Background/Objectives: In the context of active ageing, functional assessment is key to preserving autonomy in older women. The six-minute walk test (6MWT) is a practical tool for estimating general health, but its results can be influenced by various factors. This study analysed cardiorespiratory variations during the 6MWT in older women according to their physical activity level and age-related variables such as pain, sarcopenia, frailty, and motivation to exercise. Methods: A total of 163 older women with musculoskeletal pain, but without cardiac or respiratory conditions, were classified into groups with high (HPA), moderate (MPA), and low (LPA) physical activity. During the 6MWT, heart rate (HR), dyspnoea, and oxygen saturation (SpO2) were recorded. Pain, sarcopenia, frailty, and motivation to exercise were also assessed. A repeated-measures multivariate analysis of (co)variance (RM-MANCOVA) was performed. Results: The results showed differences in HR depending on the level of physical activity, conditioned by sarcopenia (p < 0.05) and walked distance (p < 0.001), and in dyspnoea conditioned by pain perception (p < 0.01) and social (p < 0.001) and psychological (p < 0.05) motivation to exercise. There were also differences in SpO2 depending on the level of physical activity (p < 0.0001). There were differences between the HPA group and both the MPA and LPA group, which had higher HR, higher dyspnoea, and lower SpO2 when undergoing the 6MWT test. Conclusions: To accurately interpret 6MWT results in older adult women, it is essential to consider physical activity level, perceived pain, sarcopenia, and motivation to exercise, as these factors influence HR, dyspnoea, and SpO2. These variables should guide physical activity recommendations for healthy ageing.

Department of Physiotherapy Faculty of Health Science Universidad Europea de Valencia Pg de l'Albereda 7 El Pla del Real 46010 Valencia Spain

Department of Physiotherapy Faculty of Physiotherapy University of Valencia Gascó Oliag St 5 46010 Valencia Spain

Exercise Intervention for Health Research Group Department of Physiotherapy University of Valencia 46010 Valencia Spain

Faculty of Physical Education and Sport Charles University 162 52 Prague Czech Republic

Ivey Business School Western University 1255 Western Rd London ON N6G 0N1 Canada

Physiotherapy in Motion Multispeciality Research Group Department of Physiotherapy University of Valencia Gascó Oliag St 5 46010 Valencia Spain

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Belmonte Darraz S., González-Roldán A.M., de María Arrebola J., Montoro-Aguilar C.I. Impacto del ejercicio físico en variables relacionadas con el bienestar emocional y funcional en adultos mayores. Rev. Esp. Geriatría Gerontol. 2021;56:136–143. doi: 10.1016/j.regg.2021.01.006. PubMed DOI

Valderrama F.P., Coronado F.B., Aichele C.V., Bravo E.C. Nivel de actividad física y funcionalidad en adultos mayores. Rev. Cienc. Act. Física UCM. 2016;17:59–65.

Petretto D., Pili R., Gaviano L., López C., Zuddas C. Envejecimiento Activo y de Éxito o Saludable: Una Breve Historia de Modelos Conceptuales. Rev. Esp. Geriatría Gerontol. 2016;51:229–241. doi: 10.1016/j.regg.2015.10.003. PubMed DOI

Silva N., Rajado A.T., Esteves F., Brito D., Apolónio J., Roberto V.P., Binnie A., Araújo I., Nóbrega C., Bragança J., et al. Measuring Healthy Ageing: Current and Future Tools. Biogerontology. 2023;24:845–866. doi: 10.1007/s10522-023-10041-2. PubMed DOI PMC

Thomas N., Gurvich C., Kulkarni J. Sex Differences in Aging and Associated Biomarkers. Adv. Exp. Med. Biol. 2019;1178:57–76. doi: 10.1007/978-3-030-25650-0_4. PubMed DOI

Zeng Y., Chen H., Liu X., Song Z., Yao Y., Lei X., Lv X., Cheng L., Chen Z., Bai C., et al. Genetic Associations with Longevity Are on Average Stronger in Females than in Males. Heliyon. 2023;10:e23691. doi: 10.1016/j.heliyon.2023.e23691. PubMed DOI PMC

Phyo A.Z.Z., Fransquet P.D., Wrigglesworth J., Woods R.L., Espinoza S.E., Ryan J. Sex Differences in Biological Aging and the Association with Clinical Measures in Older Adults. GeroScience. 2024;46:1775–1788. doi: 10.1007/s11357-023-00941-z. PubMed DOI PMC

