Background
Methods
Data sources and search strategy
Eligibility criteria
Study selection
Data extraction
Quality assessment
Data synthesis and analysis
Results
Characteristics of included studies
Study (first author and year) | Region | Setting | Design | Study Characteristics: Groups, Sample Size (%Male), Age | Heart Failure Diagnosis |
---|---|---|---|---|---|
Six Minutes Walking Test (6MWT) | |||||
Brenyo et al. [45], 2012. | United States, Canada, and Europe | Clinical Care Setting (110 Secondary Care Centres) | Retrospective | High Performance. > 350 m: n = 1021 (82%). 62.5 ± 10.5 years. Low Performance. ≤ 350 m: n = 744 (66.4%). 66.8 ± 10.7 years. | HFrEF LVEF < 30% (29 ± 3%) |
Ferreira et al. [46], 2019 | 11 European Countries | Clinical Care Setting (69 Secondary Care Centres) | Prospective | High Performance. > 360 m: n = 537 (86.6%). 62 ± 11.0 years. Middle Performance. 241-360 m: n = 586 (77.3%). 67 ± 12.0 years. Low Performance. ≤ 240 m: n = 591 (63%). 73 ± 10.0 years. | HFrEF LVEF = 30% (25–38%) |
Wegrzynowska-Teodorczyk et al. [47], 2013. | Poland | Clinical Care Setting (Secondary Care) | Prospective | All: n = 243 (100%). 60 ± 11.0 years. High Performance. > 468 m. NS. Low Performance. ≤ 468 m. NS. | HFrEF LVEF ≤ 45% (29 ± 8%) |
Bittner et al. [48], 1993. | United States, Canada, and Belgium | Clinical Care Setting (20 Tertiary Care Hospitals) | Prospective | All: n = 898 (78%). 59 ± 12.0 years. High Performance. ≥ 450: n = 201. NS. Middle Performance. 375–450: n = 215. NS. Low Performance. 300–375: n = 241. NS. Very Low Performance. < 300: n = 176. NS. | Congestive HFrEF LVEF ≤ 45% |
Arslan et al. [49], 2007. | Turkey | Not Reported | Prospective | All: n = 43 (86%). 62 ± 10.0 years. High Performance. > 300 m. NS. Low Performance. ≤ 300 m. NS. | HFrEF LVEF ≤ 40% (0.35 ± 0.06%) |
Lee et al. [50], 2006. | Singapore (Asian) | Clinical Care Setting (Primary and Secondary Care) | Prospective | All: n = 668 (67.4%). 66.1 ± 12.3 years. High Performance. > 370 m: n = 87. NS. Middle Performance. 311-370 m: n = 84. NS. Low Performance. 231-310 m: n = 87. NS. Very Low Performance. 75-230 m: n = 128. NS. | HFrEF LVEF < 40% |
Curtis et al. [51], 2004. | United States and Canada | Clinical Care Setting (39 Secondary Care Centres) | Prospective | High Performance. > 400 m: n = 131 (91.6%). 60.0 ± 11.0 years. Middle Performance. 301-400 m: n = 210 (76.7%). 63.4 ± 10.8 years. Low Performance. 201-300 m: n = 118 (61.9%). 66.8 ± 10.4 years. Very Low Performance. ≤ 200 m: n = 82 (54.9%). 70.9 ± 12.8 years | HFrEF and HFpEF LVEF < 45% (HFrEF) LVEF > 45% (HFpEF) |
Ingle et al. [52], 2014. | United Kingdom | Not Reported | Prospective | All: n = 1667 (75%). 72 (65–77) years. High Performance. > 360 m: n = NS. 64.9 ± 10.6 years. Middle Performance. 241-360 m: n = NS. 71.3 ± 8.8 years. Low Performance. 46-240 m: n = NS. 72.9 ± 9.6 years. Very Low Performance. ≤ 45 m: n = NS. 72.4 ± 10.6 years. | HFrEF LVEF < 45% |
Alahdab et al. [53], 2009. | USA | Clinical Care Setting (Tertiary Care Hospital) | Prospective | High Performance. > 200 m: n = 103 (75.7%). 50.4 ± 12.2 years. Low Performance. ≤ 200 m: n = 95 (49.5%). 59.4 ± 12.2 years. | Acute Decompensated HFrEF and HFpEF LVEF ≤ 40% (HFrEF) LVEF > 40% (HFpEF) |
