Main Article Content
Background and objectives: Six-minute walk test (6MWT) was widely used to assess the patient’s status after cardiac surgery due to its feasibility. But the 6MWD studied in Thailand trended to have shorter lengths than of western countries. It could not be applied to Thais. And the data regarding 6MWD after surgery of the elderly patients in Thailand was lacking. This study aimed to evaluate the average distance of 6MWT in cardiac-surgery elderly to assess the patient’s capability and follow up.
Methods: The data included the age, gender, types of surgery, risk stratification, and 6MWD of cardiac-surgery elderly who visited the rehabilitation department were collected. Then the mean value of 6MWD was calculated, and the correlation of 6MWD among each factor were analyzed.
Results: 98 patients with mean age of 67 years were included in the study, 55 patients underwent CABG, and 43 patients underwent valvular surgery. The overall mean 6MWD was 209.7±78.9 meters. 6MWD was significantly different in sex [95%CI (-65.4)-(-0.5), p=0.047] and type of surgery [5.6-67.8, p=0.021].
Conclusion: The normal 6MWD in Thai cardiac surgery elderly patients was 194-225 meters. This number could be used to represent the patient’s capability and further cardiac rehabilitation program.
2. Lloyd Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009; 119: 480-6.
3. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; (25 Suppl 2): S49-73.
4. Heart test? [Internet]. Heart Foundation NZ. [cited Oct 9, 2019]. Available from: https://www.heartfoundation.org.nz/your-heart/heart-tests
5. Peterson V. Exercise Capacity and Functional Testing | Heart Online [Internet]. [cited Oct 9, 2019]. Available from: https://www.heartonline.org.au/articles/exercise/exercise-capacity-and-functional-testing
6. Albouaini K, Egred M, Alahmar A. Cardiopulmonary exercise testing and its application. Postgrad Med J 2007; 83: 675–82.
7. Echocardiogram [Internet]. American Heart Association [cited Mar 16, 2019] Available from: https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/echocardiogram-echo.
8. Eisenberg MJ, Wou K, Nguyen H, Duerr R, Del Core M, Fourchy D, et al. Use of stress testing early after coronary artery bypass graft surgery. Am J Cardiol 2006; 97: 810–6.
9. Fiorina C, Vizzardi E, Lorusso R, Maggio M, Cicco GD, Nodari S, et al. The 6-min walking test early after cardiac surgery. Reference values and the effects of rehabilitation programme. Eur J Cardiothorac Surg 2007; 32: 724–9.
10. 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: 111–7.
11. Uszko-Lencer NHMK, Mesquita R, Janssen E, Werter C, Brunner-La Rocca HP, Pitta F, et al. Reliability, construct validity and determinants of 6-minute walk test performance in patients with chronic heart failure. Int J Cardiol. 2017; 240: 285–90.
12. Hamilton DM, Haennel RG. Validity and reliability of the 6-minute walk test in a cardiac rehabilitation population. J Cardiopulm Rehabil 2000; 20: 156–64.
13. O’Keeffe ST, Lye M, Donnellan C, Carmichael DN. Reproducibility and responsiveness of quality of life assessment and six minute walk test in elderly heart failure patients. Heart 1998; 80: 377–82.
14. Chen YC, Chen KC, Lu LH, Wu YL, Lai TJ, Wang CH. Validating the 6-minute walk test as an indicator of recovery in patients undergoing cardiac surgery: A prospective cohort study. Medicine 2018; 97: e12925.
15. Baptista VC, Palhares LC, Oliveira PPM de, Filho S, Mota L, Vilarinho KA de S, et al. Six-minute walk test as a tool for assessing the quality of life in patients undergoing coronary artery bypass grafting surgery. Braz J Cardiovasc Surg 2012; 27: 231–9.
16. Shabani R, Gaeini AA, Nikoo MR, Nikbackt H, Sadegifar M. Effect of Cardiac Rehabilitation Program on Exercise Capacity in Women Undergoing Coronary Artery Bypass Graft in Hamadan-Iran. Int J Prev Med 2010; 1: 247–51.
