Cardiorespiratory Physiotherapy, Critical Care and Rehabilitation
https://cpcrjournal.org/article/doi/10.4322/2675-9977.cpcr.42316
Cardiorespiratory Physiotherapy, Critical Care and Rehabilitation
Short Communication

4-meter gait speed test as a tool to prescribe walking exercise intensity in individuals with COPD

Gianna Waldrich Bisc, Andrea Akemi Morita, Felipe Vilaça Cavallari Machado, Antenor Rodrigues, Thais Sant’Anna, Nidia Aparecida Hernandes, Fabio Pitta

Downloads: 1
Views: 99

Abstract

Exercise training remains the essential component of rehabilitation programs in individuals with chronic obstructive pulmonary disease (COPD)1 . In order to guarantee the training benefits, an appropriate prescription of exercise intensity is necessary1 . The target intensity for training is generally prescribed as a percentage of maximum exercise capacity1 ; however, a simple field test such as the 6-minute walking test (6MWT) was shown to be useful in exercise prescription for walking2-4 . The importance of the 6MWT to evaluate exercise capacity is undeniable5 ; nevertheless, the test requires space and time, which may hinder its use in home visits and in some clinical settings. On the other hand, the 4-meter gait speed (4MGS) is a reliable test, which requires short time and space6-9. It reflects global well-being and captures the multisystemic effects of disease severity9 . Furthermore, walking is the main activity in a rehabilitation program and gait speed measure is modifiable through rehabilitation, therefore being a potential marker of functional improvement or decline8-9. Although the 4MGS has potential as an assessment tool, further work is necessary to confirm its utilization for exercise prescription. Therefore, the aims of this study were to verify whether it is possible to prescribe the intensity of walking exercise training and to predict the distance covered in the 6MWT through the 4MGS in individuals with moderate-to-very severe COPD. In addition, since there are different available protocols for the 4MGS, another aim was to identify which protocol better estimates these outcomes.

References

1. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013; 188(8):e13-e64. Available from: https://www.atsjournals.org/doi/pdf/10.1164/rccm.201309-1634ST. 
2. 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(1):65-9. http://dx.doi.org/10.1097/HCR.0000000000000074. PMid:24983708.
3. Probst VS, Kovelis D, Hernandes NA, Camillo CA, Cavalheri V, Pitta F. Effects of 2 exercise training programs on physical activity in daily life in patients with COPD. Respir Care. 2011;56(11):1799-807. http://dx.doi.org/10.4187/respcare.01110. PMid:22035826.
4. Rodrigues A, Di Martino M, Nellessen AG, Hernandes NA, Neder JA, Pitta F. Is the six-minute walk test a useful tool to prescribe highintensity exercise in patients with chronic obstructive pulmonary disease? Heart Lung. 2016;45(6):550-6. http://dx.doi.org/10.1016/j.hrtlng.2016.08.005. PMid:27639286.
5. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428-46. http://dx.doi.org/10.1183/09031936.00150314. PMid:25359355.
6. Kon SS, Patel MS, Canavan JL, Clark AL, Jones SE, Nolan CM, et al. Reliability and validity of 4-metre gait speed in COPD. Eur Respir J.2013;42(2):333-40.http://dx.doi.org/10.1183/09031936.00162712.PMid:23222875.
7. Karpman C, Lebrasseur NK, Depew ZS, Novotny PJ, Benzo RP. Measuring gait speed in the out-patient clinic: methodology and feasibility. Respir Care. 2014;59(4):531-7. http://dx.doi.org/10.4187/respcare.02688. PMid:23983271.
8. Kon SS, Canavan JL, Nolan CM, Clark AL, Jones SE, Cullinan P, et al.The 4-metre gait speed in COPD: responsiveness and minimal clinically important difference. Eur Respir J. 2014;43(5):1298-305. http://dx.doi.org/10.1183/09031936.00088113. PMid:24177002.
9. Karpman C, Benzo R. Gait speed as a measure of functional status in COPD patients. Int J Chron Obstruct Pulmon Dis. 2014;9:1315-20.PMid:25473277.
10. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153-61. http://dx.doi.org/10.1183/09031936.05.00034505. PMid:15994402.
11. GOLD: Global strategy for the diagnosis, management and prevention for chronic obstructive pulmonary disease [Internet]. 2016 [cited 2016 June 10]. Available from: www.goldcopd.org.
12. Britto RR, Probst VS, Andrade AFD, Samora GA, Hernandes NA, Marinho PE, et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther. 2013;17(6):556-63. http://dx.doi.org/10.1590/S1413-35552012005000122. PMid:24271092.
13. Troosters T, Vilaro J, Rabinovich R, Casas A, Barbera JA, RodriguezRoisin R, et al. Physiological responses to the 6-min walk test in patients with chronic obstructive pulmonary disease. Eur Respir J. 2002;20(3):564-9. http://dx.doi.org/10.1183/09031936.02.02092001. PMid:12358329.
14. Bisca GW, Morita AA, Hernandes NA, Probst VS, Pitta F. Simple lower limb functional tests in patients with chronic obstructive pulmonary disease: a systematic review. Arch Phys Med Rehabil. 2015;96(12):2221-30. http://dx.doi.org/10.1016/j.apmr.2015.07.017. PMid:26254951.
15. DePew ZS, Karpman C, Novotny PJ, Benzo RP. Correlations between gait speed, 6-minute walk distance, physical activity, and self-efficacy in patients with severe chronic lung disease. Respir Care. 2013;58(12):2113-9. http://dx.doi.org/10.4187/respcare.02471. PMid:23696689.
16. Karpman C, DePew ZS, LeBrasseur NK, Novotny PJ, Benzo RP. Determinants of gait speed in COPD. Chest. 2014;146(1):104-10. http://dx.doi.org/10.1378/chest.13-2017. PMid:24522522.
17. Benzo R, Siemion W, Novotny P, Sternberg A, Kaplan RM, Ries A, et al. Factors to inform clinicians about the end of life in severe chronic obstructive pulmonary disease. J Pain Symptom Manage. 2013;46(4):491-9. http://dx.doi.org/10.1016/j.jpainsymman.2012.10.283. PMid:23522520.
18. Rozenberg D, Dolmage TE, Evans RA, Goldstein RS. Repeatability of usual and fast walking speeds in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev. 2014;34(5):348-54. http://dx.doi.org/10.1097/HCR.0000000000000072. PMid:24918352.


Submitted date:
12/17/2020

Accepted date:
07/07/2021

619d5b94a953952b5f1cb673 cpcr Articles
Links & Downloads

Cardiorespir Physiother Crit Care Rehabil

Share this page
Page Sections