The Six-Minute Walk Test (6MWT)

6mwt - six minute walk testThe six-minute walk test (6MWT) was originally used for evaluating exercise tolerance in people with chronic lung disease and heart failure. The test has since been used as a one-time measurement of functional status in a variety of patients, to provide information about a patient’s ability to perform activities of daily living and to evaluate the response of exercise on certain bodily systems, including the heart, lungs, blood and circulation.

What Does the Six-Minute Walk Test Measure?

The 6MWT measures the distance you can walk over a total of six minutes on a hard, flat surface. The main goal of the test is to walk as quickly as you can and as far as possible in six minutes along a marked walkway. During the test, you’ll be encouraged to walk at your own pace and rest as needed.

How to Prepare for the Test

On the day of the test, you should:

  • Dress in comfortable clothing.
  • Wear appropriate shoes.
  • Avoid eating for at least 2 hours before the test (if possible and appropriate).
  • Take any prescribed bronchodilator medication within one hour of the test or when you arrive at the testing facility.
  • Rest for at least 15 minutes before starting the test.

Before the Test

A technician will record your blood pressure, heart rate, oxygen saturation and your dyspnea (shortness of breath) score before the test begins and immediately following completion of the test. To measure your level of dyspnea, the Borg Scale will be used that ranges from 0 (no dyspnea at all) to 10 (very, very severe dyspnea). Your technician will show you the scale and give you instructions on how to use it to obtain a score. Once your vital signs are recorded, the technician will give you instructions on how to complete the test.

During the Test

If you normally use walking aids to ambulate, such as a cane or walker, you’ll want to use them during the test. Once you begin, you’ll be permitted to slow down or stop and rest when needed. When resting, you can lean on the wall but should remain standing. Also keep in mind if you stop to rest, the timer will continue, so you should start walking again as soon as possible. Your technician will be monitoring you throughout the test, and will periodically report how many minutes have elapsed. Should you have any concerns, both before and after your test, you should immediately advise the technician.

Reasons for Stopping the Test

Your technician should stop the test, if, at any time during the test, you experience:

  • Chest pain
  • Intolerable dyspnea
  • Leg cramps or extreme muscle fatigue
  • Evolving mental confusion, lightheadedness or lack of coordination
  • Persistent oxygen saturation of less than 85%
  • Any other clinically warranted reason

Test Results

The 6MWT should be performed twice – once before and once after the implementation of an exercise training program to determine if the program has been effective.  One of the goals of an exercise program is for the patient to be able to walk further during the second test than he or she did on the first test.

The 6MWT, in healthy adults, has been reported to be in the range of 400 meters (1,312 feet) to 700 meters (2,297 feet). Reference standards based on age and sex are available for interpreting 6MWT scores for both healthy adults and people with chronic illnesses. A meaningful improvement between the first and second test is thought to be 54 meters (177 feet) based on studies of people with chronic lung disease but this number varies depending upon which study you read.

For more information about the six-minute walk test, talk to your primary care provider.

 

Source:
American Thoracic Society. ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med. Vol 166. pp 111–117, 2002. DOI: 10.1164/rccm.166/1/111.

By Deborah Leader RN, BSN, PHN

 

 

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