Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Measurements
Demographic and Anthrompometric Variables
2.3. Pulmonary Function Test Protocol
2.4. The 6-Minute Walk Test Protocol
2.5. Statistical Analysis
3. Results
3.1. Demographic, and BMI Characteristics of Patients Based on Category of SpO2 Change during the 6MWT
3.2. Pulmonary Function of Patients Based on Category of SpO2 Change during the 6MWT
3.3. The 6-Minute Walk Test Results of Patients Based on Category of SpO2 Change during the 6MWT
3.4. Demographic, and BMI Characteristics of ≥4% Oxygen Desaturators vs. Nondesaturators during the 6MWT
3.5. The 6-Minute Walk Test Results of ≥4% Oxygen Desaturators vs. Nondesaturators during the 6MWT
3.6. Regression Models to Predict Changes in SpO2 and a ≥4% Oxygen Desaturation during the 6MWT
3.7. Receiver Operating Characteristics of DLCO% for Detection of ≥4% Oxygen Desaturation during the 6MWT
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Change in SpO2 (Δ = SpO2 at End of Study–SpO2 at Start of Study) | ||||
---|---|---|---|---|
Variable | Increased (Δ ≥ +1%) N = 60 (19%) | Unchanged (−2 ≤ Δ ≤ 0%) N = 146 (46%) | Decreased (Δ ≤ −3%) N = 113 (35%) | p-Value |
Age, years | 48.30 ± 13.96 | 54.41 ± 13.35 | 57.68 ± 13.91 | <0.001 |
Sex, no. (%) | 0.236 | |||
Male | 22 (18) | 51 (42) | 47 (39) | |
Female | 37 (19) | 95 (48) | 67 (33) | |
Race, no. (%) | 0.364 | |||
White | 35 (19) | 84 (45) | 66 (36) | |
Black | 25 (19) | 59 (46) | 47 (36) | |
Hispanic | 0 (0) | 1 (100) | 0 (0) | |
Asian | 1 (100) | 0 (0) | 0 (0) | |
Other | 0 (0) | 0 (0) | 1 (100) | |
BMI (kg/m2) | 27.82 ± 7.68 | 30.06 ± 8.28 | 30.06 ± 8.06 | 0.157 |
Obstruction (FEV1/FVC < 70%), no. (%) | 12 (20) | 35 (24) | 46 (41) | <0.001 |
Restriction (TLC < 80%), no. (%) | 20 (33) | 37 (25) | 39 (35) | 0.114 |
Combined obstruction and restriction, no. (%) | 0 (0) | 2 (1) | 3 (3) | 0.387 |
FVC, L | 2.92 ± 1.06 | 2.88 ± 0.97 | 2.46 ± 1.02 | 0.003 |
FVC, %predicted | 76.33 ± 16.71 | 79.85 ± 16.53 | 68.56 ± 23.24 | <0.001 |
FEV1 L | 2.16 ± 0.93 | 2.10 ± 0.76 | 1.63 ± 0.77 | <0.001 |
FEV1, %predicted | 70.91 ± 23.49 | 74.85 ± 20.23 | 58.12 ± 21.89 | <0.001 |
FEV1/FVC ratio | 73.15 ± 16.99 | 73.86 ± 14.56 | 67.31 ± 21.21 | 0.014 |
TLC, L | 4.91 ± 1.41 | 4.92 ± 1.47 | 4.67 ± 1.55 | 0.418 |
TLC, %predicted | 89.12 ± 18.31 | 91.67 ± 21.52 | 85.92 ± 26.71 | 0.174 |
RV, L | 2.01 ± 0.94 | 2.08 ± 1.01 | 2.23 ± 1.10 | 0.363 |
RV, %predicted | 114.82 ± 53.17 | 113.01 ± 49.08 | 117.41 ± 58.12 | 0.825 |
