The Six Minute Walk Test

The six-minute walk test (6MWT) is a practical simple test that measures the distance a patient can quickly walk on a flat, hard surface in a period of 6 minutes. It is used to gather information on a patient’s functional capacity and is an excellent tool for ongoing monitoring of patients. Most patients do not achieve maximal exercise capacity during the 6MWT; instead, they choose their own intensity of exercise and are allowed to stop and rest during the test if they need to.

Pre-test Considerations

• Testing should be performed in a location where a rapid, appropriate response to an emergency is possible.
• The health care professional supervising the test should be certified in cardiopulmonary resuscitation with a minimum of Basic Life Support.
• Physicians are not required to be present during all tests.
• If a patient is on chronic oxygen therapy, oxygen should be given at their standard rate or as directed by a physician or a protocol.
• To ensure comfort your patient should be wearing comfortable clothing, appropriate shoes and should use any walking aids as they normally would.
• Use of walking aids are permitted during the 6MWT.
• Any medication should be continued as per usual and it is permitted for your patient to have had a light meal before the 6MWT, especially if the test is conducted in the early morning or early afternoon.
• Vigorous intensity exercise should be discouraged within 2 hours of beginning the test.

Contraindications

Absolute contraindications include:

• Unstable angina during the previous month
• Myocardial infarction during the previous month

Relative contraindications include:

• Resting heart rate of more than 120
• Systolic blood pressure of more than 180 mm Hg
• Diastolic blood pressure of more than 100 mm Hg

Recommended Equipment

The test requires a long hallway but no exercise equipment or advanced training for technicians. The following pieces of equipment are recommended to conduct the test:

• A countdown timer (or stopwatch)
• A mechanical lap counter or alternative means of keeping track of distance walked
• A minimum of two small cones to mark the turnaround points
• A chair that can be easily moved along the walking course
• Worksheets on a clipboard to keep notes (for example on whether the patient requires a break during the test)
• A source of oxygen
• A sphygmomanometer
• A telephone
• An automated electronic defibrillator

Interpreting the Results

To interpret the results of the test you can compare the distance achieved by your patient to normative data that has been published in the literature (see Table 1 in Rasekaba et al, 2009). Re-assessing your patient and comparing results over time can be very useful to track progress.

The six minute walk test can be very useful to to gather information on a patient’s functional capacity, but it also has limitations.

• Can you think of any limitations of the 6 minute walk test?
• Would there be any situations that the test would not be suitable?
• Could the test give results that does not reflect a patients’ status?