Correlations Between Gait Speed, 6-Minute Walk Distance, Physical Activity, and Self-Efficacy in Patients With Severe Chronic Lung Disease

BACKGROUND: Four-meter gait speed (4MGS) has been associated with functional capacity and overall mortality in elderly patients, and may easily be translated to daily practice. We evaluated the association of 4MGS with meaningful outcomes. METHODS: In 70 subjects we conducted the 4MGS, 6-min walk test (6MWT), objectively measured physical activity, and assessed dyspnea, quality of life, and self-efficacy for walking and routine physical activity. 4MGS was measured in 3 separate time epochs during the 6MWT, to explore 4MGS variability. RESULTS: Diagnoses included COPD (51.4%), interstitial lung disease (38.6%), and other pulmonary conditions (10%). The mean ± SD values were: 4MGS 0.85 ± 0.21 m/s, 6-min walk distance (6MWD) 305 ± 115 m, and physical activity level 1.28 ± 0.17, which is consistent with severe physical inactivity. The gait speeds within the time epochs 1–2, 3–4, and 5–6 min during the 6MWT were not significantly different: 1.01 ± 0.29 m/s, 0.98 ± 0.31 m/s, and 1.00 ± 0.31 m/s, respectively. 4MGS had a significant correlation with 6MWD (r = 0.70, P < .001). 6MWD was the dominant variable for predicting 4MGS. Other significant predictors of 4MGS included dyspnea, self-efficacy, quality of life, and objectively measured physical activity. CONCLUSIONS: 4MGS is significantly and independently associated with 6MWD, and may serve as a reasonable simple surrogate for 6MWD in subjects with chronic lung disease. Gait speed was remarkably stable throughout the 6MWT, which supports the validity of an abbreviated walk test such as 4MGS.

[1]  F. Martinez,et al.  Factors to inform clinicians about the end of life in severe chronic obstructive pulmonary disease. , 2013, Journal of pain and symptom management.

[2]  L. Edwards,et al.  Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization. , 2013, American journal of respiratory and critical care medicine.

[3]  Paul Cullinan,et al.  Reliability and validity of 4-metre gait speed in COPD , 2012, European Respiratory Journal.

[4]  Olaf Holz,et al.  Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. , 2011, Chest.

[5]  S. Ozalevli,et al.  Gait speed as a functional capacity indicator in patients with chronic obstructive pulmonary disease , 2011, Annals of thoracic medicine.

[6]  S. Studenski,et al.  Gait speed and survival in older adults. , 2011, JAMA.

[7]  D. Brooks,et al.  Measurement properties of the SenseWear armband in adults with chronic obstructive pulmonary disease , 2010, Thorax.

[8]  S. Studenski,et al.  Bradypedia: Is gait speed ready for clinical use? , 2009, The journal of nutrition, health & aging.

[9]  M. Inzitari,et al.  Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force , 2009, The journal of nutrition, health & aging.

[10]  Christophe Tzourio,et al.  Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study , 2009, BMJ : British Medical Journal.

[11]  H. Magnussen,et al.  Physical activity in patients with COPD , 2008, European Respiratory Journal.

[12]  J. Piette,et al.  Self-Efficacy, Social Support, and Associations With Physical Activity and Body Mass Index Among Women With Histories of Gestational Diabetes Mellitus , 2008, The Diabetes educator.

[13]  H. Magnussen,et al.  Extrapulmonary effects of chronic obstructive pulmonary disease on physical activity: a cross-sectional study. , 2008, American journal of respiratory and critical care medicine.

[14]  Chris M. Blanchard,et al.  Explaining physical activity levels from a self-efficacy perspective: the physical activity counseling trial , 2007, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[15]  B. Celli,et al.  The 6-min walk distance, peak oxygen uptake, and mortality in COPD. , 2007, Chest.

[16]  J. Buckner,et al.  Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. , 2007, Journal of pain and symptom management.

