Six-Minute Walk Test

American Thoracic Society (2002). Guidelines for the Six-Minute Walk Test. American ournal of !es"iratory and #ritical #are Medicine. $%%&$' $$$-$$(.
Description: The %-Minute Walk test is a sub maximal measure of aerobic capacity. The "erson may use an
am)ulation aid and oxy*en if they do so normally.
+The %MWT is a useful measure of functional capacity tar*eted at "eo"le ,ith at least moderately se-ere
im"airment. The test has )een ,idely used for "reo"erati-e and "osto"erati-e e-aluation and for measurin* the
res"onse to thera"eutic inter-entions for "ulmonary and cardiac disease.. (ATS' 2002)
Equipment: stethosco"e' /0 cuff' /or* !01' dys"nea scale' sto",atch' ta"e measure' "orta)le chair
Absolute contraindications:
unsta)le an*ina durin* the "re-ious month
myocardial infarction durin* the "re-ious month.
Relatie contraindications:
!estin* 2! 3 $20
S/0 3 $40 mm 2*
5/0 3 $00 mm 2*
Terminate exercise if:
An*ina' li*ht-headedness' confusion' ataxia' sta**erin* unsteadiness' "allor' cyanosis' nausea' marked dys"nea'
unusual fati*ue' claudication or other si*nificant "ain' facial ex"ressions si*nifyin* distress.
6otify "hysician if test is terminated for any of the a)o-e reasons.
!nstructions to t"e #articipant&
7The o)8ect of this test is to $alk as far as possible for % minutes. 9ou ,ill ,alk )ack and forth in this
hall,ay. Six minutes is a lon* time to ,alk' so you ,ill )e exertin* yourself. 9ou ,ill "ro)a)ly *et out of
)reath or )ecome exhausted. 9ou are "ermitted to slo, do,n' to sto"' and to rest as necessary. 9ou may
lean a*ainst the ,all ,hile restin*' )ut resume ,alkin* as soon as you are a)le.
9ou ,ill )e ,alkin* )ack and forth around the cones. 9ou should "i-ot )riskly around the cones and
continue )ack the other ,ay ,ithout hesitation. 6o, :;m *oin* to sho, you. 0lease ,atch the ,ay : turn
,ithout hesitation.7 (ATS' 2002) We ,ill a-oid ha-in* a con-ersation so that you can sa-e your ,ind for
,alkin*. 9ou can )e*in ,hen : say <*o=.
%uidelines for t"e Tester:
5o not ,alk ,ith the "atient' ho,e-er if )alance is an issue' the tester may ,alk )ehind and to the side.
After the first minute' tell the "atient the follo,in* (in e-en tones)& 79ou are doin* ,ell. 9ou ha-e >
minutes to *o.7 !e"eat this messa*e at e-ery minute (?'@'2'$). 5o not use other ,ords of encoura*ement
(or )ody lan*ua*e to s"eed u").
+:f the "atient sto"s ,alkin* durin* the test and needs a rest' say this& <9ou can lean a*ainst the ,all if you
,ould likeA then continue ,alkin* ,hene-er you feel a)le.= 5o not sto" the timer. :f the "atient sto"s
)efore the % minutes are u" and refuses to continue (or you decide that they should not continue) B the
chair o-er for the "atient to sit on' discontinue the ,alk' and note on the ,orksheet the distance' the time
sto""ed' and the reason for sto""in* "rematurely.. (ATS' 2002)
At the end of the % minutes&
2a-e "artici"ant sit do,n ("orta)le chair)
:mmediately take -ital si*ns' startin* ,ith 2! ()ecause it dro"s more Cuickly than S/0)
2a-e "atient rate their /or* !ate of 0ercei-ed 1xertion (!01)' and dys"nea
#alculate and record the distance ,alked.
Ask& 7What' if anythin*' ke"t you from ,alkin* fartherD7 (ATS' 2002)
Safety: Monitor -ital si*ns )efore after the test. :f there is an unex"ected -ital si*n res"onse' continue monitorin*
and documentin* e-ery > minutes until S/0 and 2! returns to ,ithin a)out $0-20 of "re-exercise -alues. 6ote
heart rhythm' es"ecially if it chan*es from a re*ular rhythm in "re-exercise to an irre*ular rhythm in "ost-exercise.
0(E@$E20$? 0a*e $
:f "artici"ant has con&estie "eart failure "rofile (ankle edema' dys"nea at rest or ,ith minimal exertion)&
auscultate the lun* )ases for ne, or increased crackles' and also auscultate the heart a"ically to see if you detect an
S@ heart sound.