Mangla et al. [54], 2013. | USA | Clinical Care Setting (Secondary Care) | Prospective | All: n = 900 (53%). 63.6 years. High Performance. > 189 m. NS. Low Performance. ≤ 189 m. NS. | HFpEF and HFrEF LVEF ≤ 40% (HFrEF) LVEF > 40% (HFpEF) |
Hasin et al. [55], 2012. | USA | Clinical Care Setting (Secondary Care) | Retrospective | High Performance. ≥ 300 m: n = 45 (87%). 65 (53–69) years. Low Performance. < 300 m: n = 20 (75%). 68 (59–74) years. | HFrEF LVEF < 40% (20–31%) |
Passantino et al. [56], 2006. | Italy | Clinical Care Setting (Secondary Care) | Prospective | All: n: 476 (79%). 63.6 ± 11.9 years. High Performance. ≥ 300 m: n = 301. NS. Low Performance. < 300 m: n = 175. NS. | HFrEF LVEF < 40% (29.8 ± 9.7) |
Howie-Esquivel et al. [57], 2008. | USA | An Academic Medical Centre | Prospective | High Performance. > 200 m: n = 21 (73.3%). 61.7 ± 17.3 years. Low Performance. ≤ 200 m: n = 23 (26.7%). 57.6 ± 20.0 years. | Descompensated HFpEF and HFrEF LVEF < 40% (HFrEF) LVEF ≥ 40% (HFpEF) |
Zotter-Tufaro et al. [58], 2015. | Austria | Not Reported | Prospective | High Performance. > 300 m: n = 72 (31.95%). 67.8 ± 9.1 years. Low Performance. ≤ 300 m: n = 70 (28.6%). 73.1 ± 7.4 years. | HFpEF LVEF ≥ 50% |
Boxer et al. [59], 2010. | USA | University of Connecticut Health Centre | Prospective | All: n = 60 (71.66%). 78 ± 12.0 years. High Performance. > 300 m. NS. Low Performance. ≤ 300 m. NS. | HFrEF LVEF ≤ 40% |
Ingle et al. [60], 2014 | United Kingdom | Not Reported | Prospective | All: n = 600 (75%). 77.8 (71.5–83.6) years. High Performance. > 365 m. n = NS. Middle Performance. 271–365 m. n = NS. Low Performance. 61–270 m. n = NS. Very Low Performance. < 60 m. n = NS. | HFrEF LVEF < 45% |
Guazzi et al. [61], 2009. | Italy | Clinical Care Setting (Secondary Care) | Prospective | All: n = 253 (78.66%). 61.9 ± 10.1 years. High Performance. > 300 m. n = 175. NS. Low Performance. ≤ 300 m. n = 78. NS | HFpEF and HFrEF LVEF < 50% (HFrEF) LVEF ≥ 50% (HFpEF) |
McCabe et al. [62], 2017. | USA | An University Hospital | Prospective | All: n = 71 (57.7%). 52.6 ± 12.3 years. High Performance. > 300 m. NS. Low Performance. ≤ 300 m. NS. | HFpEF and HFrEF LVEF = 24.4 ± 13.5 |
Vegh et al. [63], 2014. | USA | Clinical Care Setting (Secondary Care) | Prospective | All: n = 164 (77%). 67.3 ± 12.9 years. High Performance. ≥ 350 m. NS. Middle Performance. 280-350 m. NS. Low Performance. < 280 m. NS. | HFrEF LVEF = 25% ± 7%. |
Roul et al. [64], 1998. | France | Not Reported | Prospective | All: n = 121 (81.8%). 59 ± 11 years. High Performance. > 300 m. NS. Low Performance. ≤ 300 m. NS. | HFrEF LVEF = 29.6% ± 13% |
Frankenstein et al. [65], 2008. | Germany | Specialised HF clinic at the University of Heidelberg | Prospective | All: n = 1035 (80.2%) 54.9 ± 11.5 years. Mean 6MWT: 459 m ± 113 m | HFrEF LVEF ≤ 40% |
Mene-Afejuku et al. [66], 2017. | Nigeria | Not Reported | Prospective | All: n = 100 (NS). 64.02 ± 12.88 years. High Performance. 314.66 m ± 48.17 m. n = 59 (NS). 66.32 ± 12.29 years. Low Performance. 260.59 m ± 66.65 m. n = 41 (NS). 61.71 ± 13.46 years. | HHF (HFrEF and HFpEF) LVEF ≤ 40% (HFrEF) LVEF > 40% (HFpEF) |
Ingle et al. [67], 2007 | United Kingdom | Not Reported | Prospective | All: n = 1592 (60%). 74 (67–80) years. High Performance. ≥ 421 m. NS. Middle Performance. 346–420 m. NS. Low Performance. 241–345 m. NS. Very Low Performance. ≥ 240 m. NS. | HFrEF LVEF ≤ 45% |
