https://doi.org/10.4081/monaldi.2025.3068
Longitudinal changes in the 6-minute walk test and the Glittre-activities of daily living test in adults with cystic fibrosis
Submitted: May 28, 2024
Accepted: October 24, 2024
Published: January 9, 2025
Accepted: October 24, 2024
Abstract Views: 26
PDF_EARLY VIEW: 4
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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With the increasing use of highly effective modulator therapy (HEMT) in adults with cystic fibrosis (awCF), it is necessary to determine the evolution of the most dynamic physiological markers of this disease, such as the 6-minute walk test (6MWT) and the Glittre-activities of daily living test (TGlittre). The present study aimed to evaluate the 1-year changes in the 6- minute walking distance (6MWD), TGlittre time, and quality of life (QoL) in awCF before the initiation of HEMT and to determine the impact of habitual physical activity (HPA) and chest physiotherapy (CP). This longitudinal study enrolled 24 awCF who completed the 6MWT and TGlittre. Pulmonary function tests, handgrip strength (HGS), and the Cystic Fibrosis Questionnaire-Revised (CFQ-R) were conducted. Measurements were collected at baseline (T1) and 1 year later (T2). The median body mass index increased between T1 and T2 [19.8 (18-24) vs. 21.4 (19-24) kg/m2, p=0.038]. TGlittre time decreased both in relation to the absolute values [3.10 (2.52-3.39) vs. 2.40 (2.00-3.00) minutes, p=0.001] and in relation to the predicted values [127 (116-150) vs. 108 (102-140) % predicted, p=0.001]. Although there was no increase in 6MWD relative to the predicted values, it increased relative to the absolute values [545 (463-654) vs. 617 (540-658) meters, p=0.041]. In relation to the group that did not engage in HPA, individuals who had HPA showed an increase in HGS between T1 and T2 [7.1 (0-20) vs. 0 (-12-3) kgf, p=0.031]. In relation to the group that did not undergo CP, individuals undergoing CP showed an increase in the 'treatment burden'–CFQ-R between T1 and T2 [16.1 (-3-18) vs. -11.2 (-28-1) points, p=0.049]. In conclusion, awCF performed better on TGlittre than on 6MWT. They experienced an improvement in body composition. HPA was correlated with peripheral muscle strength, as were CP and QoL.
Giallongo A, Parisi GF, Papale M, et al. Effects of elexacaftor/tezacaftor/ivacaftor on cardiorespiratory polygraphy parameters and respiratory muscle strength in cystic fibrosis patients with severe lung disease. Genes 2023;14:449.
DOI: https://doi.org/10.3390/genes14020449
Cutting GR. Cystic fibrosis genetics: from molecular understanding to clinical application. Nat Rev Genet 2015;16:45-56.
DOI: https://doi.org/10.1038/nrg3849
Gramegna A, Contarini M, Aliberti S, et al. From ivacaftor to triple combination: a systematic review of efficacy and safety of CFTR modulators in people with cystic fibrosis. Int J Mol Sci 2020;21:5882.
DOI: https://doi.org/10.3390/ijms21165882
da Silva Filho LVRF, Maróstica PJC, Athanazio RA, et al. Extensive CFTR sequencing through NGS in Brazilian individuals with cystic fibrosis: unravelling regional discrepancies in the country. J Cyst Fibros 2021;20:473-84.
DOI: https://doi.org/10.1016/j.jcf.2020.08.007
Sanders DB, Chmiel JF. Drug development for cystic fibrosis. Pediatr Pulmonol 2021:56:S10-22.
DOI: https://doi.org/10.1002/ppul.25075
Martin C, Chapron J, Hubert D, et al. Prognostic value of six minute walk test in cystic fibrosis adults. Respir Med 2013;107:1881-7.
DOI: https://doi.org/10.1016/j.rmed.2013.10.001
Abelenda VLB, da Costa CH, Firmida MC, Lopes AJ. Evaluating the contribution of the Glittre-ADL test in adults with cystic fibrosis. Physiother Res Int 2024;29:e2087.
DOI: https://doi.org/10.1002/pri.2087
Papathanasiou J, Dionyssiotis Y, Kasnakova P, et al. Six-minute walk test: a tool for assessing mobility in frail subjects. J Frailty Sarcopenia Falls 2016;1:73-6.
DOI: https://doi.org/10.22540/JFSF-01-073
Ramos KJ, Smith PJ, McKone EF, et al. Lung transplant referral for individuals with cystic fibrosis: Cystic Fibrosis Foundation consensus guidelines. J Cyst Fibros 2019;18:321-33.
