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. 2018 Oct 31;14(5):844-850.
doi: 10.12965/jer.1836326.163. eCollection 2018 Oct.

Six-minute walk test and incremental shuttle walk test in the evaluation of functional capacity in Chagas heart disease

Henrique Silveira Costa  1 , Márcia Maria Oliveira Lima  2 , Susan Martins Lage  3 , Fábio Silva Martins da Costa  1 , Pedro Henrique Scheidt Figueiredo  2 , Manoel Otávio da Costa Rocha  1
Affiliations

Six-minute walk test and incremental shuttle walk test in the evaluation of functional capacity in Chagas heart disease

Henrique Silveira Costa et al. J Exerc Rehabil. .

Abstract

Chagas heart disease (CHD) leads to a progressive functional impairment. Field tests, as the 6-min walk test (6MWT) and the incremental shuttle walk test (ISWT), may be inexpensive approaches in the evaluation of functional capacity of these patients. The present study was addressed to compare the 6MWT and the ISWT measures, and to determine the accuracy of these tests in the identification of functional impairment in patients with CHD. Thirty-five patients with CHD (47.1±8.2 years, NYHA I-III) were evaluated by echocardiography, cardiopulmonary exercise test (CPET), 6MWT, and ISWT. Correlations between the CPET (peak oxygen uptake [peak VO2] and the ratio between ventilation and the carbon dioxide production [VE/VCO2 slope]) and the field tests (walking distances) were also performed. The receiver operating characteristic (ROC) curve was selected to identify the best distances related to identify those patients with functional impairment. There was no difference between distances walked during the 6MWT and ISWT (P=0.694). The Bland-Altman analysis showed good agreement between the field tests. Both 6MWT and ISWT correlated with peak VO2 (r=0.577, P<0.001 and r=0.587, P<0.001, respectively) and ISWT correlated with VE/VCO2 slope (r=-0.339, P=0.003). The cutoff distances of 6MWT and ISWT to identify patients with peak VO2 less than 20 mL/kg/min were 520 m and 400 m, respectively, with no difference between the areas under ROC curves (P=0.276). Both the 6MWT and the ISWT demonstrated accuracy in identify functional impairment in patients with CHD, being useful tools for the risk stratification of these patients.

Keywords: Chagas disease; Exercise; Exercise test.

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Conflict of interest statement

CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Bland-Altman diagram showing the agreement between the distances walked by the 6MWT and ISWT. 6MWT, 6-min walk test; ISWT, incremental shuttle walk test; SD, standard devation.
Fig. 2
Fig. 2
Correlation of peak VO2 and 6MWT distance (A); peak VO2 and ISWT distance (B); VE/VCO2 slope and 6MWT distance (C); VE/VCO2 slope and ISWT distance (D). VO2, oxygen uptake; 6MWT, 6-min walk test; ISWT, incremental shuttle walk test; VE/VCO2, minute ventilation-carbon dioxide production.
Fig. 3
Fig. 3
Area under the receiver operating characteristic curve demonstrating the accuracy of the distances walked during the 6MWT and ISWT in identifying patients with functional impairment (peak VO2 <20 mL/kg/min). 6MWT, 6-min walk test; ISWT, incremental shuttle walk test; VO2, oxygen uptake.
See this image and copyright information in PMC

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