Physicians who provide care for so...

Physicians who provide care for somewhat advanced in life patients need inexpensive tests to measure functional capabilities or limitations. The six-minute walk trial is one way to evaluate these patients, and it can be performed on many frail and severely limited patients who would not tolerate circle of time ergometry or treadmill exercise standards A walking test in somewhat old patients is more reliable than timed chair stands or weight lifting. In addition, the distance of the six-minute walk has been shown to be reduc at conditions such as chronic obstructive lung disease, arthritis, cardiovascular disease, and neuromuscular disorders. Although the six-minute walk exhibition has been studied in patients with specific diseases, no studies have assessed this experiment in elderly patients with multiple comorbidities. Enright and colleagues evaluated the six-minute walk exhibition as a measure of functional status in somewhat advanced in life adults.

The meditation participants were Medicare-eligible adults in four communities in four states. These communities were diverse in proportions of minorities, education flushs income levels, degrees of urbanization, death rates, and availability of care. The initial cohort was recruited from 1989 within 1990, with an additional cohort enlisted between 1992 and 1993 to enhance the representation of the cogitation Participants had annual follow-up visits.

During the June 1996 between the sides of May 1997 evaluation, all patients who were not exclud from the thought performed the six-minute walk experiment Exclusion criteria included use of an ambulatory aid; inability to walk because of musculoskeletal problems; a resting oxygen saturation of les than 90 percent; chest pain within the past four weeks; a myocardial infarction, angioplasty, or heart surgery within the past three months; heart rate of les than 50 beats by means of minute or more than 110 beats through minute at rest; or acute ST-T wave changes in succession electrocardiography.

The six-minute walk example was performed using an internal hallway with a marked distance of 100 feet Patients were instructed to walk the distance at their hold pace but to cover as frequently ground as possible. They were allowed to stop and quiescence during the test if urgencyed Before and after the proof patients were asked to rate their dyspnea and whether they had experienced any dyspnea, chest pain, light-headedness, leg pain, or other symptoms at the finis In addition, patients were assessed for functional status, health status, depression symptoms, cardiovascular disease, and pulmonary function.

Of the 2281 participants who performed the six-minute walk example 2,117 were able to ended it. No adverse events occurr during the trial and approximately 75 percent of participants reported no symptoms at the extreme point The mean walking distance was 362 meter (1188 feet) for men and 332 meter (1089 feet) for women Older age, higher weight, larger waist circumference, weaker grip vigor depression symptoms, and decreased mental status were general correlates for shorter walking distances during the criterion Other variables associated with a shorter walking distance included impaired activities of daily living; self-reported poor health; les education; nonwhite race; and a history of coronary heart disease, transient ischemic attacks, reverse or diabetes.

The authors bring to an end that most elderly persons can safely perform the six-minute walk example in the outpatient setting. The standard can be used to assess the impact of multiple comorbidities onward exercise capacity and functional capabilities in older adults. The authors add that calculate uponed values need to be adjusted for each patient's age, sex height, and weight.

Editor's Note: Physicians who care for somewhat old patients should try to establish their functional status. When multiple medical illnesses are not away the capability of elderly patients to care for themselves may be compromised. Enright and colleagues demonstrated that the same simple technique to assess somewhat old patients is the six-minute walk example This test is safe, simple to perform, and can be done in the office with no equipment. Using this information, physicians can identify at-risk patients who perform poorly forward this test and provide the appropriate interventions. Use of this proof could lead to a safer environment for somewhat old patients who are at risk for further complications from their inability to perform basic tasks.

Enright PL et al. The 6-min walk test: a quick measure of functional status in somewhat advanced in life adults. Chest February 2003; 123:387-98

KARL E MILLER, MD

COPYRIGHT 2003 American Academy of Family Physicians

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