The six-minute walk test is a medical evaluation design to measure your exercise tolerance. In addition to that, it measures your response to heart and lung treatments. Usually, people with pre-lung transplant evaluation, interstitial lung disease, or pulmonary hypertension are the subject of this test, but people undergoing scleroderma, fibromyalgia, and knee or hip arthroplasty as well as healthy adults and children are also included.
In six-minute walk test, the tester measures the distance one of the test subjects mentioned above can walk in six minutes mark. He or she can either or both walk in a flat or hard surface, depending on the tester. The goal is simply to see how far the test subject can walk with the given six-minute limit.
The test result will be used by your doctor to determine if further examination is needed both to your lungs and heart and their functions.
With the purpose of evaluating functional capacity, Balke develops it in 1963. He tests various walking time but recommends 6 minutes in the end because of its uncomplicated administration and reproducibility compared to a longer or shorter time. It was found out that 4-minute walk or under is not as effective in evaluating walk distance differences.
Originally, elderly patients in a geriatric hospital, ages 60 to 90, as well as the other frail elders in the community are the test subject of six-minute walk test. But the test was developed to use among adults with chronic diseases as well as pediatric populations and healthy elderly.
- Wear comfortable clothes and shoes
- Bring your walking aid if needed
- Light meals are allowed prior to the test
- Taking your usual medications are also encouraged
- Do not exercise for two hours before the test
Most of the equipment is prepared by the tester. The equipment needed are:
- Clipboard with pen and sheet
- Pulse oximeter
- Pre-measured marks along the track
- A chair or two, used as a positioning block for the walking course
- Sphygmomanometer for measuring blood pressure
- A validated scale to measure dyspnoea and subjective fatigue
- In case of emergency, a telephone and oxygen access
- If the patient required, portable supplemental oxygen should be in an easy-reach distance
The test objective is to see how far you can walk in six minutes. Usually, before starting the test, the tester uses a pulse oximeter to measure your pulse, blood pressure, and oxygen level. You will be asked by your tester to walk toward a cone or a chair and back using your normal pace and you’ll continue to walk back and forth until 6 minutes is done. Inform the tester if you are having chest pain, or if you’re experiencing difficulty breathing during the walking process. Slowing down, resting, or stopping is allowed during the test, and an update will be announced every after a minute interval.
The tester will observe if you are having a breathing difficulty or chest pain during the test, and there will be nearby supplies such as oxygen if you ever need them.
This section might be more for tester’s benefit than the patient. But it is better than a patient is informed.
It is important to have a standard 6-minute walk test. Additionally, it performed twice. So take note of the following:
- Record the best distance walked in meters.
- Allow at least 30 minutes in between test if the two tests will be performed on the same day. In case of weak patients, they may require separate days for the test but it should be less than a week apart.
- Walking tracks should have the same layout. It may be a continuous, rectangular or oval track or a point-to-point one. It should be flat, but with minimal obstacles and the length should be 25 meters.
- The place of the track should maintain a comfortable ambient temperature and humidity for all tests.
Before the Test
The tester should attach the oximeter to the patient so there will be no interfering in the walking pace and can simply be checked throughout the test. The tester should also give clear instructions such as the purpose of the test, the distance or point that the patient will have to walk, and the description of the walking track. Furthermore, the tester should already have the medical history of the patient and have taken into account any precautions prior to the test. If the patient has a prescribed inhaled bronchodilator, it should be taken when he arrives for the test, or one hour before the examination.
During the Test
The tester should be keen on monitoring the patient’s condition. Encourage him or her for every successful minute he/she walks. For instance, you can say, “You are doing well.” in the first minute of the test, and so on. Do not forget to record the test result for each minute, including heart rate, dyspnoea rating, and oxygen saturation.
After the Test
At the end of six minutes, mark the distance the patient had walked. Allow the patient to rest either by remaining standing or if he wants, let him sit. It will depend on his preference. While letting him rest, scribble the result of the test on the recording sheet. A patient should be asked why he or she cannot walk any further to understand the reason for the test termination. Finally, use a tape measure to measure the excess distance.
After the six-minute walk test, the patient will stay in a clinic for another test. It is not complicated and it will only last for about 15 minutes.
Note that normally the tester does not walk with the patient during the six-minute walk test to avoid setting the walking pace. If the tester has to walk with the patient, or if he or she chooses to, he or she should walk slightly behind the patient for the same reason of avoiding to set the walking pace. Additionally, the patient should wear the pulse oximeter continuously for the purpose of record every minute.