Classification of cardiorespiratory fitness using the six-minute walk test in adults: Comparison with cardiopulmonary exercise testing
V.Z. Dourado,
R.K. Nishiaka,
M.S.M.P. Simões,
V.T. Lauria,
S.E. Tanni,
I. Godoy,
A.R.T. Gagliardi,
M. Romiti,
R.L. Arantes
Affiliations
V.Z. Dourado
Department of Human Movement Sciences (Laboratory of Epidemiology and Human Movement – EPIMOV), Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil; Lown Scholars in Cardiovascular Health Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Corresponding author at: Federal University of São Paulo (UNIFESP), Laboratory of Epidemiology and Human Movement (EPIMOV), Rua Silva Jardim, 136, Vila Mathias, Santos, São Paulo, 11015-020, Brazil.
R.K. Nishiaka
Department of Human Movement Sciences (Laboratory of Epidemiology and Human Movement – EPIMOV), Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil
M.S.M.P. Simões
Department of Human Movement Sciences (Laboratory of Epidemiology and Human Movement – EPIMOV), Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil
V.T. Lauria
Department of Human Movement Sciences (Laboratory of Epidemiology and Human Movement – EPIMOV), Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil
S.E. Tanni
Department of Internal Medicine (Pulmonology Division), São Paulo State University (UNESP), Medical School, Botucatu, São Paulo, Brazil
I. Godoy
Department of Internal Medicine (Pulmonology Division), São Paulo State University (UNESP), Medical School, Botucatu, São Paulo, Brazil
A.R.T. Gagliardi
Angiocorpore Institute of Cardiovascular Medicine, Santos, São Paulo, Brazil
M. Romiti
Angiocorpore Institute of Cardiovascular Medicine, Santos, São Paulo, Brazil
R.L. Arantes
Angiocorpore Institute of Cardiovascular Medicine, Santos, São Paulo, Brazil
Background: The six-minute walk test (6MWT) distance could facilitate the assessment of cardiorespiratory fitness (CRF) in clinical practice as recommended. We aimed to develop a CRF classification using the 6MWT distance in asymptomatic adults considering the treadmill maximum oxygen uptake (V˙O2max) as the gold standard method. Methods: We evaluated V˙O2max and 6MWT distance in 1295 asymptomatic participants aged 18–80 years (60% women). Age- and sex-related CRF was classified based on the percentiles as very low (95th percentile) for both V˙O2max and 6MWT distance. We investigated the 6MWT distance cut-off (%pred.) with the highest sensitivity and specificity for identifying each V˙O2max classification. Results: V˙O2max declined by 8.7% per decade in both men and women. The 6MWT distance declined by 9.3% per decade in women and 9.5% in men. We formulated age- and sex-related classification tables for CRF using the 6MWT distance. Moreover, the 6MWT distance (%pred.) showed excellent ability to identify very low CRF (6MWT distance ≤ 96%; AUC = 0.819) and good ability to differentiate CRF as low (6MWT distance = 97%–103%; AUC = 0.735), excellent (6MWT distance = 107%–109%; AUC = 0.715), or superior (6MWT distance > 109%; AUC = 0.790). It was not possible to differentiate between participants with regular and good CRF. Conclusion: The CRF classification by the 6MWT distance is valid in comparison with V˙O2max, especially for identifying adults with low CRF. It could be useful in clinical practice for screening and monitoring the cardiorespiratory risk in adults.
