PMID- 19208563
OWN - NLM
STAT- MEDLINE
DCOM- 20090421
LR  - 20090211
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 36
IP  - 2
DP  - 2009 Feb
TI  - Limitations to the 6-minute walk test in interstitial lung disease and pulmonary 
      hypertension in scleroderma.
PG  - 330-6
LID - 10.3899/jrheum.080447 [doi]
AB  - OBJECTIVE: To determine factors that influence 6-minute walk distance (6MWD) in 
      patients with scleroderma (systemic sclerosis, SSc)-interstitial lung disease 
      (ILD), SSc-pulmonary hypertension (PH), and idiopathic pulmonary fibrosis (IPF). 
      METHODS: We retrospectively evaluated all patients with SSc or IPF who performed 
      a 6-minute walk test (6MWT) at a university hospital between 1999 and 2003. 
      Chi-square, ANOVA, simple linear regression, and backwards elimination 
      multivariable regressions were performed. RESULTS: Forty-eight consecutive IPF 
      patients with 6MWT were compared to 33 patients with SSc-ILD, 13 with SSc-PH, 19 
      with both SSc-ILD and SSc-PH (SSc-Both), and 15 with SSc without ILD or PH 
      (SSc-Neither). Mean 6MWD did not differ between groups. Limitations to 6MWT 
      trended toward dyspnea in IPF and lower extremity pain in SSc. SSc-Both had 
      dyspnea limitation more than other SSc subgroups (p = 0.017). Percentage 
      predicted forced vital capacity (FVC%) and percentage predicted carbon monoxide 
      diffusing capacity (DLCO%) were more strongly predictive of 6MWD in IPF than in 
      SSc; however, exclusion of SSc subjects with pain limitation improved the 
      predictive value. Significant correlates of 6MWD in multivariable analysis 
      differed between subgroups. CONCLUSION: Pain limitations confound the utility of 
      the 6MWT, particularly in SSc. Pain may cause failure to reach a dyspnea 
      limitation during 6MWT, especially in SSc patients without both ILD and PH. 
      Correlates of 6MWD differ between SSc subgroups and IPF; therefore, the 6MWT 
      distance is not always reflective of the same physiological process. 6MWT 
      interpretation should include consideration of vascular, pulmonary, and 
      musculoskeletal exercise limitations.
FAU - Garin, Margaret C
AU  - Garin MC
AD  - Washington University School of Medicine, St. Louis, MO, USA.
FAU - Highland, Kristin B
AU  - Highland KB
FAU - Silver, Richard M
AU  - Silver RM
FAU - Strange, Charlie
AU  - Strange C
LA  - eng
PT  - Journal Article
DEP - 20090122
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
CIN - J Rheumatol. 2009 Feb;36(2):216-8. PMID: 19208554
MH  - Adult
MH  - Dyspnea/diagnosis/etiology/physiopathology
MH  - Exercise Test/*methods
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*diagnosis/etiology/physiopathology
MH  - Ischemia/etiology/physiopathology
MH  - Lung Diseases, Interstitial/*diagnosis/etiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pain/etiology/physiopathology
MH  - Physical Endurance/*physiology
MH  - Predictive Value of Tests
MH  - Pulmonary Gas Exchange/physiology
MH  - Respiratory Physiological Phenomena
MH  - Retrospective Studies
MH  - Scleroderma, Systemic/*complications
MH  - Time Factors
MH  - Vital Capacity/physiology
MH  - Walking/physiology
EDAT- 2009/02/12 09:00
MHDA- 2009/04/22 09:00
CRDT- 2009/02/12 09:00
PHST- 2009/02/12 09:00 [entrez]
PHST- 2009/02/12 09:00 [pubmed]
PHST- 2009/04/22 09:00 [medline]
AID - jrheum.080447 [pii]
AID - 10.3899/jrheum.080447 [doi]
PST - ppublish
SO  - J Rheumatol. 2009 Feb;36(2):330-6. doi: 10.3899/jrheum.080447. Epub 2009 Jan 22.