David Vantman B., Margarita Vega B. Fisiología reproductiva y cambios evolutivos con la edad de la mujer. Rev. Médica Clínica Las Condes. 2010;21:348–362. doi: 10.1016/S0716-8640(10)70545-9. DOI

Mechling H., Netz Y. Aging and Inactivity—Capitalizing on the Protective Effect of Planned Physical Activity in Old Age. Eur. Rev. Aging Phys. Act. 2009;6:89–97. doi: 10.1007/s11556-009-0052-y. DOI

Gil M.C.R., Marín D.M., Camacho G.J.O., Andrada R.T., Mariño M.M. Desaturación arterial de oxígeno en mujeres pre y postmenopáusicas durante la realización de ejercicio aeróbico. (Arterial oxygen desaturation in pre- and post-menopausal women during aerobic exercise) Cult. Cienc. Deporte. 2009;4:167–172. doi: 10.12800/ccd.v4i12.147. DOI

Arteaga C.E., Santacruz J.G., Ramírez L.J. Evaluación del dolor musculoesquelético en el anciano. Acta Médica Colomb. 2011;36:30–35. doi: 10.36104/amc.2011.1514. DOI

Chiarotto A., Koes B.W. Nonspecific Low Back Pain. N. Engl. J. Med. 2022;386:1732–1740. doi: 10.1056/NEJMcp2032396. PubMed DOI

Vos T., Allen C., Arora M., Barber R.M., Bhutta Z.A., Brown A., Carter A., Casey D.C., Charlson F.J., Chen A.Z., et al. Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 310 Diseases and Injuries, 1990–2015: A Systematic Analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545–1602. doi: 10.1016/S0140-6736(16)31678-6. PubMed DOI PMC

Sáez López M.P., Sánchez Hernández N., Jiménez Mola S., Alonso García N., Valverde García J.A. Valoración Del Dolor En El Anciano. Rev. Soc. Esp. Dolor. 2015;22:271–274. doi: 10.4321/S1134-80462015000600008. DOI

Manejo Básico Del Dolor Agudo y Crónico. [(accessed on 1 October 2024)]. Available online: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-87712017000400077.

Blumstein H., Gorevic P.D. Rheumatologic Illnesses: Treatment Strategies for Older Adults. Geriatrics. 2005;60:28–35. PubMed

López-Benavente Y., Ros-Sánchez T., Abad-Corpa E., Lidón-Cerezuela M.B., López-Benavente Y., Ros-Sánchez T., Abad-Corpa E., Lidón-Cerezuela M.B. Promoción de La Actividad Física En Mujeres Mayores. Un Estudio Cualitativo Con Perspectiva de Género. Gerokomos. 2022;33:219–224.

Ennour-Idrissi K., Maunsell E., Diorio C. Effect of Physical Activity on Sex Hormones in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Breast Cancer Res. 2015;17:139. doi: 10.1186/s13058-015-0647-3. PubMed DOI PMC

Sandoval J.R.G., Caracuel J.C., de Sevilla U. Motivación y ejercicio físico deportivo: Una Añeja Relación. Rev. Int. Cienc. Soc. Humanidades. 2014;24:71–88.

Mecanismos Neurocognitivos de La Motivación En El Entrenamiento Físico. [(accessed on 27 September 2024)]. Available online: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S2665-20562020000100082.

Klompstra L., Jaarsma T., Strömberg A. Self-Efficacy Mediates the Relationship Between Motivation and Physical Activity in Patients With Heart Failure. J. Cardiovasc. Nurs. 2018;33:211–216. doi: 10.1097/JCN.0000000000000456. PubMed DOI PMC

Matsudo S.M.M. Recomendaciones de actividad física: Un mensaje para el profesional de la salud. Rev. Nutr. Clínica Metab. 2019;2:44–54. doi: 10.35454/rncm.v2n2.006. DOI

Ratter J., Radlinger L., Lucas C. Several Submaximal Exercise Tests Are Reliable, Valid and Acceptable in People with Chronic Pain, Fibromyalgia or Chronic Fatigue: A Systematic Review. J. Physiother. 2014;60:144–150. doi: 10.1016/j.jphys.2014.06.011. PubMed DOI