Rostagno et al. [68], 2003. | Italy | Clinical Care Setting (Secondary Care) | Prospective | All: n = 214 (93%). 53.7 (29–70) years. High Performance. ≥ 450 m. NS. Middle Performance. 300–450 m. NS. Low Performance. < 300 m. NS. | Congestive HFpEF and HFrEF LVEF < 50% (HFrEF) LVEF ≥ 50% (HFpEF) |
Cahalin et al. [69], 1996. | USA | Clinical Care Setting (Secondary Care) | Prospective | All: n = 45 (89%). 49 ± 8 years. High Performance. ≥ 300 m. NS. Low Performance. < 300 m. NS. | HFrEF LVEF = 20 ± 6 |
Frankenstein et al. [70], 2008. | Germany | Specialised HF clinic at the University of Heidelberg | Prospective | All: n = 1069 (80.6%) 55.2 ± 11.7 years. Mean 6MWT: 456 m ± 114 m | HFrEF LVEF = 29% ± 10% |
Rubim et al. [71], 2006. | Brazil | Clinical Care Setting (Secondary Care) | Prospective | All: n = 176 (67%). 58.32 ± 12.7 years. Mean 6MWT: 521.11 m ± 76.1 m. High Performance. ≥ 520 m. NS. Low Performance. < 520 m. NS. | HFpEF and HFrEF LVEF = 34.91% ± 12.4% |
Kanagala et al. [72], 2019. | United Kingdom | Clinical Care Setting (Tertiary Care Hospital) | Prospective | All: n = 140 (49%). 73 ± 9.0 years. Mean 6MWT: 180 m (120 m–250 m) | HFpEF and HFrEF LVEF > 50% |
Zugck et al. [73], 2001. | Germany | Medical Clinic of the University of Heidelberg | Prospective | All: n = 208 (82%). 54 ± 10 years. Mean 6MWT: 455 m ± 107 m (170 m–692 m) | HFrEF LVEF ≤ 40% |
Cahalin et al. [74], 2013. | Italy | Clinical Care Setting (Secondary Care) | Prospective | All: n = 258 (NS). 63 ± 8.7 years. High Performance. > 300 m. NS. Low Performance. ≤ 300 m. NS. | HFpEF and HFrEF LVEF < 50% (HFrEF) LVEF ≥5 0% (HFpEF) |
Reibis et al. [75], 2010. | Germany | Clinical Care Setting (Secondary Care) | Prospective | All: n = 1346 (73%). 64 ± 10 years. Mean 6MWT: 350.1 m ± 148.6 m | HFrEF LVEF < 45% |
Castel et al. [76], 2009. | Spain | Not Reported | Retrospective | All: n = 155 (82%). 68.6 ± 7.8 years. High Performance. > 400 m. NS. Middle Performance. 310-400 m. NS. Low Performance. 225-310 m. NS. Very Low Performance. < 225 m. NS. | HFrEF LVEF ≤ 45% |
Kamiya et al. [77], 2017. | Japan | Clinical Care Setting (Secondary Care Centre) | Retrospective | All: n = 1474 (68%). 72.2 ± 7.1 years. High Performance. ≥ 446 m: n = 485 (84%). 68.5 ± 5.6 years. Middle Performance. 342-445 m: n = 497 (69%). 71.5 ± 6.3 years. Low Performance. ≤ 341 m: n = 492 (52%). 76.5 ± 7.0 years. | HFpEF and HFrEF LVEF = 52.7 ± 15.4 |
Short Physical Performance Battery (SPPB) | |||||
García et al. [78], 2019. | Spain | Clinical Care Setting (Secondary Care) | Prospective | High Performance. SPPB > 7: n = 37 (54.1%). 83 ± 5.7 years. Low Performance. SPPB≤ 7: n = 49 (30.6%). 86 ± 6.7 years. | Acute HF |
Hornsby et al. [79], 2019. | USA | University of Michigan | Prospective | High Performance. SPPB≥ 10 points: n = 22 (55%). 64 ± 13.0 years. Middle Performance. SPPB = 7–9 points: n = 53 (42%). 67 ± 12.0 years. Low Performance. SPPB≤ 6 points: n = 39 (36%). 72 ± 13.0 years. | HFpEF HF LVEF ≥ 50% |
Chiarantini et al. [80], 2010. | Italy | Clinical Care Setting (Secondary Care) | Prospective | All: n = 157 (50.3%). 80 ± 0.5 years. High Performance. SPPB = 9–12: n = 32. NS. Middle Performance. SPPB = 5–8: n = 45. NS. Low Performance. SPPB = 1–4: n = 33. NS. Very Low Performance. SPPB = 0: n = 47. NS. | Descompensated HFrEF and HFpEF LVEF < 45% (HFrEF) LVEF ≥ 45% (HFpEF) |
