more details in : Bernard P, Romain AJ, Vancampfort D, Ninot G. Six minutes walk test for individuals with schizophrenia: systematic review. Disability and Rehabilitation (2015)

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Six minutes walk test for individuals with
schizophrenia: a systematic review
Bernard P1, Romain AJ1, Vancampfort D2, Baillot A 3, Esseul E4, Ninot G1.
1 Laboratory Epsylon EA 4556, Dynamics of Human Abilities and Health Behaviors, University of Montpellier 1, France
2 University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Kortenberg, Belgium
3 Étienne­LeBel Clinical Research Center of the Centre Hospitalier University of Sherbrooke, Qc, Canada.
4 St Clement Clinic, avenue Saint Sauveur, St Clément de Rivière, F­34980, France
Introduction
The 6­minutes walk test (6MWT) is a sub­
maximal standardized aerobic test,
practical simple and easy [1]. The 6MWT
provides information regarding the
functional capacity of individuals. The main
outcome is the distance that a subject can
walk within this period.
Regarding individuals with schizophrenia,
a growing number of studies used the 6MWT
to measure their functional capacity
because metabolic and cardiovascular
diseases have become a major issue in both
clinical care and research. Alongside, the
prevention of somatic disorders (e.g.
obesity, chronic respiratory disease) have
aroused great interest among this
population.
Aims
1­ Evaluate the responsiveness of the 6MWT to an intervention in
adults with schizophrenia
2­ Compare the distance achieved on the 6MWT in patients with
schizophrenia with general population data or matched controls.
3­ Identify the determinants of 6MWT distance.
4­ Determine the measurement properties and quality procedures for
6MWT.
Method
PRISMA statement
Inclusion and exclusion criteria
Studies were included if they met the following criteria:
i. Participants. Adults with a diagnosis of schizophrenia or
schizoaffective disorders based on DSM­IV­TR
ii. Outcomes. The primary outcome was the functional capacity
measured with 6MWT distance. Secondary outcome measures were
the measurement properties of the 6MWT, its determinants of 6MWT
and test procedures.
iii. Controls. When comparing the 6MWT distance with other
populations, studies including clinical and non­clinical controls were
included.
iv. Studies. Randomized clinical trials, controlled trials, and
observational studies were included.
Results
ATS. ATS Statement: Guidelines for the Six­Minute Walk Test. Am J Resp Crit Care Med 2002
Vancampfort D, Probst M, Sweers K, et al. Reliability, minimal detectable changes, practice effects and correlates
of the 6­min walk test in patients with schizophrenia. Psy Res 2011
Marzolini S, Jensen B, Melville P. Feasibility and effects of a group­based resistance and aerobic exercise program
for individuals with severe schizophrenia: A multidisciplinary approach. Ment Heal Phys Act, 2009
Putzhammer A, Heindl B, Broll K, et al. Spatial and temporal parameters of gait disturbances in schizophrenic
patients. Schizophr. Res. 2004
References
Responsiveness of the 6MWT to treatment
No significant increase of 6MWT distance had been obtained in 4
interventional studies.
Comparisons of the 6MWT distance of patients with schizophrenia with
control groups
Adults with schizophrenia performed a shorter distance in comparison to
healthy adults. (e.g., 573.1m ±115.5 vs. 710.6 m ±108.4) (3 studies)
BMI, diabetes, Metabolic Syndrome and low level of physical self­esteem
are the characteristics that are reported to negatively influence the 6MWT
distance.
Correlates of the 6MWT
Correlates that were negatively associated with the 6MWT distance were
higher BMI, cigarette consumption, higher Chlorpromazine equivalents.
Correlate that was positively associated was physical activity
Results were contradictory concerning duration of illness, while other factors
such as Systolic­Diastolic blood pressure and age, were clearly not
associated with 6MWT performance.
Measurement properties and quality of test procedure of 6MWT (1 study)
Test­retest reliability between the two 6MWT (ICC=0.96)
The criterion validity has not been explored.
Minimal detectable change = 56.2m (men) and 50.2m (women).
Test procedures in comparison (9/16 studies used criteria of ATS guidelines)
walk as far as possible
without jogging or running
­ 6MWT (with appropriate attention to standardization of the
testing protocol ) has been shown to be valid, reliable and
feasible for subjects with schizophrenia.
­ Responsiveness of 6MWT can not be
confirmed
­ The distance performed by adults with
schizophrenia seems generally lower than in healthy
adults.
Contact
BERNARD Paquito, PhD
paquito.bernard@gmail.com
Conclusion