The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties
The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties
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DOI：
10.2522/ptj.20120210
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发表时间：
2013-04-01
期刊：
影响因子：
3.2
通讯作者：
Terwee, Caroline B.
中科院分区：
文献类型：
--
作者：
Bartels, Bart;de Groot, Janke F.;Terwee, Caroline B.
背景六分钟步行试验（6 MWT）越来越多地被用作慢性儿科疾病的功能结局指标。需要了解其测量属性，以确定是否使用适当的测试。目的。本研究的目的是系统地回顾所有已发表的临床研究的6 MWT在慢性儿科疾病。检索数据库MEDLINE、EMBASE、CINAHL、PEDro和SPORT-Discus，截止日期为2012年2月。本系统综述纳入了旨在评价6 MWT在慢性儿科疾病中测量特性的研究。数据提取。纳入研究的方法学质量和6 MWT的测量特性进行了检查。对15项研究进行了最佳证据合成，包括9种不同的慢性儿科疾病。在各种慢性疾病中发现了有限证据到强有力证据的可靠性。强有力的证据表明，积极的标准有效性的6 MWT峰值摄氧量在某些人群中，但在其他人群中发现负标准有效性。由于方法上的缺陷，大多数患者组的结构效度仍不清楚。反应性和测量误差的证据很少。研究表明，尽管现有的6 MWT性能指南，但测试程序存在较大的变异性。没有一个特定的检查表来评估临床研究的方法学质量是本研究的一个局限性。6 MWT测量特性的证据在慢性儿科疾病中差异很大。需要在所有患者组中进行进一步研究，以探索6 MWT测量显著和临床重要变化的能力。在此之前，应谨慎解释6 MWT测量的变化。建议在儿科人群中进行关于改良试验程序的进一步研究或达成共识。
Background. The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use.Purpose. The purpose of this study was to systematically review all published clinimetric studies on the 6MWT in chronic pediatric conditions.Data Sources. The databases MEDLINE, EMBASE, CINAHL, PEDro, and SPORT-Discus were searched up to February 2012.Study Selection. Studies designed to evaluate measurement properties of the 6MWT in a chronic pediatric condition were included in the systematic review.Data Extraction. The methodological quality of the included studies and the measurement properties of the 6MWT were examined.Data Synthesis. A best evidence synthesis was performed on 15 studies, including 9 different chronic pediatric conditions. Limited evidence to strong evidence was found for reliability in various chronic conditions. Strong evidence was found for positive criterion validity of the 6MWT with peak oxygen uptake in some populations, but negative criterion validity was found in other populations. Construct validity remained unclear in most patient groups because of methodological flaws. Little evidence was available for responsiveness and measurement error. Studies showed large variability in test procedures despite existing guidelines for the performance of the 6MWT.Limitations. Unavailability of a specific checklist to evaluate the methodological quality of clinimetric studies on performance measures was a limitation of the study.Conclusions. Evidence for measurement properties of the 6MWT varies largely among chronic pediatric conditions. Further research is needed in all patient groups to explore the ability of the 6MWT to measure significant and clinically important changes. Until then, changes measured with the 6MWT should be interpreted with caution. Future studies or consensus regarding modified test procedures in the pediatric population is recommended.