728 - Standard Test, Unstandardized Practice: 6MWT Use in Pediatric Neuromuscular Disorders

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

AC

Alexandra Chenowith, BS

Clinical Research Associate
ABBEL Research Division, Rehabilitation Institute at Sinai (formerly Sinai Rehabilitation Center), Sinai Hospital of Baltimore
Baltimore, Maryland, United States
AS

Asha Stegall, MD

Physiatry Resident PGY II
ABBEL Research Division, Rehabilitation Institute at Sinai (formerly Sinai Rehabilitation Center), Sinai Hospital of Baltimore
Baltimore, Maryland, United States

Co-Author(s)

TD

Tanvi Das, BA

PhD Student
Nisonger Center, Ohio State University
Baltimore, Maryland, United States
DA

Dee Adedipe, MS

PhD Student
Nisonger Center, Ohio State University
Baltimore, Maryland, United States
VK

Victoria Kent, BS

Medical Student
The Warren Alpert Medical School of Brown University
Baltimore, Maryland, United States

Corresponding Author(s)

JW

Jordan Wickstrom, PhD

Director of Clinical Research at ABBEL Research Division
ABBEL Research Division, Rehabilitation Institute at Sinai (formerly Sinai Rehabilitation Center), Sinai Hospital of Baltimore
Baltimore, Maryland, United States

Submitter(s)

AC

Alexandra Chenowith, BS

ABBEL Research Division, Rehabilitation Institute at Sinai (formerly Sinai Rehabilitation Center), Sinai Hospital of Baltimore, Baltimore, MD
Baltimore, Maryland, United States

Objectives: Valued for its practicality and sensitivity to change, the 6-Minute Walk Test (6MWT) is a widely-accepted measure for assessing functional ability in children with neuromuscular disorders (NMDs). Despite its broad implementation in children, standardized 6MWT guidelines were initially designed for adults and later adapted for children with Duchenne Muscular Dystrophy (DMD) by McDonald et al. (2013). However, because pediatric NMDs encompass a diverse range of functional abilities, it remains uncertain whether NMD studies—even those in DMD—are consistently following McDonald’s guidelines. To address this gap, we conducted a pediatric-focused sub-analysis of our narrative review to evaluate which 6MWT guidelines are applied and what methods are used in their administration.

Design: Following SANRA guidelines, 3 databases were searched for original research published in English between 1982–2022 reporting 6MWT use in NMDs. Extracted variables included NMD type, sample size, age, and 6MWT methods (e.g., guidelines, course length, shape). A pediatric-only subsample was extracted for analysis.

Results: Of the 199 studies in the parent review, 71 (36%) consisted of pediatric-only cohorts. The mean sample size was 49.6 (SD=51.6), with 38 studies (54%) enrolling fewer than 30 participants, highlighting predominantly small-scale samples. Seven unique NMDs were studied, with DMD being the most prevalent (n=58 studies). 43 (61%) studies reported using McDonald’s guidelines, with 17 (24%) and 15 (21%) using the recommended course length (25 m) and shape (linear path), respectively. Majority of the studies lacked normative data comparison or systematic reporting of falls.

Conclusions: Although pediatric-specific guidelines exist, 6MWT protocol adherence and reporting remain inconsistent, limiting replicability and meaningful comparison across pediatric NMDs. Our findings highlight the need to clarify whether existing guidelines are sufficient across NMDs or if condition-specific standards are needed. Standardization is essential to ensure the 6MWT is a reliable, interpretable, and clinically meaningful outcome measure for children with NMDs.