Mora Vicente J., Mora Rodríguez H., González Montesinos J.L., Ruiz Gallardo P., Ares Camerino A. Medición del grado de aptitud física en adultos mayores. Aten. Primaria. 2007;39:565–568. doi: 10.1157/13110737. PubMed DOI PMC

Holland A.E., Spruit M.A., Troosters T., Puhan M.A., Pepin V., Saey D., McCormack M.C., Carlin B.W., Sciurba F.C., Pitta F., et al. An Official European Respiratory Society/American Thoracic Society Technical Standard: Field Walking Tests in Chronic Respiratory Disease. Eur. Respir. J. 2014;44:1428–1446. doi: 10.1183/09031936.00150314. PubMed DOI

Singh S.J., Puhan M.A., Andrianopoulos V., Hernandes N.A., Mitchell K.E., Hill C.J., Lee A.L., Camillo C.A., Troosters T., Spruit M.A., et al. An Official Systematic Review of the European Respiratory Society/American Thoracic Society: Measurement Properties of Field Walking Tests in Chronic Respiratory Disease. Eur. Respir. J. 2014;44:1447–1478. doi: 10.1183/09031936.00150414. PubMed DOI

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories ATS Statement: Guidelines for the Six-Minute Walk Test. Am. J. Respir. Crit. Care Med. 2002;166:111–117. doi: 10.1164/ajrccm.166.1.at1102. PubMed DOI

Gochicoa-Rangel L., Mora-Romero U., Guerrero-Zúñiga S., Silva-Cerón M., Cid-Juárez S., Velázquez-Uncal M., Durán-Cuéllar A., Salas-Escamilla I., Mejía-Alfaro R., Torre-Bouscoulet L. Prueba de caminata de 6 minutos: Recomendaciones y procedimientos. Neumol. Cir. Tórax. 2015;74:127–136. doi: 10.35366/NTS192J. DOI

Steffens D., Beckenkamp P.R., Hancock M., Paiva D.N., Alison J.A., Menna-Barreto S.S. Activity Level Predicts 6-Minute Walk Distance in Healthy Older Females: An Observational Study. Physiotherapy. 2013;99:21–26. doi: 10.1016/j.physio.2011.11.004. PubMed DOI

Camarri B., Eastwood P.R., Cecins N.M., Thompson P.J., Jenkins S. Six Minute Walk Distance in Healthy Subjects Aged 55-75 Years. Respir. Med. 2006;100:658–665. doi: 10.1016/j.rmed.2005.08.003. PubMed DOI

Alameri H., Al-Majed S., Al-Howaikan A. Six-Min Walk Test in a Healthy Adult Arab Population. Respir. Med. 2009;103:1041–1046. doi: 10.1016/j.rmed.2009.01.012. PubMed DOI

Enright P.L., Sherrill D.L. Reference Equations for the Six-Minute Walk in Healthy Adults. Am. J. Respir. Crit. Care Med. 1998;158:1384–1387. doi: 10.1164/ajrccm.158.5.9710086. PubMed DOI

Casanova C., Celli B.R., Barria P., Casas A., Cote C., de Torres J.P., Jardim J., Lopez M.V., Marin J.M., de Oca M.M., et al. The 6-Min Walk Distance in Healthy Subjects: Reference Standards from Seven Countries. Eur. Respir. J. 2011;37:150–156. doi: 10.1183/09031936.00194909. PubMed DOI

Bautmans I., Lambert M., Mets T. The Six-Minute Walk Test in Community Dwelling Elderly: Influence of Health Status. BMC Geriatr. 2004;4:6. doi: 10.1186/1471-2318-4-6. PubMed DOI PMC

Bull F.C., Al-Ansari S.S., Biddle S., Borodulin K., Buman M.P., Cardon G., Carty C., Chaput J.-P., Chastin S., Chou R., et al. World Health Organization 2020 Guidelines on Physical Activity and Sedentary Behaviour. Br. J. Sports Med. 2020;54:1451–1462. doi: 10.1136/bjsports-2020-102955. PubMed DOI PMC

Norton K., Norton L., Sadgrove D. Position Statement on Physical Activity and Exercise Intensity Terminology. J. Sci. Med. Sport. 2010;13:496–502. doi: 10.1016/j.jsams.2009.09.008. PubMed DOI

Hidalgo Lozano A., Arroyo Morales M., Moreno Lorenzo C., Castro Sánchez A. Dolor y estrés en fisioterapia: Algometría de presión. Rev. Iberoam. Fisioter. Kinesiol. 2005;9:3–10. doi: 10.1016/S1138-6045(06)73109-4. DOI