DLCO, mL/min/mmHg | 14.85 ± 5.36 | 15.58 ± 6.15 | 10.59 ± 0.94 | <0.001 |
DLCO, %predicted | 64.57 ± 21.55 | 71.40 ± 26.28 | 45.07 ± 19.25 | <0.001 |
Airway resistance, cmH2O/L/sec | 1.93 ± 1.35 | 1.88 ± 1.20 | 2.27 ± 1.48 | 0.075 |
Change in SpO2 (Δ = SpO2 at End of Study–SpO2 at Baseline) | ||||
---|---|---|---|---|
6MWT Variable | Increased (Δ ≥ +1) N = 60 (19%) | Unchanged (−2 ≤ Δ ≤ 0%) N = 146 (46%) | Decreased (Δ ≤ −3%) N = 113 (35%) | p-Value |
SpO2, % | ||||
Start of test | 96.57 ± 2.04 | 97.99 ± 1.89 | 97.20 ± 2.43 | <0.001 1 |
End of test | 98.45 ± 1.63 | 97.10 ± 2.10 | 90.42 ± 5.11 | <0.001 1 |
Change | +1.88 | −0.89 | −6.78 | <0.001 2 |
Borg Dyspnea | ||||
Start of test | 1.52 ± 1.64 | 1.20 ± 1.38 | 1.00 ± 1.34 | 0.076 |
End of test | 3.51 ± 1.93 | 3.16 ± 2.23 | 3.86 ± 6.97 | 0.465 |
Change | +1.99 | +1.96 | +2.86 | 0.611 |
Borg Fatigue | ||||
Start of test | 1.43 ± 1.90 | 1.48 ± 1.78 | 1.28 ± 1.65 | 0.660 |
End of test | 3.51 ± 3.07 | 3.59 ± 2.69 | 2.82 ± 2.31 | 0.054 |
Change | +2.08 | +2.11 | +1.54 | 0.132 |
Pulse rate, 1/min | ||||
Start of test | 79.13 ± 15.26 | 79.31 ± 15.96 | 80.73 ± 14.53 | 0.714 |
End of test | 103.88 ± 24.07 | 105.66 ± 20.71 | 113.77 ± 78.72 | 0.331 |
Change | +24.75 | +26.35 | +33.04 | 0.312 |
6-minute walk distance, m | 397.88 ± 147.42 | 392.99 ± 119.17 | 353.98 ± 138.27 | 0.033 1 |
Variable | Nondesaturators (Δ SpO2 > −3%) N = 224 (70%) | Desaturators (Δ SpO2 ≤ −4%) N = 95 (30%) | p-Value |
---|---|---|---|
Age, years | 52.92 ± 14.11 | 57.96 ± 13.20 | 0.003 |
Sex, no. (%) | 0.697 | ||
Male | 82 (68) | 38 (32) | |
Female | 142 (72) | 57 (28) | |
Race, no. (%) | 0.364 | ||
White | 53 (29) | 130 (71) | |
Black | 41 (32) | 88 (68) | |
Hispanic | 1 (100) | 0 (0) | |
Asian | 1 (100) | 0 (0) | |
Other | 0 (0) | 1 (100) | |
BMI (kg/m2) | 29.42 ± 8.10 | 30.14 ± 8.19 | 0.472 |
Obstruction (FEV1/FVC<70%), no. (%) | 39 (40) | 59 (60) | 0.01 |
Restriction (TLC < 80%), no. (%) | 33 (34.4) | 63 (65.6) | 0.238 |
Combined obstruction and restriction, no. (%) | 3 (3.2) | 2 (1.8) | 0.444 |
FVC, L | 2.88 ± 0.9 | 92.43 ± 1.05 | 0.001 |
FVC, %predicted | 78.05 ± 16.51 | 68.55 ± 24.84 | 0.002 |
FEV1, L | 2.10 ± 0.82 | 1.59 ± 0.74 | <0.001 |
FEV1, %predicted | 72.72 ± 21.55 | 57.64 ± 21.85 | <0.001 |
FEV1/FVC ratio | 73.14 ± 15.80 | 67.39 ± 21.38 | 0.027 |
TLC, L | 4.94 ± 1.45 | 4.55 ± 1.55 | 0.05 |
TLC, % predicted | 90.89 ± 20.44 | 85.08 ± 28.09 | 0.094 |
RV, L | 2.10 ± 1.00 | 2.16 ± 1.10 | 0.636 |