DOI: https://doi.org/10.1016/j.jcf.2019.03.002
Gur M, Masarweh K, Toukan Y, et al. Six-minute walk, lung clearance index, and QOL in bronchiolitis obliterans and cystic fibrosis. Pediatr Pulmonol 2019;54:451-6.
DOI: https://doi.org/10.1002/ppul.24223
Combret Y, Boujibar F, Gennari C, et al. Measurement properties of the one-minute sit-to-stand test in children and adolescents with cystic fibrosis: a multicenter randomized cross-over trial. PLoS One 2021;16:e0246781.
DOI: https://doi.org/10.1371/journal.pone.0246781
Dourado VZ, Nishiaka RK, Simões MSMP, et al. Classification of cardiorespiratory fitness using the six-minute walk test in adults: comparison with cardiopulmonary exercise testing. Pulmonology 2021;27:500-8.
DOI: https://doi.org/10.1016/j.pulmoe.2021.03.006
Frost AE, Langleben D, Oudiz R, et al. The 6-min walk test (6MW) as an efficacy endpoint in pulmonary arterial hypertension clinical trials: demonstration of a ceiling effect. Vascul Pharmacol 2005;43:36-9.
DOI: https://doi.org/10.1016/j.vph.2005.03.003
Skumlien S, Hagelund T, Bjørtuft O, Ryg MS. A field test of functional status as performance of activities of daily living in COPD patients. Respir Med 2006;100:316-23.
DOI: https://doi.org/10.1016/j.rmed.2005.04.022
Scalco JV, Martins R, Almeida ACS, Caputo F, et al. "Test-retest reliability and minimal detectable change in TGlittre-P test in children and adolescents with cystic fibrosis". Disabil Rehabil 2022;44:3701-7.
DOI: https://doi.org/10.1080/09638288.2020.1864037
de Andrade Junior AB, Ferreira AS, Assis ACB, et al. Cardiac autonomic control in women with rheumatoid arthritis during the glittre activities of daily living test. Asian J Sports Med 2020;11:e101400.
DOI: https://doi.org/10.5812/asjsm.101400
Balata MR, Ferreira AS, da Silva Sousa A, et al. Assessment of functional capacity in patients with nondialysis-dependent chronic kidney disease with the Glittre activities of daily living test. Healthcare 2023;11:1809.
DOI: https://doi.org/10.3390/healthcare11121809
Gruber W, Stehling F, Blosch C, et al. Longitudinal changes in habitual physical activity in adult people with cystic fibrosis in the presence or absence of treatment with elexacaftor/tezacaftor/ivacaftor. Front Sports Act Living 2024:6:1284878.
DOI: https://doi.org/10.3389/fspor.2024.1284878
Southern KW, Addy C, Bell SC, et al. Standards for the care of people with cystic fibrosis; establishing and maintaining health. J Cyst Fibros 2024;23:12-28.
DOI: https://doi.org/10.1016/j.jcf.2023.12.002
Gruet M, Saynor ZL, Urquhart DS, Radtke T. Rethinking physical exercise training in the modern era of cystic fibrosis: a step towards optimising short-term efficacy and long-term engagement. J Cyst Fibros 2022;21:e83-98.
DOI: https://doi.org/10.1016/j.jcf.2021.08.004
Hamedi N, Kajbafvala M, ShahAli S, et al. The effects of aerobic exercises compared to conventional chest physiotherapy on pulmonary function, functional capacity, sputum culture, and quality of life in children and adolescents with cystic fibrosis: a study protocol for randomized controlled trial study. Trials 2023;24:695.
DOI: https://doi.org/10.1186/s13063-023-07719-w
Farrell PM, White TB, Ren CL, et al. Diagnosis of cystic fibrosis: consensus guidelines from the Cystic Fibrosis Foundation. J Pediatr 2017:181S:S4-15.
DOI: https://doi.org/10.1016/j.jpeds.2016.09.064
McIlwaine M, Button B, Dwan K. Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database Syst Rev 2015;6:CD003147.
DOI: https://doi.org/10.1002/14651858.CD003147.pub4
Rozov T, Cunha MT, Nascimento O, et al. Linguistic validation of cystic fibrosis quality of life questionnaires. J Pediatr 2006;82:151-6.
DOI: https://doi.org/10.2223/JPED.1463
Crosby CA, Wehbe MA, Mawr, B. Hand strength: normative values. J Hand Surg Am 1994;19:665-70.
DOI: https://doi.org/10.1016/0363-5023(94)90280-1
Culver BH, Graham BL, Coates AL, et al. Recommendations for a standardized pulmonary function report: an official American Thoracic Society technical statement. Am J Respir Crit Care Med 2017;196:1463-72.
DOI: https://doi.org/10.1164/rccm.201710-1981ST
Pereira CA, Sato T, Rodrigues SC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol 2007;33:397-406.