Chesterton L.S., Sim J., Wright C.C., Foster N.E. Interrater Reliability of Algometry in Measuring Pressure Pain Thresholds in Healthy Humans, Using Multiple Raters. Clin. J. Pain. 2007;23:760. doi: 10.1097/AJP.0b013e318154b6ae. PubMed DOI

Hawker G.A., Mian S., Kendzerska T., French M. Measures of Adult Pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP) Arthritis Care Res. 2011;63((Suppl. S11)):S240–S252. doi: 10.1002/acr.20543. PubMed DOI

Parra-Rodríguez L., Szlejf C., García-González A.I., Malmstrom T.K., Cruz-Arenas E., Rosas-Carrasco O. Cross-Cultural Adaptation and Validation of the Spanish-Language Version of the SARC-F to Assess Sarcopenia in Mexican Community-Dwelling Older Adults. J. Am. Med. Dir. Assoc. 2016;17:1142–1146. doi: 10.1016/j.jamda.2016.09.008. PubMed DOI

Rosas-Carrasco O., Cruz-Arenas E., Parra-Rodríguez L., García-González A.I., Contreras-González L.H., Szlejf C. Cross-Cultural Adaptation and Validation of the FRAIL Scale to Assess Frailty in Mexican Adults. J. Am. Med. Dir. Assoc. 2016;17:1094–1098. doi: 10.1016/j.jamda.2016.07.008. PubMed DOI

Stenström C.H., Boestad C., Carlsson M., Edström M., Reuterhäll A. Why Exercise?: A Preliminary Investigation of an Exercise Motivation Index among Individuals with Rheumatic Conditions and Healthy Individuals. Physiother. Res. Int. J. Res. Clin. Phys. Ther. 1997;2:7–16. doi: 10.1002/pri.75. PubMed DOI

Revuelta J.M., Alconero-Camarero A.R. Corazón de mujer. Cir. Cardiovasc. 2020;27:39–41. doi: 10.1016/j.circv.2020.02.002. DOI

Escala de Evaluación de La Disnea de Borg/Medición Subjetiva En Pacientes Respiratorios—Ocronos—Editorial Científico-Técnica. [(accessed on 16 May 2024)]. Available online: https://revistamedica.com/escala-evaluacion-disnea-borg/

Torp K.D., Modi P., Pollard E.J., Simon L.V. StatPearls [Internet] StatPearls Publishing; Petersburg, FL, USA: 2023. Pulse Oximetry. PubMed

Granger C.L., Denehy L., Parry S.M., Martin J., Dimitriadis T., Sorohan M., Irving L. Which Field Walking Test Should Be Used to Assess Functional Exercise Capacity in Lung Cancer? An Observational Study. BMC Pulm. Med. 2015;15:89. doi: 10.1186/s12890-015-0075-2. PubMed DOI PMC

Marques-Sule E., Espí-López G.V., Monzani L., Suso-Martí L., Rel M.C., Arnal-Gómez A. How Does the Continued Use of the Mask Affect the Craniofacial Region? A Cross-Sectional Study. Brain Behav. 2023;13:e3077. doi: 10.1002/brb3.3077. PubMed DOI PMC

Osses A.R., Yáñez V.J., Barría P.P., Palacios M.S., Dreyse D.J., Díaz P.O., Lisboa B.C. Reference values for the 6-minutes walking test in healthy subjects 20-80 years old. Rev. Med. Chil. 2010;138:1124–1130. PubMed

Cordero A., Masiá M.D., Galve E. Ejercicio físico y salud. Rev. Esp. Cardiol. 2014;67:748–753. doi: 10.1016/j.recesp.2014.04.007. PubMed DOI

Cruz-Jentoft A.J., Bahat G., Bauer J., Boirie Y., Bruyère O., Cederholm T., Cooper C., Landi F., Rolland Y., Sayer A.A., et al. Sarcopenia: Revised European Consensus on Definition and Diagnosis. Age Ageing. 2019;48:16–31. doi: 10.1093/ageing/afy169. PubMed DOI PMC

