The 6-minute walk test (6MWT) is a sub-maximal exercise test used to assess functional capacity over 6 minutes. It requires a 30-meter unimpeded walkway and is scored based on the total distance walked in 6 minutes. The 6MWT can be used to evaluate patients with various cardiopulmonary and musculoskeletal conditions. It provides information on cardiopulmonary, circulatory and metabolic function during physical activity. The test is self-paced but involves continuous encouragement to walk as far as possible within 6 minutes while allowing for rests. Interpretation compares the distance walked to reference values based on age, gender, height and other factors.

1. 6 MINUTES WALK TEST
Presentation by Dr Ubogun ogheneakpobor Efe MD
Ho Cardiology

2. OUTLINE
• INTRODUCTION
• CONDITIONS UTILIZED IN
• EQUIPMENTS
• PATIENT INSTRUCTION
• PROCESS/PROCEDURE
• INTERPRETATION
• REFERENCE

3. Introduction
• Six minute walking test (6MWT) was developed by
the American Thoracic Society and it was officially
introduced in 2002.
• The 6 Minute Walk Test is a sub-maximal exercise
test used to assess aerobic capacity and endurance.
• The distance covered over a time of 6 minutes is
used as the outcome by which to compare changes
in performance capacity.

4. Introduction cont'd
• The 6MWT can be used in preschool children (2-5
years), children (6-12 years) adults (18-64 years),
elderly adults (65+).
• The test was initially designed to help in the
assessment of patient with cardiopulmonary issues.
• Gradually, it was introduced in numerous other
conditions.

5. Cont'd
• In healthy subjects, the 6-min walk distance
(6MWD) ranges from 400 to 700 m, the main
predictor variables being gender, age and height.
• The mean 6MWD and DW values were 593±57 and
638±44 for women and men respectively.

7. Cont'd
• It evaluates the functional capacity of the individual
and it provides valuable information regarding all
the systems during physical activity, including
pulmonary and cardiovascular systems, blood
circulation, neuromuscular units, body metabolism,
and peripheral circulation

8. Conditions it is utilized
• Arthritis
• Fibromyalgia
• Geriatrics
• Multiple Sclerosis
• Parkinson’s Disease
• Spinal Cord Injury
• Stroke
• Muscle disorders
• Spinal Muscular Atrophy
• Charcot-Marie-Tooth disease

9. Cont'd
• Pulmonary hypertension.
• interstitial lung disease.
• Pre-lung transplant evaluation.
• COPD.

10. Equipment Required
• Stopwatch
• Measuring/trundle wheel to measure distance covered
• 30-metre stretch of unimpeded walkway
• Sphygmomanometer
• Telephone
• Automated electronic defibrillator
• cones to mark the distance that needs to be covered
• Pulse oximeter for measuring heart rate and SpO2

11. Set-Up
• Place cones at either end of the 30 metre stretch as
turning points
• Have chairs set up either side and halfway along
the walking stretch

12. Patient preparation
• Wear clothes and shoes that are comfortable.
• You may use your usual walking aids such as a cane
or walker, if needed.
• It is okay to eat a light meal prior to your test.
• Take your usual medications.
• Do not exercise within two hours of testing.

13. Cont'd
• The tester will measure your blood pressure, pulse
and oxygen level usually with a pulse oximeter
before you start to walk.
• Let the staff know if you are having chest pain or
breathing difficulty.
• Oxygen and other supplies will be nearby if you
need them.

14. Patient Instructions
• The patient is told the object of this test, which is
to walk as far as possible for 6 minutes. You will
walk back and forth in this hallway.
• Six minutes is a long time to walk, so you will be
exerting yourself.
• You will probably get out of breath or become
exhausted.

15. Patient Instructions cont'd
• You are permitted to slow down, to stop, and to
rest as necessary.
• You may lean against the wall while resting, but
resume walking as soon as you are able.
• You will be walking back and forth around the
cones.
• You should pivot briskly around the cones and
continue back the other way without hesitation.

16. Cont'd
• The test is demonstrated to the patient and then
he/she is asked to carry on.
• Patient is continuously encouraged throughout the
entire exercise.

18. Stop 6MWT
• Chest pain suspicious for angina.
• Evolving mental confusion or lack of coordination.
• Evolving light-headedness.
• Intolerable dyspnoea.
• Leg cramps or extreme leg muscle fatigue.
• Persistent SpO2 < 80%.
• Any other clinically warranted reason

19. INTERPRETATION
• The following predictive equations use the
reference values determined from a study that
performed two 6MWTs according to the above
protocol
• Predictive equation for males: 6MWD(m) = 867 –
(5.71 age, yrs) + (1.03 height, cm)
• Predictive equation for females: 6MWD(m) = 525 –
(2.86 age, yrs) + (2.71 height, cm) – (6.22 BMI).

20. • The shorter the distance, thr worse the prognosis.

21. References
• Reference values for the 6-min walk test in healthy
subjects 20–50 years old by Alfredo Chetta a,
Andrea Zanini b, Giovanna Pisi c, Marina Aiello a,
Panagiota Tzani a, Margherita Neri b, Dario Olivieri
• Pulmonary rehabilitationtoolkit.
• ATS Statement guidelines for the Six-Minute Walk
Test
• Physiopedia