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Randomized Controlled Trial
. 2017 Mar;98(3):600-603.
doi: 10.1016/j.apmr.2016.08.481. Epub 2016 Sep 28.

Association Between 6-Minute Walk Test Distance and Objective Variables of Functional Capacity After Exercise Training in Elderly Heart Failure Patients With Preserved Ejection Fraction: A Randomized Exercise Trial

Sara Maldonado-Martín  1 , Peter H Brubaker  2 , Joel Eggebeen  3 , Kathryn P Stewart  3 , Dalane W Kitzman  2
Affiliations
Randomized Controlled Trial

Association Between 6-Minute Walk Test Distance and Objective Variables of Functional Capacity After Exercise Training in Elderly Heart Failure Patients With Preserved Ejection Fraction: A Randomized Exercise Trial

Sara Maldonado-Martín et al. Arch Phys Med Rehabil. 2017 Mar.

Abstract

Objective: To evaluate the change in the 6-minute walk test (6-MWT) distance relative to changes in key functional capacity measures after 16 weeks of exercise training in older patients (≥65y) who have heart failure with preserved ejection fraction (HFpEF).

Design: Prospective, randomized, single-blinded (by researchers to patient group) comparison of 2 groups of HFpEF patients.

Setting: Hospital and clinic records; ambulatory outpatients.

Participants: Participants (N=47) randomly assigned to an attention control (AC) (n=24) or exercise training (ET) (n=23) group.

Intervention: The ET group performed cycling and walking at 50% to 70% of peak oxygen uptake (V˙o2peak) intensity (3d/wk, 60min each session).

Main outcome measures: V˙o2peak, ventilatory threshold (VT), and 6-MWT distance were measured at baseline and after the 16-week study period.

Results: At follow-up, the 6-MWT distance was higher than at the baseline in both the ET (11%, P=.005) and AC (9%, P=.004) groups. In contrast, V˙o2peak and VT values increased in the ET group (19% and 11%, respectively; P=.001), but decreased in the AC group at follow-up (2% and 0%, respectively). The change in V˙o2peak versus 6-MWT distance after training was also not significantly correlated in the AC group (r=.01, P=.95) or in the ET group (r=.13, P=.57). The change in 6-MWT distance and VT (an objective submaximal exercise measure) was also not significantly correlated in the AC group (r=.08, P=.74) or in the ET group (r=.16, P=.50).

Conclusions: The results of this study challenge the validity of using the 6-MWT as a serial measure of exercise tolerance in elderly HFpEF patients and suggest that submaximal and peak exercise should be determined objectively by VT and V˙o2peak in this patient population.

Trial registration: ClinicalTrials.gov NCT00959660.

Keywords: Exercise test; Oxygen consumption; Physical fitness; Rehabilitation.

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Conflict of interest statement

There are not conflicts of interest

Figures

Figure 1.
Figure 1.
Relationship between the change in 6-MWT (m) with the change in VO2peak (mL·kg−1·min−1) and the change in VT (ml·kg−1·min−1) for Attention Control (AC) group and Exercise Training (ET) group.
See this image and copyright information in PMC

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