Session Information
Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Pulmonary vascular disease and interstitial lung fibrosis are the leading causes of morbidity and mortality in Juvenile Systemic Sclerosis (JSSc). Six-minute walk test (6MWT) is a self-paced sub maximal exercise test used for evaluating functional exercise capacity, prognosis and response to therapy in patients with cardiopulmonary diseases. While the results of studies on the availability of the test in adults are contradictory, there are limited data concerning the usefulness of 6MWT in children with JSSc. We aimed to evaluate the walking distance and oxygen desaturation during the 6MWT in JSSc, and to establish correlations between the 6MWT results and other clinical findings in children with JSSc.
Methods: 25 JSSc, 27 Juvenile Systemic Lupus Erythematosus (JSLE) and 30 healthy controls were included. The test is conducted according to the guidelines recommended by the American Thoracic Society (ATS), standardized in 2002. The Borg Scale which is a well-validated scoring system on a 0-10 point scale was used to determine the patient self reported fatigue and dyspnea levels.
Results: Demographic data are shown in Table 1. Mean walking distance was 480,18 ± 47,22 m in JSSc; 513,66 ± 51,70 m in JSLE and 553,21 ± 41,65 m in healthy controls. JSSc patients walked significantly less distance comparing to controls (p <0.001). The mean oxygen saturation in JSSc was 98.0 ± 0.9% before the test and 97.5 ± 1.6% after the test (p = 0,01). JSSc patients with lung involvement walked less than those without lung involvement (476.08 ± 47.13 m vs .483.96 ± 48.89 m), but without statistically significant difference (p = 0.68). JSSc patients with carbon monoxide diffusion capacity (DLco) ≤ 60% walked less than those with DLco ≥ 60% (466.92 ± 45.74 m vs. 485,33 ± 48,05 m). However, no statistically significant correlation was detected. (p = 0.39). No significant difference was found when patients walking distances were compared to activity scores (Juvenile Systemic Sclerosis Severity Score (J4S)) (p = 0.26). Lower extremity pain during and after the test was more statistically significant in JSSc patients (p = 0.001). Patients with myalgia were found to walk less than those without myalgia (498.61 ± 46.94 m vs. 460.20 ± 40.29 m) (p = 0.038).
|
Total |
Juvenile Systemic Sclerosis N=25 |
Juvenile Systemic Lupus Erythematosus N=27 |
Healthy children N=30 |
p-value |
|
Gender , Female, n(%) |
22 (88%) |
21 (77.8%) |
16 (53.3%) |
p=0,04 |
|
Age mean±SD (years) |
16,44±3,19 years |
16,74±3,59 years |
15,57±1,50 years |
p=0,27 |
|
Body mass index, mean±SD |
18,75±2,99 kg/m2 |
20,43±3,05 kg/m2 |
19,94±1,69 kg/m2 |
p=0,06 |
Conclusion: The findings of our study showed that patients with JSSc have limited walking distances. The pulmonary involvement and associatively high disease activity score are unable to determine the results of the 6MWT in JSSc patients. However, the musculoskeletal involvement may influence the walk distance and complicate interpretation of the 6MWT in JSSc patients. Since there are a limited number of studies regarding the role of 6MWT in the evaluation of JSSc, we believe that the results of our study will enlighten the future studies.
To cite this abstract in AMA style:
Koker O, Adrovic A, Sahin S, Barut K, Omeroglu R, Kasapcopur O. Evaluating the Validity of SIX-Minute Walk Test in Juvenile Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/evaluating-the-validity-of-six-minute-walk-test-in-juvenile-systemic-sclerosis/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluating-the-validity-of-six-minute-walk-test-in-juvenile-systemic-sclerosis/