Six-Minute Walk Test (6MWT)

Six-Minute Walk Test (6MWT) is often used to assess the response to medical treatment in patients with moderate to severe heart or lung disease. In that situation usually serial measurements are made before, while and after the medical intervention. It can also be used as a single measurement of the functional status of patients and as a predictor of morbidity and mortality [1]. 6MWT is inexpensive and easily available everywhere. Like any other tests, there are some absolute contraindications which include recent unstable angina and myocardial infarction. Resting heart rate above 120/min, systolic blood pressure above 180 mm Hg and diastolic blood pressure above 100 mm Hg have been considered as relative contraindications. Emergency resuscitation measures should be available as in case of treadmill exercise test. Chest pain, severe dyspnea, muscle cramps, staggering, undue sweating and pallor will need termination of the test.

Most tests use a 30 m long corridor with markings every 3 m. Turnaround points can be marked using a traffic cone if possible, for ease of recognition. The test is done on routine medications, and usual walking aids if any have to be used. Light meals is acceptable, but vigorous exercise in the preceding 2 hours is not permissible. There is no ‘warm-up’ period as in case of a treadmill exercise test. Subject takes rest in a chair for 10 minutes prior to the test at the starting point. Vital signs and if available pulse oximetry are documented and repeated after the test. Lap counter and timer are needed to keep track of the progress of the six minute walk. Six minute walk distance for healthy individuals is between 500 to 600 m.

Reference

1. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102. Erratum in: Am J Respir Crit Care Med. 2016 May 15;193(10):1185. doi: 10.1164/rccm.19310erratum. PMID: 12091180.