Six Minute Walk Test
Six Minute Walk Test
Standardisation of the six-minute walk test (6MWT) is very important.
At the commencement of PR, the 6MWT must be performed twice to account for a learning effect. Please note that:
The best distance walked in metres is recorded.
If the two tests are performed on the same day, at least 30 minutes rest should be allowed between tests. Debilitated patients may require tests to be performed on separate days, preferably less than one week apart.
The walking track should be the same layout for all tests for a patient:
- The track may be a continuous track (oval or rectangular) or a point-to-point (stop, turn around, go) track.
- The track should be flat, with minimal blind turns or obstacles.
- The minimum recommended length for a centre-based walking track is 25m and could be marked in metre increments.
A comfortable ambient temperature and humidity should be maintained for all tests.
6MWT Equipment
The equipment needed to conduct the 6MWT is outlined below:
- At least one chair, positioned at one end of the walking course
- A dyspnoea scale and a fatigue scale
- Sphygmomanometer for blood pressure measurement
- Pulse oximeter (Forehead probes are recommended for patients with Pulmonary Hypertension)
- Stopwatch
- Pre-measured marks each meter along the track/corridor
- Access to oxygen and telephone in case of an emergency
- An emergency plan
- Portable supplemental oxygen if required by patient to perform exercise test
- Clipboard with reporting sheet and pen
Before the Test
- The oximeter is to be attached to the patient so it is ready to be checked throughout the test without interfering with walking pace.
- Describe the walking track to the patient and then give the patient the following instructions6:
- The aim of this test is to walk as far as possible for 6 minutes. You will walk along this hallway between the markers, as many times as you can in 6 minutes.
- I will let you know as each minute goes past, and then at 6 minutes I will ask you to stop where you are.
- 6 minutes is a long time to walk, so you will be exerting yourself. You are permitted to slow down, to stop, and to rest as necessary, but please resume walking as soon as you are able.
- Remember that the objective is to walk AS FAR AS POSSIBLE for 6 minutes, but don’t run or jog.
During the Test
Monitor the patient for untoward signs and symptoms.
Use the following standard encouragements during the test6:
- 1 min “You are doing well. You have 5 minutes to go.”
- 2 min “Keep up the good work. You have 4 minutes to go.”
- 3 min “You are doing well. You are halfway.”
- 4 min “Keep up the good work. You have only 2 minutes left.”
- 5 min “You are doing well. You have only 1 minute to go.”
- 6 min “Please stop where you are.”
At the End of the 6MWT
- Put a marker on the distance walked.
- Seat the patient or, if the patient prefers, allow to the patient to stand.
- Immediately record oxygen saturation (SpO2)%, heart rate and dyspnoea rating on the 6MWT recording sheet.
- It is important to understand the reason for test termination/limitation, so patients should be asked why they could not walk any further if they had to stop during the test.
- Measure the excess distance with a tape measure and tally up the total distance.
- The patient should remain in a clinical area for at least 15 minutes following an uncomplicated test.