Six-Minute Walk Distance in Persons With Parkinson Disease: A Hierarchical Regression Model

Falvo MJ, Earhart GM. Six-minute walk distance in persons with Parkinson disease: a hierarchical regression model.ObjectivesTo determine the six-minute walk distance (6MWD) in subjects with Parkinson disease (PD) and to determine the impairments that contribute to walking capacity.DesignDescriptive cross-sectional study of subjects with PD.SettingUniversity laboratory.ParticipantsSubjects with PD (N=75; 65.0±9.5y) of mild to moderate severity, as defined by an average Hoehn and Yahr (HY) rating of 2.0±0.4 and Unified Parkinson Disease Rating Scale (UPDRS) motor score of 27±8.9, were tested on medication.InterventionsNot applicable.Main Outcome MeasuresSubjects were administered the motor subsection of the UPDRS and completed the following tests: Berg Balance Scale (BBS), Timed Up & Go (TUG), and six-minute walk test. In addition, they also provided self-reports of freezing of gait and number of falls in the past 6 months.ResultsThe average 6MWD was 391.6±99.9m. All of the aforementioned tests, with the exception of fall number (P=.07), correlated significantly with 6MWD (r range, −.64 to .55). By using a hierarchical regression model, we entered age, HY, and UPDRS motor score into the first block (ie, set of independent variables) to represent parkinsonian characteristics, which explained a significant amount of variability in 6MWD (R2=.196, P<.001). The second block entered (eg, functional measures scores, self-reports) explained a significant amount of additional variability (R2 change=.355, P<.001). The TUG, BBS, and number of falls contributed independently in the presence of all independent variables.ConclusionsThe 6MWD in subjects with PD is explained in part by disease-specific characteristics and perhaps to a greater extent by impaired balance and predisposition to falling. Training targeted at improving balance and reducing falling risk factors may increase 6MWD (ie, walking capacity) in subjects with PD.