RV, %predicted | 114.85 ± 50.58 | 114.89 ± 58.69 | 0.996 |
DLCO, mL/min/mmHg | 15.28 ± 5.92 | 9.77 ± 4.35 | <0.001 |
DLCO, %predicted | 68.54 ± 24.81 | 42.51 ± 19.25 | <0.001 |
Airway resistance, cmH2O/L/sec | 1.95 ± 1.33 | 2.20 ± 1.33 | 0.144 |
6MWT Variables | Nondesaturators (Δ SpO2 > −3%) N = 224 (70%) | Desaturators (Δ SpO2 ≤ −4%) N = 95 (30%) | p-Value |
---|---|---|---|
SpO2, % | |||
Start of test | 97.56 ± 2.07 | 97.18 ± 2.43 | 0.157 1 |
End of test | 97.24 ± 2.26 | 89.67 ± 5.15 | <0.001 1 |
Change | −0.32 | −7.51 | <0.001 2 |
Borg Dyspnea | |||
Start of test | 1.26 ± 1.48 | 1.02 ± 1.29 | 0.163 |
End of test | 3.26 ± 2.13 | 3.97 ± 7.55 | 0.196 |
Change | +2.00 | +2.95 | 0.465 |
Borg Fatigue | |||
Start of test | 1.46 ± 1.83 | 1.26 ± 1.57 | 0.354 |
End of test | 3.52 ± 2.77 | 2.77 ± 2.28 | 0.012 |
Change | +2.06 | +1.51 | 0.053 |
Pulse rate, 1/min | |||
Start of test | 79.29 ± 15.30 | 80.93 ± 15.34 | 0.383 |
End of test | 108.96 ± 57.87 | 106.33 ± 21.38 | 0.669 |
Change | +29.67 | +25.40 | 0.848 |
6-minute walk distance, m | 391.69 ± 128.83 | 352.67 ± 138.19 | 0.017 1 |
Variable | Parameter Estimate (β) ± Standard Error | p-Value |
---|---|---|
(Constant) | 4.886 ± 1.783 | 0.007 |
Age, years | 0.002 ± 0.024 | 0.933 |
FVC, L | 0.254 ± 0.79 | 0.748 |
FEV1, L | 0.197 ± 1.022 | 0.847 |
DLCO, mL/min/mmHg | −0.291 ± 0.071 | <0.001 |
Variable | Odds Ratio | 95% Confidence Interval | p-Value |
---|---|---|---|
Age, years | 0.951 | 0.892, 1.014 | 0.125 |
FVC, L | 0.883 | 0.070, 11.203 | 0.923 |
FEV1, L | 2.816 | 0.081, 98.292 | 0.568 |
DLCO, mL/min/mmHg | 0.909 | 0.742, 1.115 | 0.360 |
Variable | Odds Ratio | 95% Confidence Interval | p-Value |
---|---|---|---|
Age, years | 1.003 | 0.973, 1.034 | 0.859 |
FVC, L | 0.581 | 0.174, 1.933 | 0.376 |
FEV1, L | 3.574 | 0.751, 17.014 | 0.110 |
DLCO, mL/min/mmHg | 0.749 | 0.655, 0.856 | <0.001 |
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Gupta, R.; Ruppel, G.L.; Espiritu, J.R.D. Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test. Med. Sci. 2020, 8, 8. https://doi.org/10.3390/medsci8010008
Gupta R, Ruppel GL, Espiritu JRD. Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test. Medical Sciences. 2020; 8(1):8. https://doi.org/10.3390/medsci8010008
Chicago/Turabian StyleGupta, Raghav, Gregg L. Ruppel, and Joseph Roland D. Espiritu. 2020. "Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test" Medical Sciences 8, no. 1: 8. https://doi.org/10.3390/medsci8010008