Clinical value and status of six-minute walk test in thoracic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

NA Rongrui ¹ ,  JIN Jian ² , LEI Yuechang ² , WANG Yifan ²

1. Zunyi Medical University, Zunyi, 563000, Guizhou, P.R.China;
2. Department of Cardiothoracic Surgery, Affiliated Hospital of Chengdu University, Chengdu, 610000, P.R.China;

Corresponding author：

JIN Jian, Email: 577266594@qq.com

Keywords：

Cardiopulmonary exercise testing; six-minute walk test; preoperative assessment; rehabilitation exercise

DOI：

10.7507/1007-4848.201603041

Video：

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Six-minute walk test (6MWT) is one of the cardiopulmonary exercise testing (CPET). It is not only used to assess the cardiac and pulmonary function of patients with chronic obstructive pulmonary disease (COPD), but also used to assess COPD patients’ health-related quality of life (HRQoL) or self-management in daily life. With the concept of enhanced recovery after surgery (ERAS) put forward, assessing patients’ preoperative cardiac and pulmonary function, establishing preoperative and early postoperative exercises standards, as well as assessing cardiac and pulmonary rehabilitation after surgery become much more important. CPET gets more attention from clinical surgeons. This study focuses on the clinical value and status of 6MWT in thoracic surgery.

Citation： NA Rongrui, JIN Jian, LEI Yuechang, WANG Yifan. Clinical value and status of six-minute walk test in thoracic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(4): 310-314. doi: 10.7507/1007-4848.201603041 Copy

