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Damen KMS1,2, Takken T3, de Groot JF1,3, Backx FJG4, Radder B1, Roos ICPM1, Bloemen MAT1,2
1HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre for Healthy and Sustainable Living, Utrecht, Netherlands, 2HU University of Applied Sciences Utrecht, Master Program Physiotherapy, Specialisation Paediatric Physiotherapy, Utrecht, Netherlands, 3University Medical Center Utrecht, Child Development & Exercise Center, Wilhelmina Children’s Hospital, Utrecht, Netherlands, 4University Medical Center Utrecht, Department of Rehabilitation, Physiotherapy Science and Sports, Utrecht, Netherlands
Background: Youth with spina bifida (SB) encounter difficulties in everyday activities, resulting in lower levels of physical activity and physical fitness. This often leads to deconditioning which results in even lower levels of physical fitness. For measuring functional performance in the ambulatory pediatric population, the 6-minute walk test is the most widely used functional exercise test. Verschuren et al. (2013) developed the 6-minute push (6MPT) test for wheelchair-using youth as alternative for the 6-minute walk test in the ambulatory population. They stated that the 6MPT is a reliable, functional test for wheelchair-using youth with cerebral palsy. Diagnosis in wheelchair-using youth influences the physiologic response during exercise testing, so we do not know if the 6MPT is also a reliable and functional test for wheelchair-using youth with SB.
Purpose: The purpose of this study was to determine reliability and physiologic response of the 6MPT in youth with SB who self-propel a wheelchair.
Methods: A sample of 53 youths (5-19 years, mean age 13 years and 7 months; 32 boys/21 girls) with SB who use a manual wheelchair for daily life, long distances or sports, performed a minimum of two exercise tests: the 6MPT and the Shuttle Ride Test to maximal exhaustion. Heart rate, minute ventilation, respiratory exchange ratio and oxygen uptake were measured using a calibrated mobile gas analysis system and a heart rate monitor. For reliability, the 6MPT was administered twice in 26 youths with SB and the Intra Class Correlation coefficients (ICC), Standard Error of Measurements (SEM) and Smallest Detectable Changes (SDC) for total covered distance and heart rate were calculated. Physiologic response during the 6MPT was expressed as percentages of maximal values achieved during the Shuttle Ride Test.
Results: The ICC for total distance was excellent (ICC 0.95), the ICC for heart rate was good (ICC 0.81). The SDCs for both covered distance and heart rate were ±15% of the mean scores. The mean value of the physiologic response for all parameters during the 6MPT was 85-89% of its maximal value, except minute ventilation, which was 71% of the maximal value. However, there was a broad range in the intensity of the 6MPT compared to the Shuttle Ride Test in wheelchair-using youth with SB (range absolute VO2peak 34-135%).
Conclusion(s): Reliability of total covered distance during the 6MPT in wheelchair-using youth with SB seems to be excellent. Reliability for heart rate was good. In general the 6MPT is a functional performance test on a vigorous level of exercise for youth with SB who use a manual wheelchair for mobility or sports participation.
Implications: The 6MPT is easy to administer in clinical practice because no special equipment is needed. Pediatric physiotherapists are recommended to use the total covered distance in 6 minutes to determine and evaluate the level of functional performance of wheelchair-using youth with SB. The 6MPT can be used for all wheelchair-using youth with SB, but seems to be less appropriate for youngsters under ten years of age and for youngsters with a cognitive impairment.
Keywords: youth, 6-minute push test, Spinal Dysraphism
Funding acknowledgements: Foundation Innovation Alliance - Regional Attention and Action for Knowledge circulation, 2011-13-35P.
PhD grant HU University of Applied Sciences Utrecht.
Purpose: The purpose of this study was to determine reliability and physiologic response of the 6MPT in youth with SB who self-propel a wheelchair.
Methods: A sample of 53 youths (5-19 years, mean age 13 years and 7 months; 32 boys/21 girls) with SB who use a manual wheelchair for daily life, long distances or sports, performed a minimum of two exercise tests: the 6MPT and the Shuttle Ride Test to maximal exhaustion. Heart rate, minute ventilation, respiratory exchange ratio and oxygen uptake were measured using a calibrated mobile gas analysis system and a heart rate monitor. For reliability, the 6MPT was administered twice in 26 youths with SB and the Intra Class Correlation coefficients (ICC), Standard Error of Measurements (SEM) and Smallest Detectable Changes (SDC) for total covered distance and heart rate were calculated. Physiologic response during the 6MPT was expressed as percentages of maximal values achieved during the Shuttle Ride Test.
Results: The ICC for total distance was excellent (ICC 0.95), the ICC for heart rate was good (ICC 0.81). The SDCs for both covered distance and heart rate were ±15% of the mean scores. The mean value of the physiologic response for all parameters during the 6MPT was 85-89% of its maximal value, except minute ventilation, which was 71% of the maximal value. However, there was a broad range in the intensity of the 6MPT compared to the Shuttle Ride Test in wheelchair-using youth with SB (range absolute VO2peak 34-135%).
Conclusion(s): Reliability of total covered distance during the 6MPT in wheelchair-using youth with SB seems to be excellent. Reliability for heart rate was good. In general the 6MPT is a functional performance test on a vigorous level of exercise for youth with SB who use a manual wheelchair for mobility or sports participation.
Implications: The 6MPT is easy to administer in clinical practice because no special equipment is needed. Pediatric physiotherapists are recommended to use the total covered distance in 6 minutes to determine and evaluate the level of functional performance of wheelchair-using youth with SB. The 6MPT can be used for all wheelchair-using youth with SB, but seems to be less appropriate for youngsters under ten years of age and for youngsters with a cognitive impairment.
Keywords: youth, 6-minute push test, Spinal Dysraphism
Funding acknowledgements: Foundation Innovation Alliance - Regional Attention and Action for Knowledge circulation, 2011-13-35P.
PhD grant HU University of Applied Sciences Utrecht.
Topic: Paediatrics; Disability & rehabilitation; Neurology: spinal cord injury
Ethics approval required: Yes
Institution: University Medical Centre Utrecht
Ethics committee: Medical Ethical Committee
Ethics number: “Let’s Ride… study” procedures: number 11-557
All authors, affiliations and abstracts have been published as submitted.
