C71 USE OF THE 6–MINUTE WALKING TEST (6–MWT) AS AN ALTERNATIVE TO INCREMENTAL ERGOMETRIC TESTING FOR THERAPEUTIC EXERCISE PRESCRIPTION IN CARDIOLOGICAL REHABILITATION. (18th May 2022)

• Record Type: Journal Article
• Authors: Rossini, D; Dardi, O; Bonaguidi, E; Meoni, L
• Is Part Of: European heart journal supplements. Volume 24(2022)Supplement C
• Publication Date: 2022-05-18
• Subjects: Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/suac011.069
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: : According to the guide lines and statements from scientific societies, the determination of exercise intensity at the beginning of a cardiac rehabilitation (CR) program should include a cardiopulmonary test as the optimal standard and an incremental "symptom–limited" ergometric test (ET) as the minimal standard. However, the preliminary ergometric evaluation is often not done, because of patient's (pt) inhability to perform ET, temporary contraindications to ET or difficulties related to organization. Therefore, we assessed whether it is possible to set an effective and safe work intensity for each pt, using a submaximal test such as the 6–MWT, Methods: Thirty pts (20 M and 10 F; mean age 61 ± 10.1 yr) consecutively referred to an outpatient CR after cardiac surgery (15 pts) or acute coronary syndrome (15 pts) were enrolled. Eligible pts after assessment of balance and gait with the Tinetti scale (score ≥ 19), performed both a 6MWT and a ET on the cycle ergometer within one week of enrollment. By t–test for paired data, watts at ET peak (W peak) were compared with W peak calculated by the two formulas of Hill and that of Luxton using anthropometric data and the result of the 6–MWT (Holland AE et al. Estimating peak work rate during incremental cycle ergometry from the 6–minute walk distance: differences between reference equations. Respiration 2011;81:124–128). In addition, we tested whether the maximum heart rate (max HR) achieved at 6–MWT falls within the training frequency calculated using the Karvonen formula (THR). Results: There is a statistically significant difference between W peak and W peak calculated with the Hill formulas (p < 0.0001). On the contrary, the difference is not significant applying the Luxton formula (p = 0.7). The maximum HR values reached at 6–MWT fell within the THR in 63% of cases (confidence intervals 0.46–0.80). Conclusions: At the moment, we do not have reliable formulas for calculating the workload from a submaximal test in the population of cardiac patients. The Luxton formula deserves to be evaluated on a larger sample. Finally, the max HR at 6–MWT is a good and sufficiently safe parameter for programming an initial therapeutic exercise as it falls within the THR in the most cases and even when it does not, the difference is only a few beats.