Standard reference for the six-minute-walk test in healthy children aged 7 to 16 years

Rationale: We have previously reported that the six-minute-walk test (6MWT) is a reliable and valid functional test for assessing exercise tolerance and endurance. There is a lack of pediatric standard reference for the 6MWT. Objectives: To construct height-specific standards for the 6MWT for children aged 7 to 16 years. Methods: The anthropometric data, spirometric lung function, and six-minute-walk distance (6MWD) of Chinese children aged 7 to 16 years were prospectively measured using standardized protocols. The findings were used to construct height-specific standards for the 6MWT. The least mean square (LMS) method using maximum penalized likelihood was used to facilitate model fitting. Factors significantly associated with 6MWD were also determined. Measurements and Main Results: From January 2005 to April 2006, a total of 1,445 subjects were studied. The measured variables showed a normal distribution. Height-specific reference standards for 6MWT were constructed for both male and female children. Forward stepwise multiple regression analysis revealed height and difference in heart rate before and after the walk test to be important clinical variables associated with 6MWD. Conclusions: These 6MWD standards will provide useful references for the care of pediatric patients.