Zaharias et al. [81], 2014. | USA | Clinical Care Setting (Secondary Care) | Prospective | All: n = 32 (78.1%). 58.2 ± 13.6 years. High Performance. SPPB = 10–12: n = 7. NS. Middle Performance. SPPB = 7–9: n = 8. NS. Low Performance. SPPB = 4–6: n = 12. NS. Very Low Performance. SPPB = 0–3: n = 4. NS. | HFrEF and HFpEF LVEF < 40% (HFrEF) LVEF ≥ 40% (HFpEF) |
Gait Speed (GS) | |||||
Lo et al. [82], 2015. | USA | Community Based Population | Prospective | High Performance. GS ≥ 0.8 m/s: n = 553 (59%). 73 ± 5.0 years. Low Performance. GS < 0.8 m/s: n = 566 (39%). 76 ± 6.0 years. | HFpEF and HFrEF LVEF < 45% (HFrEF) LVEF ≥ 45% (HFpEF) |
Pulignano et al. [83], 2016. | Italy | Clinical Care Setting (7 Secondary Care Centres) | Prospective | High Performance. GS ≥ 1.0 m/s: n = 88 (64.8%). 76.4 ± 4.8 years. Middle Performance. GS = 0.66–0.99 m/s: n = 128 (60.9%). 77.1 ± 4.7 years Low Performance. GS ≤ 0.65 m/s: n = 115 (48.7%). 80.2 ± 5.6 years. | HFpEF and HFrEF LVEF < 45% (HFrEF) LVEF ≥ 45% (HFpEF) |
Chaudhry et al. [84], 2013. | USA | Not Reported | Prospective | All: n = 758 (49.5%). 79.7 ± 6.2 years. High Performance. GS > 0.8 m/s: n = 441. NS. Low Performance. GS ≤ 0.8 m/s: n = 317. NS. | HFpEF and HFrEF LVEF < 45% (HFrEF) LVEF ≥ 45% (HFpEF) |
Tanaka et al. [85], 2018. | Japan | Kitasato University Hospital | Retrospective | All: n = 603 (62.7%). 74.9 ± 6.2 years. High Performance. GS > 1.14 m/s: n = 154. NS. Middle Performance. GS = 1.0–1.14 m/s. n = 149. NS. Low Performance. GS = 0.82–0.99 m/s. n = 150. NS. Very Low Performance. GS < 0.82 m/s: n = 150. NS. | Acute HFpEF and HFrEF LVEF < 40% (HFrEF) LVEF ≥ 40% (HFpEF) |
Tanaka et al. [86], 2019. | Japan | Kitasato University Hospital | Retrospective | High Performance. GS ≥ 0.8 m/s: n = 194 (72.7%). 73.1 ± 6.7 years. Low Performance. GS < 0.8 m/s: n = 194 (44.8%). 76.5 ± 8.4 years. | Acute HFpEF and HFrEF LVEF < 40% (HFrEF) LVEF ≥ 40% (HFpEF) |
Rodríguez-Pascual et al. [87], 2017. | Spain | Clinical Care Setting (6 Secondary Care Centres) | Prospective | High Performance. GS ≥ 0.65 m/s: n = 211 (47.9%). 84.4 ± 9.4 years. Low Performance. GS < 0.65 m/s: n = 286 (32.5%). 85.7 ± 5.1 years. | HFpEF and HFrEF LVEF ≤ 45% (HFrEF) LVEF > 45% (HFpEF) |
Vidán et al. [88], 2016. | Spain | Clinical Care Setting (Secondary Care Centre) | Prospective | All: n = 416 (50.5%). 80.0 ± 6.1 years. High Performance. GS ≥ 0.65 m/s. NS. Low Performance. GS < 0.65 m/s. NS. | HFpEF and HFrEF LVEF < 50% (HFrEF) LVEF ≥ 45% (HFpEF) LVEF = 43.4% ± 14.7% |
Kamiya et al. [77], 2017. | Japan | Clinical Care Setting (Secondary Care Centre) | Retrospective | All: n = 1474 (68%). 72.2 ± 7.1 years. High Performance. GS ≥ 1.17 m/s: n = 489 (82%). 68.7 ± 5.5 years. Middle Performance. GS = 0.95–1.160 m/s: n = 489 (67%). 71.8 ± 6.6 years. Low Performance. GS ≥ 0.94 m/s: n = 496 (55%). 76.1 ± 7.2 years. | HFpEF and HFrEF LVEF = 52.7 ± 15.4 |
Meta-analyses
Study (first author and year) | Functional Test | Follow-Up | Outcomes | Main Results | Risk of Bias | Level of Evidence (GRADE) |
---|---|---|---|---|---|---|
Brenyo et al. [45], 2012. | 6MWT | 4 years | Incident HF and Mortality ≤ 350 m VS > 350 m | HR = 1.73 95%CI [1.29–2.33]*** | Low | Not Reported |
Incident HF and Mortality Per 100-m decreased | HR = 1.25 95%CI [1.09–1.44]*** | |||||
All-Cause Mortality ≤ 350 m VS > 350 m | HR = 2.40 95%CI [1.42–4.08]*** | Moderate | ||||
All-Cause Mortality Per 100-m decreased | HR = 1.32 95%CI [1.05–1.66]** | |||||
