Does the six-minute step test induce different functional and cardiorespiratory responses compared to the six-minute walk test in individuals with heart failure?
The six-minute step test induces greater cardiovascular stress and yields lower predicted performance values than the six-minute walk test in patients with heart failure.
BACKGROUND Cardiorespiratory fitness, recognized as an important marker of cardiovascular health, is a key determinant in the prognosis of heart failure (HF). These individuals frequently present with reduced exercise tolerance, highlighting the importance of simple and accessible methods for its assessment. The six-minute walk test (6MWT) and the six-minute step test (6MST) are reliable tools to estimate functional capacity, although differences in their protocols may lead to distinct functional and cardiorespiratory responses. OBJECTIVES To evaluate and compare the functional and cardiorespiratory responses between the 6MWT and the 6MST in individuals with HF. METHODS This observational study included individuals with HF of both sexes, aged 18 years or older. They performed the 6MWT and the 6MST to assess functional capacity. Statistical significance was set at p < 0.05. RESULTS A total of 60 individuals were included, showing reduced predicted percentage values in both tests, with lower performance in the 6MST compared to the 6MWT (69.7% vs. 84.7%; P < 0.001). Cardiorespiratory responses differed between tests, with the maximum heart rate (HRmax) during the 6MST significantly higher than the 6MWT (114.8 bpm vs. 104.2 bpm; P < 0.001). At the end of the tests, HR, systolic blood pressure (SBP), Borg dyspnea, and leg fatigue scores were significantly higher in the 6MST (P < 0.001). CONCLUSIONS Individuals with HF demonstrated impaired functional capacity, with lower predicted values in the 6MST. This test induced greater cardiovascular stress than the 6MWT, resulting in higher HRmax and SBP, as well as increased dyspnea and leg fatigue.
Soares et al. (Tue,) studied this question.