About the 6 Minute Walk Test

Determining the physical capability of an individual with COPD is an important aspect of planning his or her clinical treatment. Because many people, especially those who are elderly, are unable to perform the standard treadmill-based exercise test used to evaluate exercise capacity, the 6-minute walk test was developed as a valid alternative.

A 6-minute walk test is generally done at the start of a pulmonary rehabilitation program or to evaluate a patient for lung surgery. The test measures the distance a patient can walk quickly on a flat, hard surface in 6 minutes and reflects an individual’s ability to perform daily physical activities.

Reasons for performing the test

One of the most significant reasons that a 6-minute walk test is conducted is for measuring the response to medical intervention in a patient with moderate to severe heart or lung disease.

The test is also used:

• As a one-time measurement of functional status.
• To provide information about a patient’s ability to perform activities of daily living.
• To evaluate the response of bodily systems to exercise including the heart, lungs, blood and circulation.

Who should not do the test

You should not participate in the 6-minute walk if you have any of the following:

• Unstable angina during the month prior to the test.
• Heart attack the month prior to the test.
• Resting heart rate of > 120 beats per minute.
• Systolic blood pressure of > 188 mm Hg.
• Diastolic blood pressure of > 100 mm Hg.

Preparing for the test 

On the day of the test, be sure to:

• Dress in comfortable clothing.
• Wear comfortable shoes, preferably designed for walking.
• Use walking aids if you normally need them, such as a cane or walker.
• Eat a light meal before early morning or afternoon tests.
• Avoid vigorous exercise within 2 hours prior to the test

Reasons for stopping the test 

Your technician should stop the test if you experience any of the following:

• Chest pain
• Intolerable dyspnea
• Leg cramps
• Staggering
• Excessive sweating
• If you become pale or ashen in appearance

Helpful tips 

During the test:

• You will be permitted to slow down, stop and rest as needed.
• You may lean against the wall when resting, but should remain standing.
• If you do stop to rest, keep in mind the timer will not stop when you do and you should start up again when you are ready.
• Your technician will be watching you carefully, periodically reporting how many minutes have elapsed.
• Advise your technician of any concerns, both prior to and during the test.

Test results 

Most 6-minute walk tests will be done twice — once before and once following therapeutic intervention to determine if the patient has experienced significant improvement in functional status. 

One of the goals of medical intervention is for the patient to be able to walk further during the second test than he or she did during the first. One study reported that COPD patients who underwent exercise and diaphragmatic strength training could actually walk 50 meters (20%) more during their second test. Another reported that patients with very severe COPD who had lung volume reduction surgery (LVRS) experienced an increase of 55 meters (20%) in their 6-minute walk distance. 

While the 6-minute walk test is a useful tool for measuring functional capacity of many patients, the test should not be performed at home in the absence of proper medical supervision.