Determinants of the distance walked in the six-minute walk test at discharge from patients with heart failure




Heart failure; Muscle strength; Quality of life.


Background: The distance walked during the six-minute walk test (6MWD) is predicted measure for mortality and rehospitalization in patients with heart failure. Objective: To identify the determinants of 6MWD at discharge from patients with heart failure. Methods: This is a descriptive and cross-sectional clinical study. Patients aged 18 to 80 years and functional class I to II were eligible. Those who have a type of psychiatric, cognitive or locomotor disorder; atrial fibrillation; use of a fixed frequency heart pacemaker were not eligible. The following were collected from the medical records: name, age, sex, BMI (body mass index); ejection fraction of the left ventricle; hemoglobin; fasting blood glucose; etiology of stay; presence of risk factors for cardiovascular diseases; presence of infection. The muscle strength of the knee extension movement was evaluated by dynamometry, a quality of life with the Nottingham Health Profile (NHP), the previous physical activity level by the International Physical Activity Questionnaire (IPAQ) and the 6MWD. Results: Sixty patients from a final sample (58.3% males, mean age 56.23±10.44 years). Were selected as the variables selected from the multivariate analysis: age (p=0.057), dynamometry (p=0.004), Total NPH (p=0.017) and IPAQ (p=0.018). R=0.72 and R²=0.53 with p<0.05 and the mean of the 6MWD was 393.16±42.80 meters. Conclusion: In this study the determinants of 6MWD were: age, total mean knee dynamometry, total NPH and IPAQ.


American Thoracic Society ATS. (2002). Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med, 166 (1), 111–117.

Barbosa, R. R., Franklin, R. V., Stefenoni, A. V., Moraes, V. D., Jacques, T. M., Serpa, R. G., et al. (2014). Quality of life analysis among men ad women with heart failure. Rev Bras Cardiol, 27 (2), 97-103.

Bay, A., Dellborg, M., Baerghammer, M., Sandberg, C., Engstron, G., Moons, P., et al. (2017). Patient reported outcomes are associated with physical activity level in adults with congenital heart disease. Int J Cardiol, 243, 174-179.

Binotto, M. A., & El Tassa, K. O. M. Physical activity in elderly a basead systematic review in international physical activity questionnaire (IPAQ).(2014). Estud Interdiscipl Envelhec, 19(1), 249-264.

Bocchi, E. A., Marcondes-Braga, F. G., Ayub-Ferreira, S. M., Rohde, L. E., Oliveira, N. W. A., Almeida, D. R., et al. (2009). Brazillian Society of Cardiology. III Brazilian Guideline for Chornic Heart Failure. Arq Bras Cardiol, 93(1), 1-71.

Britto, R. R., Probst, V. S., Andrade, A. F. D., Samora, G. A. R., Hernades, N. A., Marinho, P. E. M., et al.(2013). Reference equations for the six-minute walk distance based on a Brazilian multicenter sdudy. Braz J Phys Ther, 17(6), 556-563.

Carvalho, E. E. V., Costa, D. C., Crescênio, J. C., Santi, G. L., Papa, V., Marques, F., et al.(2011). Heart Failure: Comparison between six-minute walk test and cardiopulmonar test. Arq Bras Cardiol, 97(1), 1-6.

Cinarli, T., & Koç, Z. (2017). Fear and risk of falling, activities of daily living, and quality of life: assessment when older adultos receive emergency departmente care. Nurs Res. 66(4), 330-335.

Enright, P. L., & Sherrill, D. L.(1998). Reference equations for the six-minute walk in healthy adults. Am J Respi Crit Cate Med, 158, 1384-1387.

Freitas, M. T. S., & Puschel, V. A. A. (2013). Heart Failure: Expressions of personal knowledge about the disease. Rev Esc Enferm USP. 47(4), 922-929.

Garcia, L. M. T., Osti, R. F. I., Ribeiro, E. H. C., & Florindo,. A A. (2013). Validation of two questionnaires to assess physical activity in adults. Rev Bras Ativ Fis Saúde, 18(3), 317-331.

Hernández-Luís, R., Ponce, E. M., Muñoz, M. M., Platt, G. Q., Santana, S. O., Reimers, M. G., et al. (2017). Prognostic value of physical function tests and muscle mass in elderly hospitalized patients. A prospective observacional study. Geriatr Gerontol Int, 1, 1-8.

