Skip to main content
SpringerLink
Log in

Determinants of 6-minute walk test in people with Parkinson’s disease

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Most of the previous studies, investigating determinants of 6-minute walk test (6MWT), were conducted on small sample sizes and/or have not explored different aspects such as freezing of gait, physical activity, gender, dual-task cost, and/or have not been able to explain large portion of variation in 6MWT in people with Parkinson’s disease.

Aims

This study aimed to investigate the determinants of 6MWT, including aspects that previous studies have not explored.

Methods

In this descriptive cross-sectional study, 6MWT determinants were investigated upon 42 people with Parkinson’s disease. After recording participants’ demographic data, walking capacity, disease stage, severity of motor symptoms, freezing of gait, balance, physical activity, fear of falling, functional balance, and dual-task cost values were evaluated and grouped into modifiable and unmodifiable variables to investigate possible therapeutic benefits aiming improvement in walking capacity.

Results

The mean distance for 6MWT was 401.7 ± 92.7 m. Significant differences between women and men were found for height, walking capacity and speed, fear of falling, and functional balance (p<0.05). Hierarchical regression analysis showed that gender, age, and time since diagnosis significantly explained 52.4% of the variance in 6MWT and disease stage, freezing of gait, dual-task cost, and functional balance added an extra 35.6% to the explained variance.

Conclusions

These results showed that gender, age, disease stage, freezing of gait, dual-task cost, and functional balance values are significant contributors to the variance in 6MWT. Therefore, while planning rehabilitation strategies to improve walking capacity, one should focus on these aspects in people with Parkinson’s disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

References

  1. Mirelman A, Bonato P, Camicioli R, Ellis TD, Giladi N, Hamilton JL, Hass CJ, Hausdorff JM, Pelosin E, Almeida QJ (2019) Gait impairments in Parkinson’s disease. Lancet Neurol 18(7):697–708. https://doi.org/10.1016/S1474-4422(19)30044-4

    Article  Google Scholar 

  2. Aktar B, Balci B, Colakoglu BD (2020) Physical activity in patients with Parkinson’s disease: a holistic approach based on the ICF model. Clin Neurol Neurosurg 198:106132. https://doi.org/10.1016/j.clineuro.2020.106132

    Article  Google Scholar 

  3. Falvo MJ, Earhart GM (2009) Six-minute walk distance in persons with Parkinson disease: a hierarchical regression model. Arch Phys Med Rehabil 90(6):1004–1008. https://doi.org/10.1016/j.apmr.2008.12.018

    Article  Google Scholar 

  4. Kobayashi E, Himuro N, Takahashi M (2017) Clinical utility of the 6-min walk test for patients with moderate Parkinson’s disease. Int J Rehabil Res 40(1):66–70. https://doi.org/10.1097/mrr.0000000000000205

    Article  Google Scholar 

  5. Falvo MJ, Earhart GM (2009) Reference equation for 6-minute walk in individuals with Parkinson disease. J Rehabil Res Dev 46(9):1121–1126. https://doi.org/10.1682/jrrd.2009.04.0046

    Article  Google Scholar 

  6. Ellis T, Cavanaugh JT, Earhart GM, Ford MP, Foreman KB, Dibble LE (2011) Which measures of physical function and motor impairment best predict quality of life in Parkinson’s disease? Parkinsonism Relat Disord 17(9):693–697. https://doi.org/10.1016/j.parkreldis.2011.07.004

    Article  CAS  Google Scholar 

  7. Kalkan AC, Kahraman T, Ugut BO, Donmez Colakoglu B, Genc A (2021) Clinical and laboratory measures of balance and comparison of balance performances according to postural instability and gait disorders in individuals with Parkinson’s disease. Somatosens Mot Res 38(1):34–40. https://doi.org/10.1080/08990220.2020.1840345

    Article  Google Scholar 

  8. Hill K, Wickerson LM, Woon LJ, Abady AH, Overend TJ, Goldstein RS, Brooks D (2011) The 6-min walk test: responses in healthy Canadians aged 45 to 85 years. Appl Physiol Nutr Metab 36(5):643–649. https://doi.org/10.1139/h11-075

    Article  Google Scholar 

  9. de Souza Fortaleza AC, Mancini M, Carlson-Kuhta P, King LA, Nutt JG, Chagas EF, Junior IFF, Horak FB (2017) Dual task interference on postural sway, postural transitions and gait in people with Parkinson’s disease and freezing of gait. Gait Posture 56:76–81. https://doi.org/10.1016/j.gaitpost.2017.05.006

    Article  Google Scholar 

  10. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1):111–117. https://doi.org/10.1164/ajrccm.166.1.at1102