1.	Balke B. A simple field test for the assessment of physical fitness. Rep Civ Aeromed Res Inst US, 1963: 1-8.
2.	Cooper KH. A means of assessing maximal oxygen intake: correlation between field and treadmill testing. JAMA, 1968, 203(3): 201-204.
3.	McGavin CR, Gupta SP, McHardy GJR. Twelve-minute walking test for assessing disability in chronic bronchitis. BMJ, 1976, 1(6013): 822-823.
4.	Butland RJA, Pang J, Gross ER, et al. Two-, six-, and 12-minute walking tests in respiratory disease. BMJ, 1982, 284(6329): 1607-1608.
5.	Solway S, Brooks D, Lacasse Y, et al. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest, 2001, 119(1): 256-270.
6.	ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med, 2002, 166(1): 111-117.
7.	Casanova C, Celli BR, Barria P, et al. The 6-min walk distance in healthy subjects: reference standards from seven countries. Eur Respir J, 2011, 37(1): 150-156.
8.	Enright PL, Sherrill DL. Reference equations for the six minute walk in healthy adults. Am J espir Crit Care Med, 1998, 158(5pt1): 1384-1387.
9.	Britto RR, Probst VS, de Andrade AF, et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther, 2013, 17(6): 556-563.
10.	Ben Saad H, Prefaut C, Tabka Z, et al. 6-minute walk distance in healthy North Africans older than 40 years: Influence of parity. Respir Med, 2009, 103(1): 74-84.
11.	Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J, 1999, 14(2): 270-274.
12.	Alameri H, Al-Majed S, Al-Howaikan A. Six-min walk test in a healthy adult Arab population. Respir Med, 2009, 103(7): 1041-1046.
13.	Kim AL, Kwon JC, Park I, et al. Reference equations for the six-minute walk distance in healthy Korean adults, aged 22-59 years. Tuberc Respir Dis, 2014, 76(6): 269-275.
14.	Camarri B, Eastwood PR, Cecins NM, et al. Six minute walk distance in healthy subjects aged 55-75 years. Respir Med, 2006, 100(4): 658-65.
15.	龚瑞, 程新春, 郭爱华. 慢性阻塞性肺疾病患者生活质量评估问卷与 6 分钟步行试验的临床应用. 中国现代医生, 2013, 51(10): 139-142.
16.	武伟华, 陈冉, 孟玲, 等. 6 分钟步行试验、BMI及MMRC对评价COPD病情严重程度的意义. 泰山医学院学报, 2013, 10(34): 740-743.
17.	王亦军, 徐云, 张慎峰. 6 分钟步行试验与稳定期 COPD 分级相关性探讨. 泰山医学院学报, 2014, 12(35): 1294-1295.
18.	刘淑, 何远强, 郑玉龙, 等. COPD 严重程度分级与 6 分钟步行试验距离的关系. 广东医学, 2011, 32(3): 344-345.
19.	Guyatt GH, Berman LB, Townsend M, et al. A measure of quality of life for clinical trials in chronic lung disease. Thorax, 1987, 42(10): 773-778.
20.	Jones PW, Quirk FH, Baveystock CM. The St George’s Respiratory Questionnaire. Respir Med, 1991, 85(Suppl B): 25-31.
21.	Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J, 2002, 19(3): 398-404.
22.	Chang NW, Lin KC, Lee SC, et al. Effects of an early postoperative walking exercise programme on health status in lung cancer patients recovering from lung lobectomy. J Clin Nurs, 2014, 23(23-24): 3391-3402.
23.	Alison JA, McKeough ZJ. Pulmonary rehabilitation for COPD: are programs with minimal exercise equipment effective? J Thorac Dis, 2014, 6(11): 1606-1614.
24.	Morales-Blanhir JE, Palafox Vidal CD, Rosas Romero Mde J, et al. Six-minute walk test: a valuable tool for assessing pulmonary impairment. J Bras Pneumol, 2011, 37(1): 110-117.
25.	Farias CC, Resqueti V, Dias FA, et al. Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial. Braz J Phys Ther, 2014, 18(2): 165-173.
26.	谭春婷, 王浩彦, 崔永, 等. 心肺运动试验在肺癌手术风险评估中的应用. 中国肺癌杂志, 2011, 4(7): 613-616.
27.	DeCamp MM Jr, Lipson D, Krasna M, et al. The evaluation and preparation of the patient for lung volume reduction surgery. Proc Am Thorac Soc, 2008, 5(4): 427-431.
28.	Agrawal MB, Awad NT. 6MWT and spirometry in chronic pulmonary diseases. J Clin Diagn Res, 2015, 9(8): OC01-OC04.
