Application of the six-minute Walk Test in Assessment of the Cardiopulmonary Function of Children with Idiopathic Scoliosis

Haibin Guo; Xuan Zhou; Yanyan Li; Yuqi Yang; Hong Yu; Xin Li; Haiyan Yuan; Yushan Chen; Yufei Feng; Jiaoling Huang; Qing Du

doi:10.1097/BRS.0000000000004913

Application of the six-minute Walk Test in Assessment of the Cardiopulmonary Function of Children with Idiopathic Scoliosis

Spine (Phila Pa 1976). 2023 Dec 30;49(12):840-846. doi: 10.1097/BRS.0000000000004913. Online ahead of print.

Authors

Haibin Guo¹, Xuan Zhou¹, Yanyan Li¹, Yuqi Yang², Hong Yu¹, Xin Li¹, Haiyan Yuan³, Yushan Chen³, Yufei Feng⁴, Jiaoling Huang⁵, Qing Du¹

Affiliations

¹ Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² College of Global Public Health, New York University, New York NY, USA.
³ Chongming branch of Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China.
⁴ School of Kinesiology, Shanghai University of Sport, Shanghai, China.
⁵ School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Study design: A retrospective observational study.

Obsjective: To assess whether the 6-minute walk test (6MWT) can predict cardiopulmonary function in children with idiopathic scoliosis (IS) as an alternative to the cardiopulmonary exercise test (CPET).

Summary of background data: Cardiopulmonary functional impairment in the setting of IS is a common health problem. A simple and convenient assessment method is needed.

Methods: We recruited 65 children (eight male, 57 female) aged 10.70-14.84 years old with IS. Radiographic characteristics of the cohort were measured, including Risser's sign and Cobb angle. We measured cardiopulmonary exercise tolerance using both the 6MWT and CPET and their corresponding indicators, including six-minute walking distance (6MWD) and peak oxygen uptake (peak VO2), respectively. Pearson correlation analysis was used to determine the relationship between 6MWT indicators and IS parameters. Linear regression models were used to explore the relationship between 6MWT and CPET response indicators.

Results: Over a third of the cohort (35.4%) had a Risser's sign grade of 0, with 21.5% in grade 2 and 3, respectively. The cohort's mean Cobb angle was 26.02 degrees. 6MWD was significantly positively correlated with Risser's sign (R=0.258; P=0.038) and change in respiratory rate (△RR) positively correlated with vertebral rotation (R=0.264; P=0.034). 6MWD positively correlated with peak VO2, peak VO2/heart rate (HR) and metabolic equivalents (METs), and negatively correlated with ventilation equivalent of carbon dioxide slope (VE/VCO2 slope) (P<0.05). These four CPET indicators were found to be predicted from 6MWD in the linear regression model (P<0.05).

Conclusion: CPET response indicators, especially peak VO2, can be predicted using 6MWD among other factors. The 6MWT can therefore be used to rapidly and efficiently predict the cardiorespiratory tolerance of children with IS.

Level of evidence: 3.