A&in& of t"e 'ardioascular system:
!estin* 2! in the elderly does not -ary si*nificantly from restin* 2! in normal' youn* "o"ulation.
:n the elderly "o"ulation' 2! res"onse to exercise can )e less )risk' and also ,ill not rise to as hi*h of a
maximal 2! (com"ared to youn* normal)'
For the "erson ,ith cardiac risk factors' if *raded exercise stress test results are not a-aila)le (the *old
standard for esta)lishin* a tar*et 2!)' kee" the "eak exercise 2! under $20-$@0 )"m. Alternati-ely' only
allo, a 2! rise of 20 )"m.
:f "artici"ant is takin* a /1TA /GH#I1! it ,ill )lunt their 2! res"onse to exercise' therefore 2! is not a
relia)le measure. !ely on !01 and dys"nea scales and their /0 res"onse.
#ro&nosis:
0rediction formula for JH2 Max& #eak ()* K 0.0@ x distance (in meters) L @.M4
#ahalin G.0. ($MM%). The six minute ,alk test "redicts "eak oxy*en u"take and sur-i-al in "atients ,ith ad-anced heart failure. #hest $$0' @2>-@@2
#2F& %MW distances of + ,-- meters (M4?=) ha-e )oth a "oorer short term and lon* term sur-i-al rate.
.ittner/ (0 ($MM@). 0rediction of mortality and mor)idity ,ith a %-minute ,alk test in "atients ,ith left -entricular dysfunction. AMA 2(0& $(02-$(0(.
Norms for 6 Minute Walk Distances: 3 studies
/ro,n M. (un"u)lished). 1xercise S"ecificity in 0hysical Frailty.
Mean a*e of frail elder "artici"ants& 4?A 6um)er of "artici"ants& n K M>
1xcluded su)8ects if scored 3 @0 on the Modified 0hysical 0erformance Test (m00T)
Also excluded if )lind' dementia' "ro*ressi-e neurolo*ical disease
1 minute $alk distance: Mean: *12 m0/ 3415 ft06 S5& M> m.' (@$@ ft.)
Gusardi M. (200@). Functional 0erformance in #ommunity Gi-in* Hlder Adults. ournal of Geriatric Physical Therapy 2%A@A$?-22
0artici"ants& (% (22 men' >? ,omen)A mean a*e& 4@ L 4
1xclusion criteria& unsta)le an*inaA cardiac e-ent' cardiac sur*ery last % moA use of H2 or inhalersA neuro disease
1 minute $alk distances:
A*e Gender (6) Mean S5
%0-%M Male ($)
Female (>)
?M4 m $%@? ft.
?0> m $@2M ft.
-
$$0 m
(0-(M Male (M)
Female ($0)
?(> m $>>4 ft.
?0% m $@@2 ft.
M@ m
M> m
40-4M Male (M)
Female (2?)
6o Assist 5e-ice (2?)
Assist 5e-ice (M)
@20 m $0>0 ft.
242 m M22 ft.
@24 m $0(% ft.
$M( m %?% ft.
40 m
$2@ m
$02 m
42 m
M0-$0$ Male (2)
Female ($>)
6o Assist 5e-ice (()
Assist 5e-ice ($0)
2M% m M($ ft.
2%$ m 4>% ft.
@2? m $0%@ ft.
22? m (@> ft.
$> m
4$ m
(0 m
>$ m
Steffen T.M. (2002). A*e and Gender !elated Test 0erformance in #ommunity-5,ellin* 1lderly 0eo"le& %MW Test' //S'
TNG' and Gait S"eed. Physical Therapy' Jol.42' 6o.2' Fe)' 2002
Su)8ects included needed to )e a)le to ,alk % minutes ,ithout shortness of )reath' chest "ain' or 8oint
"ain in the le*s' neck' or )ack that ,ould limit %MW.
Su)8ects ,ere excluded if& smokers' history of diOOiness' used an assisti-e de-ice
1 minute $alk distances:
A*e Gender
(6)
Mean S5 6ormal !an*e
(2S5)
%0-%M Male ($>)
Female (22)
>(2m ($'4(( ft.)
>@4 m ($.(%> ft.)
M2 m
M2 m
@44-(>% m
@>?-(22 m
(0-(M Male ($?)
Female (22)
>2( m ($.(2M ft.)
?($ m ($'>?> ft.)
4> m
(> m
@>(-%M( m
@2$-%2$ m
40-4M Male (4)
Female ($>)
?$( m ($'@%4 ft.)
@M2 m ($.24% ft.)
(@ m
4> m
2($->%@ m
222->%2 m
0(E@$E20$? 0a*e 2
0(E@$E20$? 0a*e @