Ferreira et al. [46], 2019. | 6MWT | 21 months (9–26 months) | Hospitalisation and Mortality 241-360 m VS > 360 m | HR = 1.44 95%CI [1.14–1.80]** | Moderate | Low |
Hospitalisation and Mortality ≤ 240 m VS > 360 m | HR = 1.73 95%CI [1.38–2.18]*** | |||||
Hospitalisation and Mortality Per each 50 m decreased | HR = 1.08 95%CI [1.04–1.11]*** | |||||
All-Cause Mortality 241-360 m VS > 360 m | HR = 1.49 95%CI [1.08–2.06]** | Moderate | ||||
All-Cause Mortality ≤ 240 m VS > 360 m | HR = 2.41 95%CI [1.76–3.29]*** | |||||
All-Cause Mortality Per each 50 m decreased | HR = 1.14 95%CI [1.09–1.18]*** | |||||
Wegrzynowska-Teodorczyk et al. [47], 2013. | 6MWT | 1 year | HF Mortality ≤ 468 m VS > 468 m | HR = 3.22 95%CI [1.17–8.86]** | Low | Moderate |
Hospitalisation and Mortality ≤ 468 m VS > 468 m | HR = 2.77 95%CI [1.30–5.88]** | Low | ||||
3 years | HF Mortality ≤ 468 m VS > 468 m | HR = 2.18 95%CI [1.18–4.03]** | Moderate | |||
Hospitalisation and Mortality ≤ 468 m VS > 468 m | HR = 1.71 95%CI [1.08–2.72]** | Low | ||||
Bittner et al. [48], 1993. | 6MWT | 1 year (242 ± 82 days) | All-Cause Mortality Per each 120 m decreased | OR = 1.50 95%CI [1.11–2.03]** | Low | Moderate |
HF Hospitalisation Per each 120 m decreased | OR = 2.60 95%CI [1.78–3.80]*** | Low | ||||
Hospitalisation and Mortality Per each 120 m decreased | OR = 1.77 95%CI [1.38–2.26]*** | Low | ||||
All-Cause Mortality < 300 m VS ≥ 450 m | OR = 3.7 95%CI [1.44–9.55]** | Moderate | ||||
All-Cause Mortality 300-375 m VS ≥ 450 m | OR = 2.78 95%CI [1.09–7.11]** | |||||
All-Cause Mortality 375-450 m VS ≥ 450 m | OR = 1.42 95%CI [0.50–4.06]* | |||||
All-Cause Hospitalisation < 300 m VS ≥ 450 m | OR = 14.02 95%CI [4.90–40.14]*** | Low | ||||
All-Cause Hospitalisation 300-375 m VS ≥ 450 m | OR = 6.21 95%CI [2.14–18.08]*** | |||||
All-Cause Hospitalisation 375-450 m VS ≥ 450 m | OR = 1.90 95%CI [0.56–6.42]* | |||||
Arslan et al. [49], 2007. | 6MWT | 2 years (18 ± 6 months) | HF Mortality ≤ 300 m VS > 300 m | HR = 2.38 95%CI [2.02–5.76]** | Moderate | Moderate |
Lee et al. [50], 2006. | 6MWT | 36 ± 12 months | Hospitalisation and Mortality 75-230 m VS > 370 m. | OR = 3.5 95%CI [1.1–11.7]** | Low | Low |
Hospitalisation and Mortality 231-310 m VS > 370 m | OR = 3.4 95%CI [1.01–11.5]** | |||||
Hospitalisation and Mortality 311-370 m VS > 370 m | OR = 4.9 95%CI [1.5–16.0]** | |||||
Curtis et al. [51], 2004. | 6MWT | 32 months | All-Cause Mortality ≤ 200 m VS > 400 m | HR = 1.59 95%CI [0.88–2.86]* | Low | Moderate |
All-Cause Mortality 201-300 m VS > 400 m | HR = 1.01 95%CI [0.57–1.79]* | |||||
All-Cause Mortality 301-400 m VS > 400 m | HR = 1.16 95%CI [0.72–1.88]* | |||||
HF Mortality ≤ 200 m VS > 400 m | HR = 2.62 95%CI [1.02–6.74]** | Moderate | ||||
HF Mortality 201-300 m VS > 400 m | HR = 0.93 95%CI [0.34–2.55]* | |||||
HF Mortality 301-400 m VS > 400 m | HR = 0.86 95%CI [0.35–2.09]* | |||||
All-Cause Hospitalisation ≤ 200 m VS > 400 m | HR = 1.76 95%CI [1.19–2.60]** | Low | ||||
All-Cause Hospitalisation 201-300 m VS > 400 m | HR = 1.41 95%CI [1.01–1.99]** | |||||
All-Cause Hospitalisation 301-400 m VS > 400 m | HR = 1.09 95%CI [0.80–1.47]* | |||||
HF Hospitalisation ≤ 200 m VS > 400 m | HR = 1.84 95%CI [0.97–3.49]* | Low | ||||
HF Hospitalisation 201-300 m VS > 400 m | HR = 1.84 95%CI [1.04–3.29]** | |||||
HF Hospitalisation 301-400 m VS > 400 m | HR = 1.45 95%CI [0.85–2.45]* | |||||