[17]  Frank C Sciurba,et al.  Activity Monitoring and Energy Expenditure in COPD Patients: A Validation Study , 2007, COPD.

[18]  A. S. Leung,et al.  Reliability, validity, and responsiveness of a 2-min walk test to assess exercise capacity of COPD patients. , 2006, Chest.

[19]  S. Studenski,et al.  Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults , 2006, Journal of the American Geriatrics Society.

[20]  M. Bartels,et al.  Exercise testing determines survival in patients with diffuse parenchymal lung disease evaluated for lung transplantation. , 2005, Respiratory medicine.

[21]  R. Arusell,et al.  A Prospective Study of Quality of Life in Adults with Newly Diagnosed High-grade Gliomas: The Impact of the Extent of Resection on Quality of Life and Survival , 2005, Neurosurgery.

[22]  H. Palevsky,et al.  Health-related quality of life in patients with pulmonary arterial hypertension , 2005, Respiratory research.

[23]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[24]  V. Backer,et al.  Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients--a pilot study. , 2004, Respiratory medicine.

[25]  S. Butcher,et al.  Reductions in functional balance, coordination, and mobility measures among patients with stable chronic obstructive pulmonary disease. , 2004, Journal of cardiopulmonary rehabilitation.

[26]  S. Studenski,et al.  Physical Performance Measures in the Clinical Setting , 2003, Journal of the American Geriatrics Society.

[27]  M. Tsukino,et al.  Relationship between different indices of exercise capacity and clinical measures in patients with chronic obstructive pulmonary disease. , 2002, Heart & lung : the journal of critical care.

[28]  L. Mollinger,et al.  Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. , 2002, Physical therapy.

[29]  W. Rodgers,et al.  Task, Coping, and Scheduling Self-Efficacy in Relation to Frequency of Physical Activity1 , 2001 .

[30]  S J Jay,et al.  Reference equations for the six-minute walk in healthy adults. , 2000 .

[31]  M. Fujita,et al.  Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension. Comparison with cardiopulmonary exercise testing. , 2000, American journal of respiratory and critical care medicine.

[32]  G. Raghu,et al.  Assessment of health-related quality of life in patients with interstitial lung disease. , 1999, Chest.

[33]  P. Jones,et al.  Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease , 1999, Thorax.

[34]  T. Rummans,et al.  Quality of life in hospice patients. A pilot study. , 1999, Psychosomatics.

[35]  E H Wagner,et al.  Evidence for a non-linear relationship between leg strength and gait speed. , 1996, Age and ageing.

[36]  R B Wallace,et al.  Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. , 1995, The New England journal of medicine.

[37]  R. J. Shephard,et al.  Physical Activity Is the Strongest Predictor of All-Cause Mortality in Patients With COPD: A Prospective Cohort Study , 2012 .

[38]  S. Fritz,et al.  White paper: "walking speed: the sixth vital sign". , 2009, Journal of geriatric physical therapy.

[39]  S. Harari,et al.  Walking distance on 6-MWT is a prognostic factor in idiopathic pulmonary fibrosis. , 2009, Respiratory medicine.

[40]  Karen L McCulloch,et al.  Development of a Clinical Measure of Dual‐task Performance in Walking: Reliability and Preliminary Validity of the Walking and Remembering Test , 2009, Journal of geriatric physical therapy.

[41]  ATS statement: guidelines for the six-minute walk test. , 2002, American journal of respiratory and critical care medicine.

[42]  Ack,et al.  LOWER-EXTREMITY FUNCTION IN PERSONS OVER THE AGE OF 70 YEARS AS A PREDICTOR OF SUBSEQUENT DISABILITY , 2001 .

[43]  R. Kaplan,et al.  Specific efficacy expectations mediate exercise compliance in patients with COPD. , 1984, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[44]  A. Dobson,et al.  Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. , 1981, Journal of chronic diseases.