Usual-Paced 400m Long Distance Corridor Walk Estimates Cardiorespiratory Fitness among Older Adults: The Study of Muscle, Mobility and Aging (SOMMA).

Moffit RE, Cawthon PM, Nicklas BJ, Goodpaster BH, Coen PM, Forman DE, Cummings SR, Newman AB, Glynn NW. Usual-Paced 400m Long Distance Corridor Walk Estimates Cardiorespiratory Fitness among Older Adults: The Study of Muscle, Mobility and Aging (SOMMA). medRxiv : the preprint server for health sciences [Preprint]. 2023 Nov 6.

BACKGROUND: Cardiopulmonary exercise testing (CPET), the gold-standard method to quantify cardiorespiratory fitness (CRF), is not always feasible due to cost, access, and burden. The usual-paced 400m long-distance corridor walk (LDCW), a measure of mobility among older adults, may provide an alternate method to assess CRF among populations unable to complete maximal intensity testing. The purpose of this study was to develop and validate an estimating equation to estimate VO peak from average 400m walking speed (WS) among participants in the Study of Muscle, Mobility and Aging (SOMMA). METHODS: At baseline, participants (N = 820, 76.2±4.9 years, 58% Women, 86% Non-Hispanic White) completed a 400m LDCW (400m WS = 400m/completion time in seconds) and symptom-limited maximal CPET (Modified Balke Protocol). VO peak (mL/kg/min) was considered the highest 30-second average oxygen consumption during CPET. Other covariates included: age, sex, race, physical activity (7-day wrist-worn accelerometer), physical function (Short Physical Performance Battery, range 0-12), perceived physical fatigability (Pittsburgh Fatigability Scale, range 0-50), and Borg Rating of Perceived Exertion (RPE, range 6-20) at completion of the 400m LDCW. Stepwise linear regression was used. Internal validation was completed using data-splitting method (70%; 30%). RESULTS: Mean VO peak was 20.2±4.8 mL/kg/min and mean 400m WS was 1.06±0.2 m/s. Each 0.05 m/s increment in 400m WS was associated with a 0.40 mL/kg/min higher VO peak after adjustment for covariates. An estimating equation including 400m WS, age, sex, race, and RPE was developed. Internal validation showed low overall bias (-0.26) and strong correlation (r = 0.71) between predicted and measured VO peak values. Bland-Altman plot and regression analyses indicated predicted VO peak was an acceptable alternative, despite mean underestimation of 4.53 mL/kg/min among those with CPET VO peak = 25 mL/kg/min. CONCLUSIONS: Usual-paced 400m LDCW strongly correlates with direct measures of cardiorespiratory fitness during CPET in older adults with lower fitness and can be used to test both fitness and function.