The six-minute walk test (6MWT) is a measure of how far a patient can walk in six minutes on a hard, flat surface.

The original purpose of the 6MWT was to determine exercise tolerance in patients with heart failure and respiratory disease, but the test has been used to measure exercise capacity in other patient groups, including those with muscular dystrophy.

How the 6MWT is performed

The test, start to finish, normally takes less than 15 minutes. A flat 30-meter track is recommended, but a long corridor may also be used. The patient will walk to the end of the track and return, doing as many laps as they can during the six-minute time frame.

During the test, the patient may wear a blood oxygen monitor (usually a small device on a fingertip). The nurse or physician running the test will also measure the patient’s blood pressure at the start and the end of the test.

If the patient normally walks with a cane or other support device, they may use it during the test. If the patient needs to stop and rest during the test, chairs will be available. The test is for diagnostic purposes rather than exercise, so it is not necessary for the patient to walk as quickly as they can.

In fact, the test results are more reliable if patients walk continuously rather than walking quickly and exhausting themselves, then being unable to complete the test.

Patients normally perform better on the test the second or third time they take it. So the test is generally repeated two to three times several days apart to get an accurate measurement. For clinical trials, these would take place both before treatment begins and after treatment has concluded.

The 6MWT in muscular dystrophy

The 6MWT is considered predictive of disease progression in muscular dystrophy patients over age 1. In Duchenne muscular dystrophy, distances of more than 30 meters walked during six minutes have been linked to slower disease progression.

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