E.V. BUSHUEVA¹, L.I. GERASIMOVA², O.V. SHARAPOVA², T.I. DIANOVA¹, O.N. IVANOVA¹

 ¹Chuvash State University named after I.N. Ulyanov, Cheboksary

²Medical Institute of Continuing Education, Moscow

 Contact details:

Bushueva E.V. — MD, Professor of the Department of Pediatrics and Pediatric Surgery, Faculty of Medicine

Address: 45 Moskovskiy prospekt, Cheboksary, Russian Federation, 428017, tel.: +7-903-066-99-91, е-mail: evbush@mail.ru

Exercise tolerance, as a functional indicator of the health status of children and adolescents, can be determined using a simple, accessible, safe and maximally physiological out-of-laboratory 6-minute walking test (T6MX), which is based on the quantitative result of the distance traveled in 6 minutes at the submaximal load level. This test was introduced in 1963, more than 15 countries presented reference equations and formulas, percentile curves and control values for children and adolescents. In the Russian Federation, normative data developed on a large sample of children were not presented, therefore the use of the test in childhood is limited.

The purpose — to create normative parameters of T6MX depending on gender and age for healthy children and adolescents.

Materials and methods. A continuous one-time personalized examination was conducted of 3693 children of the I–II health groups aged 7 to 18 (girls — 48.8%, boys — 51.2%) who attended comprehensive and secondary specialized educational institutions of the Chuvash Republic. Anthropometric and physiometric measurements were carried out, all children passed the 6-minute walking test.

Results. The median distance traveled by boys of the junior school group was 492.5 [435; 535.8] m, by girls — 504.8 [463; 548.5] m, by boys of the middle school group —570.5 [503.5; 614.3] m, by girls — 551.8 [519.5; 608] m, by boys of the senior school group —500.8 [452.8; 539] m, by girls — 509.5 [464.5; 548.5] m. The results of T6MX in the general population of the examined schoolchildren did not show a significant correlation with anthropometric or physiometric indicators.

Conclusions. In the junior and middle school age, the distance traveled by boys was greater compared to girls; with increasing age in the senior school group, test results decrease in adolescents; 17 and 18-year-old girls walk a longer distance in 6 minutes than boys of the same age.

Key words: 6-minute walking test, children and adolescents, physical activity.