29.	Cataneo DC, Kobayasi S, Carvalho LR, et al. Accuracy of six minute walk test, stair test and spirometry using maximal oxygen uptake as gold standard. Acta Cirúrgica Brasileira, 2010, 25(2): 194-200.
30.	王俊义. 运动心肺试验及六分钟步行试验预测肺癌患者术后肺部并发症的研究. 天津: 天津医科大学, 2013. 1-60.
31.	Ginsburg ME, Thomashow BM, Bulman WA, et al. The safety, efficacy, and durability of lung-volume reduction surgery: A 10-year experience. J Thorac Cardiovasc Surg. 2016, 151(3): 717-724.
32.	Santos BF, Souza HC, Miranda AP, et al. Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study. Braz J Phys Ther, 2016, 20(1): 66-72.
33.	Keeratichananont W, Thanadetsuntorn C, Keeratichananont S. Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications. Ther Adv Respir Dis, 2016, 10(1): 18-25.
34.	Agnew N. Preoperative cardiopulmonary exercise testing. Contin Educ Anaesth Crit Care Pain, 2010, 10(2): 33-37.
35.	Marjanski T, Wnuk D, Bosakowski D, et al. Patients who do not reach a distance of 500 m during the 6-min walk test have an increased risk of postoperative complications and prolonged hospital stay after lobectomy. Eur J Cardiothorac Surg, 2015, 47(5): e213-e219.
36.	Castleberry AW, Englum BR, Snyder LD, et al. The utility of preoperative six-minute-walk distance in lung transplantation. Am J Respir Crit Care Med, 2015, 192(7): 843-852.
37.	Ha D, Choi H, Zell K, et al. Association of impaired heart rate recovery with cardiopulmonary complications after lung cancer resection surgery. J Thorac Cardiovasc Surg, 2015, 149(4): 1168-1173.
38.	Granger CL, Parry SM, Edbrooke L, et al. Deterioration in physical activity and function differs according to treatment type in non-small cell lung cancer future directions for physiotherapy management. Physiotherapy, 2016, 102(3): 256-263.
39.	Cavalheri V, Jenkins S, Cecins N, et al. Impairments after curative intent treatment for non-small cell lung cancer: A comparison with age and gender-matched healthy controls. Respir Med, 2015, 109(10): 1332-1339.
40.	Brocki BC, Westerdahl E, Andreasen JJ, et al. Improvements in physical performance and health-related quality of life one year after radical operation. Cancer Treat Commun, 2015, 4: 65-74.
41.	Kaneda H, Saito Y, Okamoto M, et al. Early postoperative mobilization with walking at 4 hours after lobectomy in lung cancer patients. Gen Thorac Cardiovasc Surg, 2007, 55(12): 493-498.
42.	Sterzi S, Cesario A, Cusumano G, et al. Post-opertaive rehabilitation for surgically resected non-small cell lung cancer patients: serial pulmonary functional analysis. J Rehabil Med, 2013, 45(9): 911-915.
43.	Weisman IM. Cardiopulmonary exercise testing in the preoperative assessment for lung resection surgery. Semin Thorac Cardiovase Surg, 2001, 13(2): 116-125.
44.	Jones L, Eves ND, Mackey JR, et al. Safety and feasibility of cardiopulmonary exercise testing in patients with advanced cancer. Lung Cancer, 2007, 55(2): 225-232.
45.	Jones LW, Watson D, Herndon 2nd JE, et al. Peak oxygen consumption and long-term all-cause mortality in nonsmall cell lung cancer. Cancer, 2010, 116(20): 4825-4832.
46.	Brunelli A, Belardinelli R, Refai M, et al. Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in andidates to major lung resection. Chest, 2009, 135(5): 1260-1267.
47.	于斌, 昊楚财, 冯起校. 六分钟步行试验在肺功能评价中的应用现状及展望. 国际呼吸杂志, 2010, 3, 30(5): 314-316.
48.	冯慧萍. 六分钟步行试验在慢性阻塞性肺疾病患者心肺功能检测中的应用. 吉林医学, 2012, 6, 33(17): 3711-3712.
49.	王俊义, 张鹏, 刘毅梅, 等. 6 分钟步行试验与运动心肺功能测定预测肺癌患者术后并发症的价值. 天津医科大学学报, 2013, 19(2): 137-139.

