Assessment of cardiopulmonary function: updated two-minute walk distance and walk work equations for obese Chinese populations

Q: What are the key findings of this study?

The two-minute walk test produced a mean walk distance of 185.9 ± 15.7 meters and mean walk work of 15,630.7 ± 2,136.4 kg·m in obese Chinese adults, with males walking significantly farther (190.0 ± 15.4 m vs 181.9 ± 15.0 m, p < 0.001).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Obese Chinese adults aged 18-69 years with BMI ≥30 kg/m² without significant cardiovascular, pulmonary, or other disabling diseases (n=288). Intervention: Two-minute walk test (2MWT). Primary outcome: Two-minute walk distance (2MWD) and two-minute walk work (2MWW).

He Zou; Xiaoshu Chen; Jia Zhang; Senxiang Wu; Cong Lin; Yuan Zhu; Xudong Wu; Lei Wu

doi:10.1186/s12890-025-03955-9

February 21, 2026BMC Pulmonary MedicineOpen Access

Assessment of cardiopulmonary function: updated two-minute walk distance and walk work equations for obese Chinese populations

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Key result

The two-minute walk test produces a ~186 meter mean distance in obese Chinese adults.

n=288

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Why the study?

Current reference equations for 2MWD are limited and none exist for 2MWW in obese individuals, limiting clinical applicability for cardiopulmonary function assessment.

Key Points

To establish sex-specific reference equations for the two-minute walk distance (2MWD) and two-minute walk work (2MWW) in obese Chinese adults.
Cross-sectional study conducted at Wenzhou People’s Hospital (May 2019–April 2022) evaluating 288 obese Chinese participants (144 males, 144 females; aged 18–69 years; BMI > 30 kg/m²).
Participants performed the two-minute walk test adapted from 2002 ATS guidelines across two trials, followed by stepwise multiple regression analysis to construct sex-specific reference equations.
Mean overall 2MWD was 185.9 ± 15.68 m and mean 2MWW was 15630.7 ± 2136.38 kg·m, with males recording significantly greater values than females for distance (190.0 ± 15.35 m vs. 181.9 ± 15.00 m; p < 0.001) and work (16974.5 ± 1754.88 kg·m vs. 14287.0 ± 1563.34 kg·m; p < 0.001).
Sex-specific regression equations accounted for 35% of 2MWD variance in men and 33% in women, and 61% and 62% of 2MWW variance, respectively.
The intraclass correlation coefficient between test trials was 0.89, with a small learning effect demonstrating a mean trial difference of +2.19 ± 7.26 m (p < 0.001).

Study Design

Type

Cross-Sectional (n=288)

Multicenter

No

Structured PICO

P

Population

288 obese Chinese adults aged 18–69 years (mean age 44, 50% male) with BMI ≥30 kg/m². Exclusions: history of cerebrovascular, cardiovascular, pulmonary, or other relevant diseases; walking difficulties; resting HR ≥100 or <50 bpm; uncontrolled BP.

I

Intervention

Two-minute walk test (2MWT) adapted from the 6MWT following ATS 2002 guidelines, with a 30-metre corridor and two trials.

O

Outcome

Development of sex-specific reference equations for two-minute walk distance (2MWD) and two-minute walk work (2MWW)surrogate

Newly developed sex-specific reference equations for the 2MWD and 2MWW in obese Chinese adults enhance the accuracy of cardiopulmonary function assessment compared to previous equations.

Limitations

Cross-sectional design limits causal inference.
Convenience sampling method may affect generalizability.
Exclusion of individuals with comorbidities limits applicability to all obese populations.
Use of convenience sampling may limit the generalizability of findings
Future large-scale multicentre studies are needed to validate the reference equations across diverse populations and age groups

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Implication

May support refined 2MWD interpretation in obese Chinese adults; leaves open validation in prospective cohorts.

Abstract

The two-minute walk test (2MWT) is a practical cardiopulmonary function assessment for obese individuals; however, the current reference equations for the two-minute walk distance (2MWD) are limited, and there are no equations for two-minute walk work (2MWW), reducing its clinical applicability. This study aimed to create new reference equations for the 2MWD and 2MWW in obese Chinese adults. This cross-sectional study was conducted at Wenzhou People’s Hospital (May 2019–April 2022) and targeted Chinese individuals aged 18–69 years with a BMI greater than 30 kg/m². Following the 2002 American Thoracic Society (ATS) recommendations, the 2MWT was adapted from the 6MWT. Separate equations for the 2MWD and 2MWW were developed by sex via stepwise multiple regression analysis. Among the 288 participants, the mean 2MWD was 185.9 ± 15.68 m, and the mean 2MWW was 15630.7 ± 2136.38 kg·m, with males showing significantly greater results than females did (P < 0.001). Sex-specific equations explained 35% and 61% of the variance for men, and 33% and 62% for women, respectively. The newly developed reference equations for obese Chinese adults enhance the accuracy of cardiopulmonary function assessment and may facilitate more precise monitoring and individualized management of obesity-related cardiopulmonary conditions.

Discussion

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Cite This Study

Zou et al. (2026) conducted a cross-sectional in Obese Chinese adults aged 18-69 years with BMI ≥30 kg/m² without significant cardiovascular, pulmonary, or other disabling diseases (n=288). Two-minute walk test (2MWT) was evaluated on Two-minute walk distance (2MWD) and two-minute walk work (2MWW). The two-minute walk test produced a mean walk distance of 185.9 ± 15.7 meters and mean walk work of 15,630.7 ± 2,136.4 kg·m in obese Chinese adults, with males walking significantly farther (190.0 ± 15.4 m vs 181.9 ± 15.0 m, p < 0.001).

synapsesocial.com/papers/699bee931c6c6bad5398021d https://doi.org/10.1186/s12890-025-03955-9

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Assessment of cardiopulmonary function: updated two-minute walk distance and walk work equations for obese Chinese populations

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Assessment of cardiopulmonary function: updated two-minute walk distance and walk work equations for obese Chinese populations

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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