Ingle et al. [52], 2014. | 6MWT | 5 years | All-Cause Mortality Per each 10 m increased. | HR = 0.980 95%CI [0.974–0.985]*** | Low | Moderate |
Alahdab et al. [53], 2009. | 6MWT | 40 months-Mortality | All-Cause Mortality ≤ 200 m VS > 200 m | HR = 2.14 95%CI [1.20–3.81]** | Low | Moderate |
40 months-Mortality | All-Cause Mortality Per each 1 m increased | HR = 0.998 95%CI [0.995–0.999]** | ||||
18 months-Hospitali- zation | HF Hospitalisation ≤ 200 m VS > 200 m | HR = 1.62 95%CI [1.10–2.39]** | Low | |||
Mangla et al. [54], 2013. | 6MWT | 1080 days | Hospitalisation and Mortality ≤ 189 m VS > 189 m in HFpEF. | OR = 2.81 95%CI [1.24–6.40]** | Low | Low |
Hospitalisation and Mortality ≤ 189 m VS > 189 m in HFrEF. | OR = 1.94 95%CI [1.30–2.90]** | |||||
Hasin et al. [55], 2012. | 6MWT | Median 592 days (115–1453 days) | All-Cause Mortality Per 10 m walked short of 300 m | HR = 1.211 95% CI [1.108–1.322]*** | Moderate | Moderate |
Passantino et al. [56], 2006. | 6MWT | 23.9 months | All-Cause Mortality < 300 m VS ≥ 300 m | HR = 2.66 95%CI [1.60–4.42]*** | Low | Moderate |
All-Cause Mortality Per each 70 m decreased | HR = 2.03 95%CI [1.29–3.18]** | |||||
Howie-Esquivel et al. [57], 2008. | 6MWT | 90 days | HF Hospitalisation > 200 m | HR = 0.99 95%CI [0.99–1.00]* | High | Low |
Zotter-Tufaro et al. [58], 2015. | 6MWT | 14.0 ± 10.0 months | Hospitalisation and Mortality > 300 m VS ≤ 300 m | HR = 0.992 95%CI [0.990–0.995]*** | Moderate | Low |
Boxer et al. [59], 2010. | 6MWT | 4 years | All-Cause Mortality Per each 30 m increased | HR = 0.84 95%CI [0.74–0.94]** | Moderate | Moderate |
Ingle et al. [60], 2014. | 6MWT | 8 years | All-Cause Mortality Per each 10 m increased | HR = 0.988 95%CI [0.981–0.995]*** | Low | Moderate |
Guazzi et al. [61], 2009. | 6MWT | 20.4 ± 16.6 months. | Cardiac Mortality Per each 1 m increased | HR = 0.998 95%CI [0.995–1.001]* | Low | Moderate |
McCabe et al. [62], 2017. | 6MWT | 30 days | HF Hospitalisation Per each 30 m increased | OR = 0.84 95% CI [0.71–0.99]** | Moderate | Low |
Vegh et al. [63], 2014. | 6MWT | 3 years | HF Hospitalisation ≥ 350 m VS < 280 m | HR = 0.61 95% CI [0.44–0.85]** | Moderate | Low |
Hospitalisation and Mortality ≥ 350 m VS < 280 m | HR = 0.58 95% CI [0.43–0.80]*** | Low | ||||
HF Hospitalisation ≥ 402 m VS < 256 m | HR = 0.60 95% CI [0.44–0.82]*** | Low | ||||
Hospitalisation and Mortality ≥ 402 m VS < 256 m | HR = 0.55 95% CI [0.43–0.75]*** | Low | ||||
Roul et al. [64], 1998. | 6MWT | 1000 days | Hospitalisation and Mortality ≤ 300 m VS > 300 m | Log rank = 6.16 ** | Moderate | Low |
Frankenstein et al. [65], 2008. | 6MWT | 52.9 ± 36.2 months | All-Cause Mortality Per each 1 m increased | HR = 0.996 95% CI [0.995–0.997]*** | Low | Moderate |
Mene-Afejuku et al. [66], 2017. | 6MWT | 6 months | Hospitalisation and Mortality 314.66 m ± 48.17 m VS 260.59 m ± 66.65 m | OR = 0.819 95% CI [0.206–3.257]* | Moderate | Low |
Ingle et al. [67], 2007. | 6MWT | 36.6 months (28.2–45.0 months) | All-Cause Mortality Per each 1 m increased | HR = 0.998 95% CI [0.996–1.000]* | Low | Moderate |
Rostagno et al. [68], 2003. | 6MWT | 34 months | All-Cause Mortality Per each 1 m increased | HR = 0.995 95% CI [0.993–0.997]*** | Low | Moderate |
Cahalin et al. [69], 1996. | 6MWT | 62 ± 45 weeks (1–183 weeks) | Hospitalisation and Mortality < 300 m VS ≥ 300 m | X2 = 40% vs 12% ** | Moderate | Low |
