What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy (n=266). Intervention: Male sex vs. Female sex. Primary outcome: Six-minute walking distance (6MWD) (p=<0.0001).

What does this research mean for the field?

In healthy Chinese people aged 60-85 years, the mean six-minute walking distance is 502 m, with males achieving a significantly longer distance than females, and age, height, and BMI serving as independent predictors. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To measure the six-minute walking distance (6MWD) of healthy Chinese individuals aged 60-85 and establish reference equations for predicting 6MWD.

June 22, 2020Open Access

Six-minute walking distance in healthy Chinese people older than 60 years

Q: What are the key findings of this study?

In healthy Chinese people aged 60-85 years, the mean six-minute walking distance was 502 m, with males achieving a significantly longer distance than females (518 m vs. 487 m).

Q: What does this research mean for the field?

In healthy Chinese people aged 60-85 years, the mean six-minute walking distance is 502 m, with males achieving a significantly longer distance than females, and age, height, and BMI serving as independent predictors. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To measure the six-minute walking distance (6MWD) of healthy Chinese individuals aged 60-85 and establish reference equations for predicting 6MWD.

HZHe ZouWenzhou Medical University JZJia ZhangWenzhou Medical University YZYingying ZouNanfang Hospital

Key Result

In healthy Chinese people aged 60-85 years, the mean six-minute walking distance was 502 m, with males achieving a significantly longer distance than females (518 m vs. 487 m).

Key Points

To measure the six-minute walking distance (6MWD) of healthy Chinese individuals aged 60-85 and establish reference equations for predicting 6MWD.
266 healthy subjects aged 60-85 years completed two six-minute walking tests (6MWTs) to measure their walking distance.
Demographic and anthropometric data were collected, including age, height, and body mass index (BMI) before testing.
Multivariate regression analysis was conducted to identify independent predictors of 6MWD.
Mean 6MWD was 518 ± 72 m for males and 487 ± 70 m for females (p < 0.0001).
Active subjects demonstrated a longer 6MWD than nonactive subjects (512 ± 76 m vs. 485 ± 63 m; p < 0.0001).
Age, height, and BMI were identified as independent predictors of the 6MWD.

Study Design

Type

Cross-Sectional (n=266)

Multicenter

Structured PICO

Population

266 healthy Chinese adults aged 60-85 years (mean age 72, 48% male). Key inclusion: healthy, BMI 18-30 kg/m2. Key exclusion: preexisting limitations of exercise ability, organic disease, resting BP ≥140/90 mmHg, resting HR <50 or ≥100 bpm, abnormal lung function.

Intervention

Six-minute walking test (6MWT) performed twice according to ATS guidelines

Outcome

Six-minute walking distance (6MWD) and establishment of reference prediction equationssurrogate

This study establishes the first reference equations for the six-minute walking distance in healthy Chinese individuals aged 60-85 years, based on age, height, and BMI.

Main Result

Absolute Event Rate: 518% vs 487%

p-value: p=<0.0001

Limitations

The study used a convenience sample rather than a random sample.
Did not recruit overweight people, so reference equations are not applicable to subjects with a BMI > 30 kg/m2.

Abstract

BACKGROUND: The six-minute walking test (6MWT) is a tool that plays a key role in evaluating the functional exercise capacity, prognosis and evaluation of treatment response of patients with various cardiopulmonary diseases. However, standard reference equations are currently unavailable for the six-minute walking distance (6MWD) for people aged 60-85 years in China. The purpose of this study was to 1) measure the 6MWD of healthy Chinese people aged 60-85 years, 2) establish reference equations for predicting the 6MWD, and 3) compare our reference equations with equations reported in previously published studies. METHOD: We obtained informed consent from each participant prior to the test, and the research design was approved by the Ethics Committee of Wenzhou People's Hospital. The demographic and anthropometric data and the 6MWD of healthy Chinese subjects aged 60-85 years old were measured using a standardized protocol. Every subject completed two 6MWTs, and the longest 6MWD further analyzed. RESULTS: Two hundred sixty-six subjects (128 males and 138 females) completed the 6MWT, and the mean walking distance was 518 ± 72 m. Males achieved a longer walking distance than females (518 ± 72 m vs. 487 ± 70 m; p < 0.0001), and active subjects achieved a longer walking distance than nonactive subjects (512 ± 76 m vs. 485 ± 63 m; p < 0.0001). According to the univariate analysis, the 6MWD was significantly associated with age, height, body mass index (BMI), heart rate and blood pressure after exercise and changes in heart rate before and after exercise. The stepwise multivariate regression analysis identified age, height and BMI as independent predictors of the 6MWD. The reference equations for Caucasians and South Americans tended to overestimate the 6MWD of our subjects, while the equations for Asian and African populations tended to underestimate the 6MWD. CONCLUSIONS: This study is the first to describe the 6MWD of healthy Chinese people aged 60-85 years, and reference prediction equations were proposed. These findings will help to improve the evaluation of Chinese patients with diseases that affect exercise capacity.

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