 (�1.29) 605 (�80)

Vanhelst et al. [11] France 97 7–18 30.2 (�5.8) 689.4 (�98)

aSkewed data are presented as the median (interquartile range).

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4. Lammers AE, Hislop AA, Flynn Y, Haworth SG. The 6-minute walktest: normal values for children of 4–11 years of age. Arch Dis Child2008;93:464–8.

5. Tonklang N, Roymanee S, Sopontammarak S. Developing standardreference data for Thai children from a six-minute walk test. J MedAssoc Thai 2011;94:470–5.

6. Saad HB, Prefaut C, Missaoui R, et al. Reference equation for 6-minwalk distance in healthy North African children 6–16 years old.Pediatr Pulmonol 2009;44:316–24.

7. D’silva C, Vaishali K, Venkatesan P. Six-minute walk test-normalvalues of school children aged 7–12y in India: a cross-sectionalstudy. Indian J Pediatr 2011;79:1–5.

8. Klepper SE, Muir N. Reference values on the 6-minute walk test forchildren living in the United States. Pediatr Phys Ther 2011;23:32–40.

9. Priesnitz CV, Rodrigues GH, Stumpf CS, et al. Reference values forthe 6-min walk test in healthy children aged 6-12 years. PediatrPulmonol 2009;44:1174–9.

10. Cunha MT, Rozov T, Oliveira RC, et al. Six-minute walk test inchildren and adolescents with cystic fibrosis. Pediatr Pulmonol2006;41:618–22.

11. Vanhelst J, Fardy PS, Salleron J, et al. The six-minute walk test inobese youth: reproducibility, validity, and prediction equation toassess aerobic power. Disabil Rehabil 2012; doi:10.3109/09638288.2012.699581 [Epub ahead of print].

DOI: 10.3109/09638288.2012.742576 Six-minute walking test 1587

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