1. Balke B. A simple field test for the assessment of physical fitness. Rep Civ Aeromed Res Inst US, 1963: 1-8.
2. Cooper KH. A means of assessing maximal oxygen intake: correlation between field and treadmill testing. JAMA, 1968, 203(3): 201-204.
3. McGavin CR, Gupta SP, McHardy GJR. Twelve-minute walking test for assessing disability in chronic bronchitis. BMJ, 1976, 1(6013): 822-823.
4. Butland RJA, Pang J, Gross ER, et al. Two-, six-, and 12-minute walking tests in respiratory disease. BMJ, 1982, 284(6329): 1607-1608.
5. Solway S, Brooks D, Lacasse Y, et al. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest, 2001, 119(1): 256-270.
6. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med, 2002, 166(1): 111-117.
7. Casanova C, Celli BR, Barria P, et al. The 6-min walk distance in healthy subjects: reference standards from seven countries. Eur Respir J, 2011, 37(1): 150-156.
8. Enright PL, Sherrill DL. Reference equations for the six minute walk in healthy adults. Am J espir Crit Care Med, 1998, 158(5pt1): 1384-1387.
9. Britto RR, Probst VS, de Andrade AF, et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther, 2013, 17(6): 556-563.
10. Ben Saad H, Prefaut C, Tabka Z, et al. 6-minute walk distance in healthy North Africans older than 40 years: Influence of parity. Respir Med, 2009, 103(1): 74-84.
11. Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J, 1999, 14(2): 270-274.
12. Alameri H, Al-Majed S, Al-Howaikan A. Six-min walk test in a healthy adult Arab population. Respir Med, 2009, 103(7): 1041-1046.
13. Kim AL, Kwon JC, Park I, et al. Reference equations for the six-minute walk distance in healthy Korean adults, aged 22-59 years. Tuberc Respir Dis, 2014, 76(6): 269-275.
14. Camarri B, Eastwood PR, Cecins NM, et al. Six minute walk distance in healthy subjects aged 55-75 years. Respir Med, 2006, 100(4): 658-65.
15. 龚瑞, 程新春, 郭爱华. 慢性阻塞性肺疾病患者生活质量评估问卷与 6 分钟步行试验的临床应用. 中国现代医生, 2013, 51(10): 139-142.
16. 武伟华, 陈冉, 孟玲, 等. 6 分钟步行试验、BMI及MMRC对评价COPD病情严重程度的意义. 泰山医学院学报, 2013, 10(34): 740-743.
17. 王亦军, 徐云, 张慎峰. 6 分钟步行试验与稳定期 COPD 分级相关性探讨. 泰山医学院学报, 2014, 12(35): 1294-1295.
18. 刘淑, 何远强, 郑玉龙, 等. COPD 严重程度分级与 6 分钟步行试验距离的关系. 广东医学, 2011, 32(3): 344-345.
19. Guyatt GH, Berman LB, Townsend M, et al. A measure of quality of life for clinical trials in chronic lung disease. Thorax, 1987, 42(10): 773-778.
20. Jones PW, Quirk FH, Baveystock CM. The St George’s Respiratory Questionnaire. Respir Med, 1991, 85(Suppl B): 25-31.
21. Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J, 2002, 19(3): 398-404.
22. Chang NW, Lin KC, Lee SC, et al. Effects of an early postoperative walking exercise programme on health status in lung cancer patients recovering from lung lobectomy. J Clin Nurs, 2014, 23(23-24): 3391-3402.
23. Alison JA, McKeough ZJ. Pulmonary rehabilitation for COPD: are programs with minimal exercise equipment effective? J Thorac Dis, 2014, 6(11): 1606-1614.
24. Morales-Blanhir JE, Palafox Vidal CD, Rosas Romero Mde J, et al. Six-minute walk test: a valuable tool for assessing pulmonary impairment. J Bras Pneumol, 2011, 37(1): 110-117.
25. Farias CC, Resqueti V, Dias FA, et al. Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial. Braz J Phys Ther, 2014, 18(2): 165-173.
26. 谭春婷, 王浩彦, 崔永, 等. 心肺运动试验在肺癌手术风险评估中的应用. 中国肺癌杂志, 2011, 4(7): 613-616.
27. DeCamp MM Jr, Lipson D, Krasna M, et al. The evaluation and preparation of the patient for lung volume reduction surgery. Proc Am Thorac Soc, 2008, 5(4): 427-431.
28. Agrawal MB, Awad NT. 6MWT and spirometry in chronic pulmonary diseases. J Clin Diagn Res, 2015, 9(8): OC01-OC04.
