Limited evidence to strong evidence was found for reliability in various chronic conditions .
Little evidence was available for responsiveness and measurement error .
Studies showed large variability in test procedures despite existing guidelines for the performance of the 6MWT .
Evidence for measurement properties of the 6MWT  varies largely among chronic pediatric conditions .
BACKGROUND The Six-Minute Walk Test ( 6MWT ) is increasingly being used as a functional outcome measure for chronic pediatric conditions .
Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use .
PURPOSE The purpose of this study was to systematic ally review all published clinimetric studies on the 6MWT in chronic pediatric conditions .
Reproducibility of Maximal and Submaximal Exercise Testing in “Normal Ambulatory” and “Community Ambulatory” Children and Adolescents With Spina Bifida: Which Is Best for the Evaluation and Application of Exercise Training?
Background With emerging interest in exercise and lifestyle interventions for children and adolescents with spina bifida , there is a need for appropriate measurements in exercise testing . Objective The purpose of this study was to assess both reliability and agreement of maximal and submaximal exercise measures in “ normal ambulatory ” and “ community ambulatory ” children and adolescents with spina bifida . Design This was a reproducibility study . Methods Twenty-three children and adolescents with spina bifida ( 10 normal ambulatory and 13 community ambulatory ) participated in the study . Maximal exercise outcomes were measured using a grade d treadmill test .  Peak measures ( peak oxygen uptake [ V̇o2peak ] , peak heart rate [ HRpeak ] , heart rate response [ HRR ] , and oxygen pulse ) were recorded . For submaximal measures , heart rate ( HR ) and oxygen uptake ( V̇o2 ) at the ventilatory threshold and oxygen uptake efficiency slope ( OUES ) were derived from the maximal measures . Functional performance was measured as the 6-minute walking distance and the maximal speed during the treadmill test . After checking for normality and heteroscedasticity , paired t tests , intraclass correlation coefficients ( ICCs ) , and the smallest detectable difference ( SDD ) or the coefficient of variation ( CV ) were calculated . Results Performance measures showed good reliability and agreement . For maximal measures , acceptable ICCs were found for all measures . For submaximal measures , only HR at the ventilatory threshold showed an ICC of less than .80 . Agreement showed a CV of less than 10 % for all measures , except for V̇o2 at the ventilatory threshold , HRR , and OUES . Limitations Limitations of the study include missing data due to equipment failure . Furthermore , the outcomes were limited to normal ambulatory and community ambulatory children and adolescents with spina bifida . Conclusions Both maximal and submaximal measures of exercise testing can be used for discriminative purpose s in ambulatory children and adolescents with spina bifida . For evaluative purpose s , HR measures are superior to V̇o2 measures , while taking into account the individual variation of 5 % to 8 % . The SDD was 0.5 km/h for peak speed and 36.3 m for 6-minute walking distance . Heart rate response , oxygen pulse , and OUES are not recommended in the evaluation of exercise testing in this population
Limited evidence to strong evidence was found for reliability in various chronic conditions .
Little evidence was available for responsiveness and measurement error .
Studies showed large variability in test procedures despite existing guidelines for the performance of the 6MWT .
Evidence for measurement properties of the 6MWT  varies largely among chronic pediatric conditions .
BACKGROUND The Six-Minute Walk Test ( 6MWT ) is increasingly being used as a functional outcome measure for chronic pediatric conditions .
Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use .
PURPOSE The purpose of this study was to systematic ally review all published clinimetric studies on the 6MWT in chronic pediatric conditions .