Abstract
Objective
To evaluate the change in the 6-minute walk test (6-MWT) distance relative to changes
in key functional capacity measures after 16 weeks of exercise training in older patients
(≥65y) who have heart failure with preserved ejection fraction (HFpEF).
Design
Prospective, randomized, single-blinded (by researchers to patient group) comparison
of 2 groups of HFpEF patients.
Setting
Hospital and clinic records; ambulatory outpatients.
Participants
Participants (N=47) randomly assigned to an attention control (AC) (n=24) or exercise
training (ET) (n=23) group.
Intervention
The ET group performed cycling and walking at 50% to 70% of peak oxygen uptake (o2peak) intensity (3d/wk, 60min each session).
Main Outcome Measures
o2peak, ventilatory threshold (VT), and 6-MWT distance were measured at baseline and
after the 16-week study period.
Results
At follow-up, the 6-MWT distance was higher than at the baseline in both the ET (11%,
P=.005) and AC (9%, P=.004) groups. In contrast, o2peak and VT values increased in the ET group (19% and 11%, respectively; P=.001), but decreased in the AC group at follow-up (2% and 0%, respectively). The
change in o2peak versus 6-MWT distance after training was also not significantly correlated in
the AC group (r=.01, P=.95) or in the ET group (r=.13, P=.57). The change in 6-MWT distance and VT (an objective submaximal exercise measure)
was also not significantly correlated in the AC group (r=.08, P=.74) or in the ET group (r=.16, P=.50).
Conclusions
The results of this study challenge the validity of using the 6-MWT as a serial measure
of exercise tolerance in elderly HFpEF patients and suggest that submaximal and peak
exercise should be determined objectively by VT and o2peak in this patient population.
Keywords
List of abbreviations:
6-MWT (6-minute walk test), AC (attention control), ET (exercise training), HF (heart failure), HFpEF (heart failure with preserved ejection fraction), HFrEF (heart failure with reduced ejection fraction), V˙o2peak (peak oxygen uptake), VT (ventilatory threshold)To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: September 27, 2016
Footnotes
Supported by the National Institutes of Health (grant nos. R01AG18915, P30AG021332, R01HL093713, R01AG020583).
Clinical Trial Registration No.: NCT00959660.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