  11. Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, Giladi N, Holloway RG, Moore CG, Wenning GK (2004) Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations the Movement Disorder Society Task Force on rating scales for Parkinson’s disease. Mov Disord 19(9):1020–1028. https://doi.org/10.1002/mds.20213

    Article  Google Scholar 

  12. Fahn S, Elton R (1987) UPDRS Program Members. Unified Parkinson’s disease rating scale. Recent developments in Parkinson’s disease 2:153–163

    Google Scholar 

  13. Giladi N, Shabtai H, Simon E, Biran S, Tal J, Korczyn A (2000) Construction of freezing of gait questionnaire for patients with Parkinsonism. Parkinsonism Relat Disord 6(3):165–170. https://doi.org/10.1016/S1353-8020(99)00062-0

    Article  CAS  Google Scholar 

  14. Berg K, Wood-Dauphinee S, Williams J, Gayton D (1989) Measuring balance scale: reliability assessment with an elderly population. Arch Phys Med Rehabil 73:1073–1080

    Google Scholar 

  15. Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MMB (2006) The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis 3(4): A118

  16. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C (2005) Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 34(6):614–619. https://doi.org/10.1093/ageing/afi196

    Article  Google Scholar 

  17. Lim L, Van Wegen E, De Goede C, Jones D, Rochester L, Hetherington V, Nieuwboer A, Willems A-M, Kwakkel G (2005) Measuring gait and gait-related activities in Parkinson’s patients own home environment: a reliability, responsiveness and feasibility study. Parkinsonism Relat Disord 11(1):19–24. https://doi.org/10.1016/j.parkreldis.2004.06.003

    Article  CAS  Google Scholar 

  18. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

    Article  CAS  Google Scholar 

  19. Candan SA, Çatıker A, Özcan TŞ (2019) Psychometric properties of the Turkish version of the freezing of gait questionnaire for patients with Parkinson’s disease. Neurol Sci Neurophysiology 36(1):44-50. https://doi.org/10.5152/NSN.2019.11115

    Article  Google Scholar 

  20. Rabey JM, Korczyn AD (1995) The Hoehn and Yahr Rating Scale for Parkinson’s Disease. In: Przuntek H, Kraus PH, Klotz P, Korczyn AD (eds) Instrumental Methods and Scoring in Extrapyramidal Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78914-4_2

  21. Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease (2003) The unified Parkinson’s disease rating scale (UPDRS): status and recommendations. Mov Disord 18(7):738–750. https://doi.org/10.1002/mds.10473

  22. Kahraman T, Genç A, Söke F, Göz E, Çolakoğlu BD, Keskinoğlu P (2018) Validity and reliability of the Turkish version of the 8-item Parkinson’s disease questionnaire. Noro Psikiyatr Ars 55(4):337-340. https://doi.org/10.5152/npa.2017.19343

    Article  Google Scholar 

  23. Sahin F, Yilmaz F, Ozmaden A, Kotevoglu N, Sahin T, Kuran B (2008) Reliability and validity of the Turkish version of the Berg balance scale. J Geriatr Phys Ther 31(1):32–37. https://doi.org/10.1080/10749357.2020.1841424

    Article  Google Scholar 

  24. Kobayashi E, Himuro N, Takahashi M (2017) Clinical utility of the 6-min walk test for patients with moderate Parkinson’s disease. Int J Rehabil Res 40(1):66–70. https://doi.org/10.3310/hta23360

    Article  Google Scholar 

  25. Lang JT, Kassan TO, Devaney LL, Colon-Semenza C, Joseph MF (2016) Test-retest reliability and minimal detectable change for the 10-meter walk test in older adults with Parkinson’s disease. J Geriatr Phys Ther 39(4):165–170. https://doi.org/10.1519/JPT.0000000000000068

    Article  Google Scholar 

  26. Kelly VE, Eusterbrock AJ, Shumway-Cook A (2012) A review of dual-task walking deficits in people with Parkinson’s disease: motor and cognitive contributions, mechanisms, and clinical implications. Parkinsons Dis 2012:918719. https://doi.org/10.1155/2012/918719

  27. Çekok FK, Kahraman T, Kalkışım M, Genç A, Keskinoğlu P (2017) Cross-cultural adaptation and psychometric study of the Turkish version of the rapid assessment of physical activity. Geriatr Gerontol Int 17(11):1837–1842. https://doi.org/10.1111/ggi.12970

    Article  Google Scholar 

  28. Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O (2012) Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr 54(3):429–433. https://doi.org/10.1016/j.archger.2011.06.010

    Article  Google Scholar 

  29. Carvalho DV, Santos RMS, Magalhães HC, Souza MS, Christo PP, Almeida-Leite CM, Scalzo PL (2020) Can fatigue predict walking capacity of patients with Parkinson’s disease? Arq Neuropsiquiatr 78(2):70–75. https://doi.org/10.1590/0004-282X20190136