Domínguez-Chávez C.J., Rosales-Garza R.B., Aguilar-Arámbul S.C., Mata Reyes M.D.C., Monfil Bautista J., Mendoza Catalán G., Domínguez-Chávez C.J., Rosales-Garza R.B., Aguilar-Arámbul S.C., Mata Reyes M.D.C., et al. Asociación de los factores del estilo de vida con la sarcopenia: Revisión sistemática. Horiz. Sanit. 2022;21:561–572. doi: 10.19136/hs.a21n3.4832. DOI

Rexach J.A.S. Consecuencias clínicas de la sarcopenia. Nutr. Hosp. 2006;21((Suppl. S3)):46–50. PubMed

Roubenoff R. Sarcopenia and Its Implications for the Elderly. Eur. J. Clin. Nutr. 2000;54((Suppl. S3)):S40–S47. doi: 10.1038/sj.ejcn.1601024. PubMed DOI

Illamola Martin L., Granados Granados A., Sanllorente Melenchón A., Rodríguez Cristobal J.J., Broto Hernandez M. Prevalencia de Inactividad Física y Riesgo de Sarcopenia En Atención Primaria. Estudio Transversal. Aten. Primaria. 2024;56:102993. doi: 10.1016/j.aprim.2024.102993. PubMed DOI PMC

Salvà A., Serra-Rexach J.A., Artaza I., Formiga F., Rojano i Luque X., Cuesta F., López-Soto A., Masanés F., Ruiz D., Cruz-Jentoft A.J. La prevalencia de sarcopenia en residencias de España: Comparación de los resultados del estudio multicéntrico ELLI con otras poblaciones. Rev. Esp. Geriatría Gerontol. 2016;51:260–264. doi: 10.1016/j.regg.2016.02.004. PubMed DOI

Joobeur S., Rouatbi S., Latiri I., Sfaxi R., Ben Saad H. Influencing Factors of the 6-Min Walk Distance in Adult Arab Populations: A Literature Review. Tunis. Med. 2016;94:339–348. PubMed

Delgado Acosta H., Acuña Corrales E. Efecto de un programa de ejercicio aeróbico y un programa de circuito con pesas sobre la calidad de vida, disnea y resistencia cardiorrespiratoria en sujetos con enfermedad pulmonar crónica. MHSalud Rev. Cienc. Mov. Hum. Salud. 2007;4:1–8. doi: 10.15359/mhs.4-1.1. DOI

Lacasse Y., Martin S., Lasserson T.J., Goldstein R.S. Meta-Analysis of Respiratory Rehabilitation in Chronic Obstructive Pulmonary Disease. A Cochrane Systematic Review. Eur. Medicophysica. 2007;43:475–485. PubMed

Awadallah M.F., Sobh E., Shendy M.A., Al-Shenqiti A.M., Al-Jeraisi T.M., Eweda R.S. Impaired Pulmonary Function in Patients with Chronic Neck Pain. J. Med. Sci. 2021;41:123. doi: 10.4103/jmedsci.jmedsci_31_20. DOI

Renzi G.M., Vanyay M.E., Almada C.E. La motivación de los adultos mayores hacia la práctica de actividad física en Avellaneda. Perspect. Investig. Educ. Física. 2022;1:1–8.

Warburton D.E.R., Nicol C.W., Bredin S.S.D. Health Benefits of Physical Activity: The Evidence. CMAJ. 2006;174:801–809. doi: 10.1503/cmaj.051351. PubMed DOI PMC

López-Marmolejo A.L., Vallecilla-Campo L.M. Comparación de variables morfo-fisiológicas en mujeres de la tercera edad con diferente nivel de actividad física. Arrancada. 2022;22:183–206.

Marca Fuertes C., Canales M.G., Miguel-Tobal F., Escudero P.M. La Pulsioximetría y Su Aplicación En Pruebas de Esfuerzo Máximo. Apunts Med. Esport. 2011;46:23–27. doi: 10.1016/j.apunts.2010.11.002. DOI

Miyachi M., Katayama K. Effects of Maximal Interval Training on Arterial Oxygen Desaturation and Ventilation during Heavy Exercise. Jpn. J. Physiol. 1999;49:401–407. doi: 10.2170/jjphysiol.49.401. PubMed DOI

deS Barbosa J.F., Bruno S.S., Cruz N.S.O., de Oliveira J.S., Ruaro J.A., Guerra R.O. Perceived fatigability and metabolic and energetic responses to 6-minute walk test in older women. Physiotherapy. 2016;102:294–299. doi: 10.1016/j.physio.2015.08.008. PubMed DOI