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Developmental Neurorehabilitation Volume 24, 2021 - Issue 1
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Research Article

Reference Centiles to Monitor the 6-minute-walk Test in Ambulant Children with Cerebral Palsy and Identification of Effects after Rehabilitation Utilizing Whole-body Vibration

Kyriakos Martakisa Medical Faculty and University Hospital, Centre of Prevention and Rehabilitation, Cologne, Germany;b Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany;c Faculty of Health, Medicine and Life Sciences, Department of International Health, Care and Public Health Research Institute, School CAPHRI, Maastricht University, Maastricht, The Netherlands;d Department of Pediatric Neurology, Social Pediatrics and Epileptology, Justus-Liebig-University Giessen and UKGM, Giessen, GermanyCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0003-3982-0914View further author information
ORCID Icon,
Christina Starkb Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany;e Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne, Cologne, GermanyORCID Iconhttps://orcid.org/0000-0003-4247-0679View further author information
ORCID Icon,
Mirko Rehbergb Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany;f Centre for Rare Skeletal Diseases in Childhood, University of Cologne, Cologne, GermanyView further author information
,
Oliver Semlerb Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany;f Centre for Rare Skeletal Diseases in Childhood, University of Cologne, Cologne, GermanyView further author information
,
Ibrahim Durana Medical Faculty and University Hospital, Centre of Prevention and Rehabilitation, Cologne, GermanyORCID Iconhttps://orcid.org/0000-0003-4044-8822View further author information
ORCID Icon &
Eckhard Schoenaua Medical Faculty and University Hospital, Centre of Prevention and Rehabilitation, Cologne, Germany;b Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany;e Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne, Cologne, GermanyView further author information
Pages 45-55 | Received 17 Jun 2019, Accepted 14 May 2020, Published online: 21 Jun 2020

Figures & data

Table 1. Characteristics of the study population and evaluation of the effect of the rehabilitation program on the walking capacity assessed by the 6MWT

Figure 1. Flowchart of the study population

Figure 1. Flowchart of the study population

Table 2. Tabulated 6MWT reference for use with children having cerebral palsy (GMFCS 1 and 2). Distance in meters, age in years. C: centile, L: skewness, M: mean, S: coefficient of variation

Table 3. Tabulated values of the standard deviation of 6MWT Z-score differences (6 months apart), age in years

Figure 2. Reference curves for 6MWT in children with CP GMFCS levels 1 and 2. The centiles are labeled with the corresponding Z‐scores. The dashed line represents the standard deviation of the difference of 2 GMFM‐66 Z‐scores measured 6 months apart

Figure 2. Reference curves for 6MWT in children with CP GMFCS levels 1 and 2. The centiles are labeled with the corresponding Z‐scores. The dashed line represents the standard deviation of the difference of 2 GMFM‐66 Z‐scores measured 6 months apart

Figure 3. Reference curves for 6MWT: a. in children with CP GMFCS level 1 and b. in children with CP GMFCS level 2. Centiles presented 5th, 10th, 25th, 50th, 75th, 90th and 95th

Figure 3. Reference curves for 6MWT: a. in children with CP GMFCS level 1 and b. in children with CP GMFCS level 2. Centiles presented 5th, 10th, 25th, 50th, 75th, 90th and 95th

Figure 4. Case study. The figure illustrates the use of the tool. First, the two 6MWT scores are entered (two crosses, age1 = 11 years 6 months, age2 = 12 years 0 months). The corresponding Z-scores are Z1 = −0.5 for M0, Z2 = 0.25 for M6. The age-dependent standard deviation (SD) of the centile change is determined by using the dashed curve (or more precisely) and the age of the child at the first 6MWT assessment at M0 (SD = 0.64). Using the formula (Z2-Z1)/SD, the Z-score for the centile change can be calculated. It corresponds to a large individual effect size 0.75/0.64 = 1.17

Figure 4. Case study. The figure illustrates the use of the tool. First, the two 6MWT scores are entered (two crosses, age1 = 11 years 6 months, age2 = 12 years 0 months). The corresponding Z-scores are Z1 = −0.5 for M0, Z2 = 0.25 for M6. The age-dependent standard deviation (SD) of the centile change is determined by using the dashed curve (or more preciselyTable 3) and the age of the child at the first 6MWT assessment at M0 (SD = 0.64). Using the formula (Z2-Z1)/SD, the Z-score for the centile change can be calculated. It corresponds to a large individual effect size 0.75/0.64 = 1.17

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