Frankenstein et al. [70], 2008. | 6MWT | 42 months (22–80 months) | All-Cause Mortality Per each 1 m increased | HR = 0.996 95% CI [0.995–0.997]** | Moderate | Moderate |
Rubim et al. [71], 2006. | 6MWT | 18 months (12–24 months) | All-Cause Mortality ≥ 520 m VS < 520 m | OR = −0.0081 95% CI [0.0029–0.0133]*** | Low | Moderate |
Kanagala et al. [72], 2019. | 6MWT | 1429 days (1157–1657 days) | Hospitalisation and Mortality Per each 1 m increased | HR = 0.659 95% CI [0.465–0.934]** | Low | Low |
Zugck et al. [73], 2001. | 6MWT | 28.3 ± 14.1 months | All-Cause Mortality Per each 1 m increased | HR = 0.99 95% CI [0.98–0.99]** | Moderate | Moderate |
Cahalin et al. [74], 2013. | 6MWT | 22.8 ± 22.1 months | Cardiac Mortality Per each 1 m increased | HR = 0.99 95% CI [0.99–0.99]** | Low | Moderate |
Cardiac Mortality > 300 m VS ≤ 300 m | HR = 0.18 95% CI [0.04–0.89]** | |||||
Reibis et al. [75], 2010. | 6MWT | 731 ± 215 days | All-Cause Mortality Per each 50 m increasd | HR = 0.93 95% CI [0.86–1.00]** | Low | Moderate |
Castel et al. [76], 2009. | 6MWT | 24.4 ± 18.1 months | Cardiac Mortality < 225 m VS > 400 m | HR = 5.60 95% CI [1.23–25.30]** | Low | Moderate |
Cardiac Mortality 225-310 m VS > 400 m | HR = 1.28 95% CI [0.23–7.08]* | |||||
Cardiac Mortality 310-400 m VS > 400 m | HR = 4.10 95% CI [0.79–21.52]* | |||||
Kamiya et al. [77], 2017. | 6MWT | 2.3 ± 1.9 years | All-Cause Mortality Per each 10 m increased | HR = 0.96 95% CI [0.94–0.97]*** | Low | Moderate |
García et al. [78], 2019. | SPPB | 1 year | HF Hospitalisation SPPB ≤ 7 VS SPPB > 7 | OR = 6.7 95%CI [1.5–30.4]** | Moderate | Not Reported |
All-Cause Mortality SPPB ≤ 7 VS SPPB > 7 | OR = 1.2 95%CI [0.3–5.4]* | Very Low | ||||
Hospitalisation and Mortality SPPB ≤ 7 VS SPPB > 7 | OR = 3.6 95%CI [1.0–12.9]** | Very Low | ||||
Hornsby et al. [79], 2019. | SPPB | 6 months | Hospitalisation and Mortality Per 1-unit change in SPPB | OR = 0.81 95%CI [0.69–0.94]** | Moderate | Very Low |
Number of All-Cause Hospitalisations Per 1-unit change in SPPB | IRR = 0.92 95%CI [0.86–0.97]** | Not Reported | ||||
Days Hospitalized or Dead Per 1-unit change in SPPB | IRR = 0.85 95%CI [0.73–0.99]** | Not Reported | ||||
Chiarantini et al. [80], 2010. | SPPB | 30 months (median 444 days) | All-Cause Mortality SPPB 0 VS SPPB 9–12 | HR = 6.06 95%CI [2.19–16.76]*** | Moderate | Very Low |
All-Cause Mortality SPPB 1–4 VS SPPB 9–12 | HR = 4.78 95%CI [1.63–14.02]** | |||||
All-Cause Mortality SPPB 5–8 VS SPPB 9–12 | HR = 1.95 95%CI [0.67–5.70]* | |||||
Zaharias et al. [81], 2014. | SPPB | 3 months | Hospitalisation and Mortality Per each 1 point decreased | HR = 1.042 95%CI [0.89–1.23]* | Moderate | Very Low |
Lo et al. [82], 2015. | Gait Speed | 10 years | All-Cause Mortality < 0.8 m/s VS ≥ 0.8 m/s | HR = 1.37 95%CI [1.10–1.70]** | Low | Low |
Pulignano et al. [83], 2016. | Gait Speed | 1 year | All-Cause Mortality Gait speed (tertiles) | HR = 0.620 95%CI [0.434–0.884]** | Low | Low |
HF Hospitalisation Gait speed (tertiles) | OR = 0.697 95%CI [0.547–0.899]** | Low | ||||
All-Cause Hospitalisation Gait speed (tertiles) | HR = 0.741 95%CI [0.613–0.895]** | Low | ||||
Chaudhry et al. [84], 2013. | Gait Speed | 20 years | All-Cause Hospitalisation ≤ 0.8 m/s VS > 0.8 m/s | HR = 1.28 95%CI [1.06–1.55]** | Low | Low |