DOI: https://doi.org/10.1590/S1806-37132007000400008
American Thoracic Society/European Respiratory Society. ATS/ERS statement on respiratory muscle testing. Am J Respir Crit Care Med 2002;166:518-624.
DOI: https://doi.org/10.1164/rccm.166.4.518
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111-7.
DOI: https://doi.org/10.1164/ajrccm.166.1.at1102
Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med 1998;158:1384-7.
DOI: https://doi.org/10.1164/ajrccm.158.5.9710086
Reis CMD, Karloh M, Fonseca FR, et al. Functional capacity measurement: reference equations for the Glittre Activities of Daily Living test. J Bras Pneumol 2018;44:370-7.
DOI: https://doi.org/10.1590/s1806-37562017000000118
Gusev E, Liang F, Bhattarai S, et al. Characterization of skeletal muscle wasting pathways in diaphragm and limb muscles of cystic fibrosis mice. Am J Physiol Regul Integr Comp Physiol 2022;322:R551-61.
DOI: https://doi.org/10.1152/ajpregu.00225.2021
Kerem E, Orenti A, Adamoli A, et al. Cystic fibrosis in Europe: improved lung function and longevity - reasons for cautious optimism, but challenges remain. Eur Respir J 2024;63:2301241.
DOI: https://doi.org/10.1183/13993003.01241-2023
Boutou AK, Manika K, Hajimitrova M, et al. Longitudinal changes in exercise capacity among adult cystic fibrosis patients. Adv Respir Med 2020;88:420-3.
DOI: https://doi.org/10.5603/ARM.a2020.0145
Lima TRL, Almeida VP, Ferreira AS, et al. Handgrip strength and pulmonary disease in the elderly: what is the link? Aging Dis 2019;10:1109-29.
DOI: https://doi.org/10.14336/AD.2018.1226
Andrade Lima C, Dornelas de Andrade A, et al. Six-minute walk test as a determinant of the functional capacity of children and adolescents with cystic fibrosis: a systematic review. Respir Med 2018:137:83-8.
DOI: https://doi.org/10.1016/j.rmed.2018.02.016
Bhatia R, Kaye M, Roberti-Miller A. Longitudinal assessment of exercise capacity and quality of life outcome measures in cystic fibrosis: a year-long prospective pilot study. J Eval Clin Pract 2020;26:236-41.
DOI: https://doi.org/10.1111/jep.13105
Campos NE, Vendrusculo FM, Da Costa GA, et al. The association of field test outcomes with peak oxygen uptake in patients with cystic fibrosis: a systematic review. Int J Exerc Sci 2022;15:1381-94.
DOI: https://doi.org/10.70252/RXNS4914
Bradley J, McAlister O, Elborn S. Pulmonary function, inflammation, exercise capacity and quality of life in cystic fibrosis. Eur Respir J 2001;17:712-5.
DOI: https://doi.org/10.1183/09031936.01.17407120
Cherobin IA, Dalcin PTR, Ziegler B. Association between lung function, physical activity level and postural evaluation variables in adult patients with cystic fibrosis. Clin Respir J 2018;12:1510-7.
DOI: https://doi.org/10.1111/crj.12698
Ribeiro Moço VJ, Lopes AJ, dos Santos Vigário P, et al. Pulmonary function, functional capacity and quality of life in adults with cystic fibrosis. Rev Port Pneumol 2015;21:198-202.
DOI: https://doi.org/10.1016/j.rppnen.2014.10.003
Kenn K, Gloeckl R, Soennichsen A, et al. Predictors of success for pulmonary rehabilitation in patients awaiting lung transplantation. Transplantation 2015;99:1072-7.
DOI: https://doi.org/10.1097/TP.0000000000000472
Ministry of Health of Brazil. Approves the clinical protocol and therapeutic guidelines for cystic fibrosis, 30 April 2024. Available from: https://www.gov.br/saude/pt-br/assuntos/pcdt/arquivos/2022/portal-portaria-conjunta-no-25_pcdt_fibrose-cistica.pdf/view.
Ethics Approval
The study was approved by the Research Ethics Committee of the Pedro Ernesto University Hospital of the State University of Rio de Janeiro under protocol number CAAE-93586318.0.0000.5259.How to Cite
Abelenda, Vera Lucia Barros, Cláudia Henrique da Costa, Mônica de Cássia Firmida, Raphael Freitas Jaber de Oliveira, Rogério Rufino, and Agnaldo José Lopes. 2025. “Longitudinal Changes in the 6-Minute Walk Test and the Glittre-Activities of Daily Living Test in Adults With Cystic Fibrosis”. Monaldi Archives for Chest Disease, January. https://doi.org/10.4081/monaldi.2025.3068.
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