17. Arslan S, Erol MK, Gundogdu F, Sevimli S, Aksakal E, Senocak H, et al. Prognostic Value of 6-Minute Walk Test in Stable Outpatients with Heart Failure. Tex Heart Inst J 2007; 34: 166–9.
18. Zainuldin R, Mackey MG, Alison JA. Prescription of walking exercise intensity from the 6-minute walk test in people with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2015; 35: 65–9.
19. Solak O, Yaman F, Ulasli AM, Eroglu S, Akci O, Ozkececi G, et al. Improvement in Quality of Life, Functional Capacity, and Depression Level after Cardiac Rehabilitation. Turk J Phys Med Rehab 2015; 61: 130-5.
20. Chambela MC, Mediano MFF, Ferreira RR, Japiassú AM, Waghabi MC, da Silva GMS, et al. Correlation of 6-min walk test with left ventricular function and quality of life in heart failure due to Chagas disease. Trop Med Int Health 2017; 22: 1314–21.
21. Paorod P, Chidnok W, Panomchaisawang P, Sayasathid J. The Study of Exercise Capacity by 6 Minute Walk Test in Open Heart Surgery Patients at Naresuan University Hospital Before Discharge. Songklanagarind Med J 2016; 34: 321–9.
22. Bautmans I, Lambert M, Mets T. The six-minute walk test in community dwelling elderly: influence of health status. BMC Geriatr 2004; 4: 6.
23. Rampaipan T. Six-minute walk test in Thai healthy elderly people between 60-80 years old. Kasetsart University Kamphaengsaen annual conference; 2009 Dec: akhonprathom, Thailand.
24. De Feo S, Mazza A, Camera F, Maestri A, Opasich C, Tramarin R. Distance covered in walking test after heart surgery in patients over 70 years of age: outcome indicator for the assessment of quality of care in intensive rehabilitation. Monaldi Arch Chest Dis 2003; 60: 111–7.
25. Poh H, Eastwood PR, Cecins NM, Ho KT, Jenkins SC. Sixminute walk distance in healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations. Respirology 2006; 11: 211-6.
26. Vaish H, Ahmed F, Singla R, Shukla DK. Reference equation for the 6-minute walk test in healthy North Indian adult males. Int J Tuberc Lung Dis 2013; 17: 698-703.
27. Enright PL, Sherrill DL. Reference equations for the sixminute walk in healthy adults. Am J RespirCrit Care Med 1998; 158: 1384-7.
28. Camarri B, Eastwood PR, Cecins NM, Thompson PJ, Jenkins S. Six minute walk distance in healthy subjects aged 55-75 years. Respir Med 2006; 100: 658-65.
29. Lusardi MM, Pellecchia GL, Schulman M. Functional Performance in Community Living Older Adults. J GeriatrPhysTher 2003; 26: 14-22.
30. Busch JC, Lillou D, Wittig G, Bartsch P, Willemsen D, Oldridge N, et al. Resistance and Balance Training Improves Functional Capacity in Very Old Participants Attending Cardiac Rehabilitation After Coronary Bypass Surgery. J Am Geriatr Soc 2012; 60: 2270–6.
31. Enright PL, Sherrill DL. Reference Equations for the Six-Minute Walk in Healthy Adults. Am J RespirCrit Care Med 1998; 158: 1384–7.
32. Daniel WW, Cross CL. Biostatistics: A Foundation for Analysis in the Health Sciences. New Jersey: Wiley, 2013.
33. Serra AJ, de Carvalho P de TC, Lanza F, de Amorim Flandes C, Silva SC, Suzuki FS, et al. Correlation of Six-Minute Walking Performance with Quality of Life is Domain- and Gender-Specific in Healthy Older Adults. PLoS One 2015; 10: e0117359.
34. Harnphadungkit K. 6-Minute Walk Test. J Thai Rehabil Med 2014; 24: 1-4.
35. Srisaeng A, Wungsang C. Cardiopulmonary Assessment by Six Minute Walk Test. Siriraj Med Bull 2018; 11: 57-64.
36. Cacau LA, de Santana-Filho VJ, Maynard LG, Gomes M Neto, Fernandes M, Carvalho VO.. Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review. Braz J Cardiov Surg 2016; 31: 381-8.