Hospitalisation and Mortality ≤ 0.8 m/s VS > 0.8 m/s | HR = 1.31 95%CI [1.08–1.58]** | Low | ||||
Tanaka et al. [85], 2018. | Gait Speed | 1.7 ± 0.5 years | All-Cause Mortality 1.0–1.14 m/s VS > 1.14 m/s | HR = 0.80 95%CI [0.37–1.74]* | Moderate | Low |
All-Cause Mortality 0.82–0.99 m/s VS > 1.14 m/s | HR = 1.46 95%CI [0.75–2.83]* | |||||
All-Cause Mortality < 0.82 m/s VS > 1.14 m/s | HR = 2.65 95%CI [1.35–5.20]** | |||||
Tanaka et al. [86], 2019. | Gait Speed | 2.1 ± 1.9 years | All-Cause Mortality Per each 0.1 m/s increased | HR = 0.83 95% CI [0.73–0.95]** | Low | Low |
HF Hospitalisation Per each 0.1 m/s increased | HR = 0.91 95% CI [0.83–0.99]** | Low | ||||
Hospitalisation and Mortality Per each 0.1 m/s increased | HR = 0.90 95% CI [0.83–0.97]** | Low | ||||
Rodríguez-Pascual et al. [87], 2017. | Gait Speed | 1 year | All-Cause Mortality GS < 0.65 m/s VS GS ≥ 0.65 m/s | HR = 1.86 95% CI [0.95–3.65]* | Low | Low |
All-Cause Hospitalisation GS < 0.65 m/s VS GS ≥ 0.65 m/s | HR = 1.57 95% CI [0.98–2.52]* | Low | ||||
Vidán et al. [88], 2016. | Gait Speed | 1 year | All-Cause Mortality GS < 0.65 m/s VS GS ≥ 0.65 m/s | HR = 1.48 95% CI [0.95–2.32]* | Low | Low |
All-Cause Hospitalisation GS < 0.65 m/s VS GS ≥ 0.65 m/s | OR = 1.67 95% CI [0.98–2.85]* | Low | ||||
Kamiya et al. [77], 2017. | Gait Speed | 2.3 ± 1.9 years | All-Cause Mortality Per each 0.1 m/s increased | HR = 0.87 95% CI [0.81–0.93]*** | Low | Low |
Sensitivity analyses
Descriptive quantitative analysis
Physical functional performance and mortality
Physical functional performance and the combined endpoint of hospitalisation and mortality
Physical functional performance and hospitalisation
Risk of Bias assessment
Summary of findings | Quality of evidence assessment (GRADE) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Outcomes | N° studies | N° participants | Designa | Risk of Biasb | Inconsistencyc | Indirectness d | Imprecisione | Other f | Level of Evidence | Importance |
Six Minutes Walking Test (6-MWT) | ||||||||||
All-Cause Mortality | 18 | 15,033 | Observational | NO | Consistency (+ 1) | NO | NO | NO | Moderate | Critical |
All-Cause Hospitalisation | 2 | 1374 | Observational | NO | Not Serious | NO | NO | NO | Low | Critical |
HF Mortality | 6 | 1493 | Observational | NO | Consistency (+ 1) | NO | NO | NO | Moderate | Critical |
HF Hospitalisation | 6 | 1851 | Observational | Not Serious | Not Serious | NO | Not Serious | NO | Low | Critical |
Hospitalisation and Mortality | 11 | 4788 | Observational | Serious (−1) | Consistency (+ 1) | Not Serious | NO | NO | Low | Critical |
Short Physical Performance Battery (SPPB) | ||||||||||
All-Cause Mortality | 2 | 243 | Observational | Very Serious (−2) | Serious (−1) | Not Serious | Serious (−1) | NO | Very Low | Critical |
Hospitalisation and Mortality | 3 | 231 | Observational | Serious (−1) | Not Serious | Not Serious | Not Serious | NO | Very Low | Critical |
Gait Speed | ||||||||||
All-Cause Mortality | 7 | 4828 | Observational | NO | Not Serious | NO | Not Serious | NO | Low | Critical |
All-Cause Hospitalisation | 4 | 2002 | Observational | NO | Not Serious | NO | Not Serious | NO | Low | Critical |
HF Hospitalisation | 2 | 719 | Observational | NO | Not Serious | NO | Not Serious | NO | Low | Critical |
Hospitalisation and Mortality | 2 | 1146 | Observational | NO | Not Serious | NO | Not Serious | NO | Low | Critical |