What is the six-minute walk test and why is it done?

If you don’t have a habit of walking every morning or evening, walking for six minutes in one go can feel like a really long time. But if you have a lung or heart problem, you would like to know how severe it is. This is where the six-minute walk test comes in. It is a common test that measures how much you can walk in six minutes while sharing with a medical expert how you feel. You may feel short of breath or find it hard to walk for six minutes if your heart and lungs are not strong. Apart from assessing people with heart and lung conditions, the six-minute walk test can also be used to measure exercise capacity in elderly people with other health conditions such as rheumatic conditions like osteoarthritis.

What is the six-minute walk test?

The six-minute walk test is a simple measure taken during clinical and rehabilitation settings for the evaluation of a person’s functional exercise capacity. The test is simple, safe and does not require any sophisticated equipment. It assesses the submaximal level of a person’s functional capacity while walking on a flat and hard surface during a six-minute walk, as per research published in Therapeutic Advances In Cardiovascular Disease in 2019.

“It is normally used in people with chronic obstructive pulmonary disease, heart failure, and pulmonary hypertension,” says physiotherapist and fitness expert Dr Aijaz Ashai. Arthritis, spinal cord injury, and muscle disorders are also some of the conditions where this test can be used.

Purpose of the six-minute walk test

The purpose of the six-minute walk test is to test the cardiovascular and pulmonary endurance of a person. “It can follow along the changes of exercise capacity over time, especially for people with chronic conditions,” says the expert. Since this test measures cardiovascular and pulmonary function, significant problems can be detected early, and so, intervention may be instituted.

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“It also encourages a person to get into some sort of physical activity, which is an essential behavioural aspect of maintenance for health,” says the expert. It can also be applied in the rehabilitation area to monitor progress when recovered, following surgery or handling chronic diseases.

How is the six-minute walk test done?

Here’s the procedure of this test:

• A brief explanation is given to participants about the test and what they are expected to do.
• They walk back and forth on a predetermined distance, typically 30 meters, for six minutes.
• The total distance covered in meters is recorded, and any additional observations, such as heart rate, perceived exertion, and oxygen saturation, may be noted. These distances are compared with normative values based on age, gender, and health status to assess an individual’s functional capacity.

Here are a few points to keep in mind before taking the six-minute walk test:

• Wear comfortable clothes and shoes.
• Stay hydrated before the test, but avoid excessive fluid intake.
• Perform a light warm-up exercise before the test.
• Heavy meals, caffeine and stimulants should be avoided before the test, as they can affect your heart rate and perceived exertion.
• You should confirm your medicine intake with your doctor before the test.

What is a good six-minute walk test score?

Most adults are declared healthy if they attain a score of 400 to 700 metres in six minutes, as per research published in the Respiratory Medicine in 2006. “The test score for elderly people should be about 300 to 600 metres. People with chronic conditions may have lower scores, but anything less than 300 metres may mean there is a significant functional impairment,” says Dr Ashai.

Being able to walk a greater distance suggests better cardiovascular fitness, endurance, and functional capacity. It may indicate that a person is better able to engage in daily activities without excessive fatigue whereas distances significantly below the average for one’s demographic may signal reduced functional capacity or limitations in physical health. This can prompt further evaluation and interventions, such as rehabilitation or lifestyle changes.

Who should not take the six-minute walk test?

People with uncontrolled hypertension and a resting heart rate more than 120 beats per minute should avoid taking this test, as per research published in StatPearls in 2023. Others who should not take the six-minute walk test are people:

• Who may have undergone a recent surgery
• Have severe joint issues
• Have high risk of falling
• Have a history of an acute coronary syndrome, which is a range of health conditions associated with sudden, reduced flow of blood to the heart
• Have acute respiratory failure

Summary

The six-minute walk test is self-paced, and can be useful in knowing how well your heart and lungs are functioning. It serves as an indicator of cardiovascular and pulmonary function, allowing for early intervention if necessary. With frequent follow-up and assessment, health conditions can become better managed and improve the quality of life. All you have to do is walk as far as you can within six minutes along a flat and straight course.