Holland, A. E., Spruit, M. A., Milo, T. T. A., Pepin, V. P., Saey, M. D., McCormack, C. B. W., et al. (2014). An European Respiratory Society/ America Thoracic Society Technical Standard: field walking tests in chornic respiratory disease. Eur Respir J, 30, 1-19.

Iwana, A. M., Andrade, G. N., Shima, P., Tanni, S. E., Godoy, I., Dourado, V. R. (2009). The six-minute walk test and body weight- walk distance produtcs in healthy Brazilian subjects. Bras J Med Biol Res, 42(11), 1080-1085.

Liu, X., Lou, X., Cheng, X., & Meng, Y. (2017). Impact of metoprolol treatment on mental status of chronic heart failure patients with neuropsychiatric disorders. Durg Design, Development and Therapy, 11, 305-312.

Marcassa, C., Giordano, A., & Giannuzzi, P. (2016). Five-year hospitalizations and survival in patients admitted to inpatient cardiac rehabilitation after cardiac surgery. Eur J Prev Cardiol, 23(15), 1609-1616.

Marcassa, C., Pistono, M., Maserati, R., Giordano, A., & Giannuzzi, P. (2016). Disability after cardiac sugery is the major predictor of infections occuring in the rehabilitation phase. Eur J Prev Cardiol, 23(6), 584-592.

Milton, S. (1986). A sample size formula for multiple regression studies. Americ Association for Public Opinion Research, 50, 112-118.

Morais, E. R., Rassi, S., Correa, K. S., & Borges, B. A. (2013). Effects of unsupervised exercise training program in the quality of life and functional capacity of patients with chornic heart failure. Cient Biol Saúde, 15(2), 97-103.

Neves, C. D. C., Gomes, R. T., Avelar, N. C. P., Simão, A. P., Lacerda, A. C. R. (2011). Assessin the reliability of isometric strengh of knee extenders by usisng load cell. Rev Ter Man, 9(41), 16-21.

Oliveira, G. U., Carvalho, V. O., Cacau, L. P. A., Araujo Filho, A. A., Cerqueira Neto, M. L., Silva Júnior, W. M., et al. (2014). Determinats of distance walked during the six-minute walk test in patients undergoing cardiac sugery at hospital discharge. J Cardiothorac Surg, 9(95), 1-6.

Omar, H. R., & Guglin, M. (2017). Determinants of improvement in six-minute walk distance from admission to discharge in acute systolic heart failure: Analysis from the ESCAPE trial. Cardiol J, 24(2), 227-230.

Pierik, V. D., Meskers, C. G., Ancum, J. M. V., Numans, S. T., Verlaan, S., Scheerman, K., et al. (2017). High risk of malnutrition is associated with low muscle mass in older hospitallized patients – a prospective cohort study. BMC Geriatrics, 17(118), 1-8.

Rubim, V. S. M., Drumond Neto, C., Romeo, J. L. M., & Montera, M. W. (2006). Prognostic valeu of the six-minute walk test in heart failure. Arq Bras Cardiol, 86(2), 120-125.

Santos Souza, K. M., Cerqueira Neto, M. L., Carvalho, V. O., Santana Filho, V. J., Silva Júnior, W. M., Araújo Filho, A. A., et al. (2014). Evaluation of peripheral muscle strenght of patients undergoing elective cardiac sugery: a longitudinal study. Rev Bras Cir Cardiovasc, 29(3), 355-359.

Teixeira-Salmela, L. F. T., Magalhães, L. C., Souza, A. C., Lima, M. C., Lima, R. C. M., & Goulart, F. (2004). Adaptation of the Nottingham Health Profile a simple measure to assess quality of life. Cad. Saúde Pública, 20(4), 905-914.

Ussavarungsi, K., Lee, A. S., & Burger, C. D. (2016). Can a six minute walk distance predict right ventricular dysfunction in patients with diffuse parenchymal lung disease and pulmanary hypertension? Oman Med J, 31(5), 345-351.




How to Cite

ANDRADE, I. F. dos R. .; SILVA JÚNIOR, W. M. da .; CARVALHO, V. O. .; OLIVEIRA, G. U. .; CERQUEIRA NETO, M. L. de .; CERQUEIRA, T. C. F. .; CACAU, L. A. P. . Determinants of the distance walked in the six-minute walk test at discharge from patients with heart failure. Research, Society and Development, [S. l.], v. 12, n. 2, p. e2112229735, 2023. DOI: 10.33448/rsd-v12i2.29735. Disponível em: Acesso em: 3 jun. 2023.



Health Sciences