Six Minute Walk Test (6MWT) #
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Description #
This unit will describe the correct administration, scoring and interpretation of the Six Minutes Walk Test performed for TJA patients.
Learning Objectives #
By the end of this unit, the learner will be able to perform the following tasks for TJA patients:
– Administer the Six Minute Walk Test
– Score the Six Minute Walk Test
– Interpret the Six Minute Walk Test
What is this test? #
What is the Six Minute Walk Test? #
The Six Minute Walk Test (6MWT) is a valid, reliable, and responsive measure that is useful for assessing THA and TKA patients and falls within the WHO’s ICF domain of Activity1(Figure 1). The 6MWT measures submaximal aerobic capacity and ability to walk over longer distances. In addition, it can be completed relatively quickly requiring approximately 10 minutes to administer and score.
Figure 1. The International Classification of Functioning, Disability and Health (ICF) Conceptual Model. Taken from Riddle, D. & Stradford, P. (2013). Is this Change Real? Interpreting Patient Outcomes in Physical Therapy. Figure 2-1.
When do I use it? #
When do I use the Six Minute Walk Test? #
The Six Minute Walk Test (6MWT) can be used in a number of phases along the TJA Continuum of Care. Specifically, as seen in Figure 2, the 6MWT is recommended for use in the Pre-Operative, Post-Acute, and Active Living phases. Health professionals can therefore use this outcome measure to monitor change in the patient’s status as he or she moves through these phases of care (*note that it is not recommended in the Acute Phase).
Figure 2. The phases along the TJA Continuum of Care for which the 6MWT is recommended.
Equipment needed? #
What equipment is used to perform the Six Minute Walk Test? #
To perform the Six Minute Walk Test (6MWT) with a patient, a few pieces of equipment are required:
- A 30 metre pre-measured walking area with interval markings every 3 metres
- Cones or brightly coloured tape to mark boundaries
- A stop watch or a timer
- Chairs for rest at each end
- The patient’s usual walking aid if one is used
How do I do it? #
How do I administer the Six Minute Walk Test? #
To learn how to administer the Six Minute Walk Test (6MWT), please review the instructional video below.
Insert instructional video here.**
IMPORTANT LINKS!
- A written version of the instructions can be found at the following link → Instructions
- Do you want all the module information on a single piece of paper? If so, click this link! → 6MWT One Pager
How do I score it? #
How do I score the Six Minute Walk Test? #
Scoring the Six Minute Walk Test (6MWT) is easy to do:
1.Record the total distance walked in metres (to the nearest metre) in 6 minutes
What does it mean? #
How do I interpret the Six Minute Walk Test? #
It is simple to interpret the Six Minute Walk Test (6MWT): the greater the distance a patient can walk in six minutes, the better their performance. Furthermore, did you know that a TRUE CHANGE is indicated by an improvement of only 61.34 metres? It is true! It has been established that the:
MDC is 61.34 metres in THA and TKA patients4
- What does this mean for my patient? It means that in patients who have had THA and TKA, the change in score between test occasions must be greater than 61.34 metres in order to reflect true change and not just measurement error.
MCID of 20 – 50 metres in community dwelling older adults2
- What does this mean for my patient? It means that in community dwelling older adults, the change in score between test occasions must be greater than or equal to 50 metres in order to indicate that a clinically meaningful change has occurred.
DID YOU KNOW?
For healthy Caucasians aged 45-85 years, the average distance walked during the 6MWT for2,8:
- Females = 643 metres
- Men = 682 metres
Examples #
Examples #
Mr S is post op 21 days and has come to your clinic for treatment. On initial assessment, Mr. S walks 223 metres on the 6MWT and used a cane. After 4 weeks of treatment, Mr S is able to walk 365 metres on the 6MWT with a cane. Please determine if:
- True change has occurred
- Clinically meaningful change has occurred.
Has true change occurred? #
1. Calculate the change in score between test occasions
365 m – 223 m = 142 m
2. To determine if true change has occurred, compare the MDC to the change in score between test occssions
142 m > 61.34 m
Yes, true change has occurred because the difference between test occasions is greater than the MDC of 61.34 metres.
Has clinically meaningful change occurred? #
1. Calculate the change in score between test occasions
365 m – 223 m = 142 m
2. To determine if clinically meaningful change has occurred, compare the MCID to the change in score between test ocasions
142 m > 50 m
Yes, clinically meaningful change has occurred because the difference between test occasions is greater than the MCID of 50 metres.
References #
- Six Minute Walk Test Form QXQ SMW version 1,0 7/12/11 www.rheumatology.org/Practice/Clinical/Clinicianresearchers/Outcomes_Instrumentation/ Six_Minute_Walk_Test_%286MWT%29/
- Bennell K, Dobson F. Measures of physical performance assessments. Patient outcomes in rheumatology, A review of measures. Arth Care Res.2011;63(11):S350-S370.
- Ko V, Naylor JM et al. The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC MSK Disorders 2013;14:145. Available at: www.biomedcentral.com/1471-2474/14/145
- Kennedy DM, Stratford PW et al. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 2005;6:3.
- Unver B, Kahraman T et al. Reliability of the six-minute walk test after total hip arthroplasty. Hip Int 2013;23(6):541-5.
- Jakobsen TL, Kehlet H et al. Reliability of the 6-min walk test after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2013;21(11):2625-8.
- Parent E, Moffet H: Comparative responsiveness of locomotor tests and questionnaires used to follow early recovery after total knee arthroplasty. Arch Phys Med Rehabil 2002;83(1):70-80.
- www.rehabmeasures.org/Lists/RehabMeasures/PrintView.aspx?ID=895
- Dobson F, Hinman RS et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013;21(8):1042-52. Manual available at: www.oarsi.org/sites/default/files/docs/2013/manual.pdf
- WHO International Classification of Functioning, Disability, and Health – http://www.who.int/classifications/icf/icf_more/en/
- Riddle, D. & Stradford, P. (2013). Is this Change Real? Interpreting Patient Outcomes in Physical Therapy. F.A. Davis Company: Philadelphia.