29. Cataneo DC, Kobayasi S, Carvalho LR, et al. Accuracy of six minute walk test, stair test and spirometry using maximal oxygen uptake as gold standard. Acta Cirúrgica Brasileira, 2010, 25(2): 194-200.
30. 王俊义. 运动心肺试验及六分钟步行试验预测肺癌患者术后肺部并发症的研究. 天津: 天津医科大学, 2013. 1-60.
31. Ginsburg ME, Thomashow BM, Bulman WA, et al. The safety, efficacy, and durability of lung-volume reduction surgery: A 10-year experience. J Thorac Cardiovasc Surg. 2016, 151(3): 717-724.
32. Santos BF, Souza HC, Miranda AP, et al. Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study. Braz J Phys Ther, 2016, 20(1): 66-72.
33. Keeratichananont W, Thanadetsuntorn C, Keeratichananont S. Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications. Ther Adv Respir Dis, 2016, 10(1): 18-25.
34. Agnew N. Preoperative cardiopulmonary exercise testing. Contin Educ Anaesth Crit Care Pain, 2010, 10(2): 33-37.
35. Marjanski T, Wnuk D, Bosakowski D, et al. Patients who do not reach a distance of 500 m during the 6-min walk test have an increased risk of postoperative complications and prolonged hospital stay after lobectomy. Eur J Cardiothorac Surg, 2015, 47(5): e213-e219.
36. Castleberry AW, Englum BR, Snyder LD, et al. The utility of preoperative six-minute-walk distance in lung transplantation. Am J Respir Crit Care Med, 2015, 192(7): 843-852.
37. Ha D, Choi H, Zell K, et al. Association of impaired heart rate recovery with cardiopulmonary complications after lung cancer resection surgery. J Thorac Cardiovasc Surg, 2015, 149(4): 1168-1173.
38. Granger CL, Parry SM, Edbrooke L, et al. Deterioration in physical activity and function differs according to treatment type in non-small cell lung cancer future directions for physiotherapy management. Physiotherapy, 2016, 102(3): 256-263.
39. Cavalheri V, Jenkins S, Cecins N, et al. Impairments after curative intent treatment for non-small cell lung cancer: A comparison with age and gender-matched healthy controls. Respir Med, 2015, 109(10): 1332-1339.
40. Brocki BC, Westerdahl E, Andreasen JJ, et al. Improvements in physical performance and health-related quality of life one year after radical operation. Cancer Treat Commun, 2015, 4: 65-74.
41. Kaneda H, Saito Y, Okamoto M, et al. Early postoperative mobilization with walking at 4 hours after lobectomy in lung cancer patients. Gen Thorac Cardiovasc Surg, 2007, 55(12): 493-498.
42. Sterzi S, Cesario A, Cusumano G, et al. Post-opertaive rehabilitation for surgically resected non-small cell lung cancer patients: serial pulmonary functional analysis. J Rehabil Med, 2013, 45(9): 911-915.
43. Weisman IM. Cardiopulmonary exercise testing in the preoperative assessment for lung resection surgery. Semin Thorac Cardiovase Surg, 2001, 13(2): 116-125.
44. Jones L, Eves ND, Mackey JR, et al. Safety and feasibility of cardiopulmonary exercise testing in patients with advanced cancer. Lung Cancer, 2007, 55(2): 225-232.
45. Jones LW, Watson D, Herndon 2nd JE, et al. Peak oxygen consumption and long-term all-cause mortality in nonsmall cell lung cancer. Cancer, 2010, 116(20): 4825-4832.
46. Brunelli A, Belardinelli R, Refai M, et al. Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in andidates to major lung resection. Chest, 2009, 135(5): 1260-1267.
47. 于斌, 昊楚财, 冯起校. 六分钟步行试验在肺功能评价中的应用现状及展望. 国际呼吸杂志, 2010, 3, 30(5): 314-316.
48. 冯慧萍. 六分钟步行试验在慢性阻塞性肺疾病患者心肺功能检测中的应用. 吉林医学, 2012, 6, 33(17): 3711-3712.
49. 王俊义, 张鹏, 刘毅梅, 等. 6 分钟步行试验与运动心肺功能测定预测肺癌患者术后并发症的价值. 天津医科大学学报, 2013, 19(2): 137-139.

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