REFERENCES

1. Rodríguez-Núñez I., Mondaca F., Casas B., Ferreira C., 1. Zenteno D. Normal values of 6-minute walk test in healthy children and adolescents: A systematic review and meta-analysis. Rev Chil Pediatr, 2018, vol. 89, pp. 128–136 DOI: 10.4067/S0370-41062018000100128
2. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. American Journal of Respiratory and Critical Care Medicine, 2002, vol. 166, pp. 111–117. DOI: 10.1164/ajrccm.166.1.at1102
3. Chikina S.A., Ataman K.S. Non-laboratory stress tests. Astma i allergiya, 2018, no. 4, pp. 17–21 (in Russ.).
4. Nixon P.A., Joswiak M.L., Fricker F.J. A six-minute walk test for assessing exercise tolerance in severely ill children. J Pediatr, 1996, vol. 129, pp. 362–366.
5. Li A.M., Yin J., Yu C.C.W., Tsang T., So H.K., Wong E., Chan D., Hon E.K.L., Sung R. The six-minute walk test in healthy children: reliability and validity. Eur Respir J, 2005, vol. 25, pp. 1057–1060. DOI: 10.1183/09031936.05.00134904
6. Geiger R., Strasak A., Treml B., Gasser K., Kleinsasser A., Fischer V., Geiger H., Loeckinger A., Stein J. Six-minute walk test in children and adolescents. J Pediatr, 2007, vol. 150, pp. 395–399. DOI: 10.1016/j.jpeds.2006.12.052
7. Lammers A.E., Hislop A.A., Flynn Y., Haworth S.G. The 6-minute walk test: normal values for children of 4–11 years of age. Arch Dis Child, 2008, vol. 93, pp. 464–468. DOI: 10.1136/adc.2007.123653
8. Priesnitz C.V., Rodrigues G.H., Stumpf C.S., Viapiana G., Cabral C.P., Stein R.T., Marostica P.J., Donadio M.V. Reference values for the 6-min walk test in healthy children aged 6–12 years. Pediatr Pulmonol, 2009, vol. 44, pp. 1174–1179. DOI: 10.1002/ppul.21062
9. D’silva C., Vaishali K., Venkatesan P. Six-minute walk test-normal values of school children aged 7–12 y in India: a cross-sectional study. Indian J Pediatr, 2012, vol. 79, pp. 597–601. DOI: 10.1007/s12098-011-0559-x
10. Klepper S.E., Muir N. Reference values on the 6-minute walk test for children living in the United States. Pediatr Phys Ther, 2011, vol. 23, pp. 32–40. DOI: 10.1097/PEP.0b013e3182095e44
11. Gatica D., Puppo H., Villarroel G., San Martín I., Lagos R., Montecino J.J., Lara C., Zenteno D. Reference values for the 6-minutes walking test in healthy Chilean children. Rev Med Chil, 2012, vol. 140, pp. 1014–1021. DOI: 10.4067/S0034-98872012000800007
12. Foeldvari I., Himmelmann G.W. Preliminary results for 6-minute walk values in healthy German children. Pediatric Rheumatology, 2011, p. 74. DOI: 10.1186/1546-0096-9-S1-P74
13. Ulrich S., Hildenbrand F.F., Treder U., Fischler M., Keusch S., Speich R., Fasnacht M. Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland. BMC Pulm Med, 2013, p. 49. DOI: 10.1186/1471-2466-13-49
14. Kanburoglu M.K., Ozdemir F.M., Ozkan S., Tunaoglu F.S. Reference values of the 6-minute walk test in healthy Turkish children and adolescents between 11 and 18 years of age. Respir Care, 2014, vol. 59, pp. 1369–1375. DOI: 10.4187/respcare.02891
15. Chen Chun-An, Chang Chin-Ha, Lin Ming-Tai, Hua Yu-Chuan,Fang Wei-Quan, Wu Mei-Hwan, Lue Hung-Chi, Wang Jou-Kou. Six-Minute Walking Test: Normal Reference Values for Taiwanese Children and Adolescents. Acta Cardiol Sin, 2015, vol. 31, pp. 193–201. DOI: 10.6515/ acs20140721d
16. Lucas de Assis Pereira Cacau, Vitor Oliveira Carvalho, Alessandro Dos Santos Pin, Carlos Raphael Araujo Daniel, Daisy Satomi Ykeda, Eliane Maria de Carvalho, Juliana Valente Francica, Luíza Martins Faria, Mansueto Gomes-Neto, Marcelo Fernandes, Marcelo Velloso, Marlus. Reference Values for the 6-min Walk Distance in Healthy Children Age 7 to 12 Years in Brazil: Main Results of the TC6minBrasil Multi-Center Study. Multicenter Study. Respir Care, 2018, vol. 63, pp. 339–346, avaialable at: https://pubmed.ncbi.nlm.nih.gov/?term=de+Santana-Filho+VJ&cauthor_id=29162717. DOI: 10.4187/respcare.05686
17. Vandoni M., Correale L., Mariangela Valentina Puci, Christel Galvani, Roberto Codella, Fabio Togni, Antonio La Torre, Francesco Casolo, Alberto Passi, Claudio Orizio, Cristina Montomoli. Correction: Six-minute walk distance and reference values in healthy Italian children: A cross-sectional study. PLoS One, 2018, vol. 21, p. 13e0208179. DOI: 10.1371/ journal. pone.0205792
18. Kasovi1 ć M., Štefan L., Petrić V. Normative data for the 6-min walk test in 11–14 year-olds: a population-based study. BMC Pulm Med, 2021, vol. 21, p. 297. DOI: 10.1186/s12890-021-01666-5
19. Alana Lalucha de Andrade Guimarães, Mansueto Gomes Neto, Vitor Oliveira Carvalho. Can the use of reference values for the 6-min walk test from another country result in misinterpretation? Pediatr Pulmonol, 2022, vol. 57, pp. 2866–2867. DOI: 10.1002/ppul.26106
20. Chikina S.Yu. The role of the 6-minute walk test in the management of patients with bronchopulmonary diseases. Prakticheskaya pul’monologiya, 2015, no. 4, pp. 34–38 (in Russ.).
21. Mikhaylovskaya T.V., Mishina I.E., Nazarova O.A., Dovgalyuk Yu.V., Chistyakova Yu.V. Methods for assessing exercise tolerance based on the results of a six-minute walk test during the rehabilitation of patients with coronary heart disease. Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya, 2021, vol. 3, no. 1, pp. 4–10 (in Russ.). DOI: 21.10.36425/rehab64360
22. Chechel’nitskaya S.M., Baerbakh A.V., Saraykin Yu.V., Kasatkin V.N., Karelin A.F., Zhuk D.V., Nikulin V.A. Application of the 6-minute walk test to assess the physical endurance of children and adolescents treated for cancer. Sovremennye problemy nauki i obrazovaniya, 2018, no. 6 (in Russ.), avaialble at: https://science-education.ru/ru/article/view?id=28343
23. Vorontsov I.M., Mazurin A.V. Propedevtika detskikh bolezney. 3-e izd. dop. i pererabot. [Propaedeutics of childhood diseases. 3rd ed. add. and reworked]. Saint Petersburg: Foliant, 2009. 1008 p.
24. Peterkova V.A., Nagaeva E.V., Shiryaeva T.Yu. Otsenka fizicheskogo razvitiya detey i podrostkov: metodicheskie rekomendatsii [Assessment of the physical development of children and adolescents: guidelines]. Moscow: FGBU «NMITs endokrinologii» MZ RF, Al’fa-Endo, 2017. 94 p.
25. Kuchma V.R. Morfofunktsional’noe razvitie sovremennykh shkol’nikov [Morphofunctional development of modern schoolchildren]. Moscow: GEOTAR-Media, 2018. 352 p.
26. Aleksandrov A.A., Kislyak O.A., Leont’eva I.V. Clinical guidelines. Diagnosis, treatment and prevention of arterial hypertension in adolescent children. Sistemnye gipertenzii, 2020, vol. 17, no. 2, pp. 7–35 (in Russ.).