    Article  Google Scholar 

  30. Soke F, Guclu-Gunduz A, Kocer B, Fidan I, Keskinoglu P (2021) Task-oriented circuit training combined with aerobic training improves motor performance and balance in people with Parkinson’s disease. Acta Neurol Belg 121(2):535–543. https://doi.org/10.1007/s13760-019-01247-8

  31. Hoang OTT, Jullamate P, Piphatvanitcha N, Rosenberg E (2017) Factors related to fear of falling among community-dwelling older adults. J Clin Nurs 26(1–2):68–76. https://doi.org/10.1111/jocn.13337

    Article  Google Scholar 

  32. Tomita Y, Arima K, Tsujimoto R, Kawashiri SY, Nishimura T, Mizukami S, Okabe T, Tanaka N, Honda Y, Izutsu K, Yamamoto N, Ohmachi I, Kanagae M, Abe Y, Aoyagi K (2018) Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Medicine (Baltimore) 97(4):e9721. https://doi.org/10.1097/MD.0000000000009721

  33. Combs SA, Diehl MD, Filip J, Long E (2014) Short-distance walking speed tests in people with Parkinson disease: reliability, responsiveness, and validity. Gait Posture 39(2):784–788. https://doi.org/10.1016/j.gaitpost.2013.10.019

    Article  Google Scholar 

  34. Antonini A, Moro E, Godeiro C, Reichmann H (2018) Medical and surgical management of advanced Parkinson’s disease. Mov Disord 33(6):900–908. https://doi.org/10.1002/mds.27340

    Article  Google Scholar 

  35. Cheng DK, Nelson M, Brooks D, Salbach NM (2020) Validation of stroke-specific protocols for the 10-meter walk test and 6-minute walk test conducted using 15-meter and 30-meter walkways. Top Stroke Rehabil 27(4):251–261. https://doi.org/10.1080/10749357.2019.1691815

    Article  Google Scholar 

  36. Shearin S, Medley A, Trudelle-Jackson E, Swank C, Querry R (2021) Differences in predictors for gait speed and gait endurance in Parkinson’s disease. Gait Posture 87:49–53. https://doi.org/10.1016/j.gaitpost.2021.04.019

    Article  Google Scholar 

  37. Blum L, Korner-Bitensky N (2008) Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review. Phys Ther 88(5):559–566. https://doi.org/10.2522/ptj.20070205

    Article  Google Scholar 

  38. Schlenstedt C, Brombacher S, Hartwigsen G, Weisser B, Möller B, Deuschl G (2015) Comparing the Fullerton advanced balance scale with the Mini-BESTest and Berg balance scale to assess postural control in patients with Parkinson disease. Arch Phys Med Rehabil 96(2):218–225. https://doi.org/10.2522/ptj.20150249

    Article  Google Scholar 

  39. Radder DL, Silva L, de Lima A, Domingos J, Keus SH, van Nimwegen M, Bloem BR, de Vries NM (2020) Physiotherapy in Parkinson’s disease: a meta-analysis of present treatment modalities. Neurorehabil Neural Repair 34(10):871–880. https://doi.org/10.1177/1545968320952799

    Article  Google Scholar 

  40. Genc A, Donmez Colakoglu B, Kara B, Cakmur R (2012) Evaluation of the effects of home-based deep breathing exercises in Parkinson’s disease patients. Noro Psikiyatr Ars 49(1):59–62. https://doi.org/10.4274/npa.y6209

    Article  Google Scholar 

Download references

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Author information

Authors and Affiliations

  1. Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey

    Birön Onur Üğüt & Aybüke Cansu Kalkan

  2. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University , Izmir, Turkey

    Birön Onur Üğüt, Aybüke Cansu Kalkan & Turhan Kahraman

  3. Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Berril Dönmez Çolakoğlu & Raif Çakmur

  4. Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey

    Arzu Genç

Authors
  1. Birön Onur Üğüt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aybüke Cansu Kalkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Turhan Kahraman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Berril Dönmez Çolakoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raif Çakmur
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arzu Genç
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Birön Onur Üğüt, Aybüke Cansu Kalkan, Turhan Kahraman, Berril Dönmez Çolakoğlu, Raif Çakmur, and Arzu Genç. The first draft of the manuscript was written by Birön Onur Üğüt and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Birön Onur Üğüt.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the Ethics Committee of Dokuz Eylul University (Protocol Number: 3624-GOA; Approval Number: 2017/25–37).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Patients signed informed consent regarding publishing their data.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 32 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Üğüt, B.O., Kalkan, A.C., Kahraman, T. et al. Determinants of 6-minute walk test in people with Parkinson’s disease. Ir J Med Sci 192, 359–367 (2023). https://doi.org/10.1007/s11845-022-02954-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-022-02954-7

Keywords

Search

Navigation