Six Minute Walk Test Instructions and Tracking Sheet
Equipment needed:
Flat straight corridor or hallway 30m (100ft) long marked every 3 m
Countdown timer or stopwatch
Lap counter (or mark laps on flow sheet)
Two small cones to mark the turnaround points
A chair that can easily be moved along the walking course
Worksheets on a clipboard
Oxygen source
Sphygmomanometer
Crash cart/defibrillator and telephone within close range
Pulse oximeter with clip to attach to patient
Rate of perceived dyspnea (RPD) scale (Borg scale)
Rate of perceived fatigue scale
Patient instructions:
Wear comfortable clothing and shoes
Bring usual walking aids (canes, walkers) to use during test
A light meal prior to the test is acceptable
Take all usual medications
No vigorous exercise should be done prior to the test
No warm-up is required
Measurements:
1. The patient should sit and rest in a chair located near the starting position, for at least 10
   minutes before the test starts. During that time, check for contraindications, measure pulse
   and BP, and make sure that clothing and shoes are appropriate. Start paperwork.
2. Pulse oximetry is optional. If it is used, measure and record baseline heart rate and oxygen
   saturation (SpO2). The Sp02 should not be used for constant monitoring during the exercise,
   and the technician must not walk with the patient to observe the Sp02. Clip the pulse oximeter
   to patient's clothing or use a fanny pack.
3. Have the patient stand and rate their baseline dyspnea and overall fatigue using the Borg
   dyspnea scale (RPD)
      Six Minute Walk Test Instructions and Tracking Sheet
4. Instruct the patient as follows:
     "The object of this test is to walk as far as possible for 6 minutes. You will walk back and forth in this
     hallway. Six minutes is a long time to walk, so you will be exerting yourself. You will probably get out of
     breath or become exhausted. You are permitted to slow down, to stop, and to rest as necessary. You
     may lean against the wall while resting, but resume walking as soon as you are able. You will be walking
     back and forth around the cones. You should pivot briskly around the cones and continue back the
     other way without hesitation.
     Now I'm going to show you. Please watch the way I turn without hesitation. (Do a demonstration at this
     time). I am going to keep track of the number of laps you complete.
     I will mark a line on my paper each time you turn around at this starting line. Remember that the object
     is to walk AS FAR AS POSSIBLE for 6 minutes, but don't run or jog. You can start now."
5. Have the patient start at the starting line. Stand near the patient at the starting line, but do not walk
   with the patient during the test. Start the timer as soon as the patient starts to walk.
6. Staff should not talk to anyone or become distracted during the test. Watch the patient and use even
   tone of voice when using standard words of encouragement. Keep close track of the laps, and each
   time the patient returns to the starting line, mark the total lap on the worksheet, which would equal
   200 feet. Let the patient see you recording the laps. After each minute, staff should tell the patient how
   many minutes they have to go, with simple words of encouragement, such as "Keep up the good work.
   You have 5 minutes to go." Do not use any other words of encouragement or body language to get the
   patient to speed up.
7. If the patient stops walking during the test and needs to rest, tell the patient that he/she can lean
   against the wall and can continue walking whenever he/she feels safe. DO NOT STOP THE TIMER. If
   the patient stops before the 6 minutes are up and cannot continue (or staff decides patient should not
   continue) wheel the chair over to the patient to sit on, discontinue the walk, and record notes on the
   worksheet, including time stopped and the reason for stopping.
8. When the timer is at 15 seconds, tell the patient, "in a moment I'm going to tell you to stop. When I do,
    just stop right where you are and I will come to you." When the timer buzzes, tell the patient to stop
    walking. Walk over to the patient, bringing a chair if necessary. Place a marker on the floor where the
    patient stopped.
9. Record the post-test vital signs and the number of laps on the worksheet, plus the additional
   distance covered. Calculate the total distance walked, rounding to the nearest foot, and record
   on the worksheet.
10. Congratulate the patient on good effort and offer a drink of water.
                       SIX MINUTE WALK TEST WORKSHEET
Name____________________ DOB____________Test
date_____________
Gender: M/F     Race ___________
Height ____ft ____in    Weight ________lbs________kg
Medications taken before the test (dose and time)
____________________________________________________________________
__________________________________________________________________
Supplemental O2: no       yes ____ L/min      Assistive device: no    yes _______
Pre Test/Baseline                                   End of Test
BP__________________                                BP_________________
HR _________________                                HR ________________
SpO2________________                                SpO2_______________
Dyspnea (Borg) _______                              Dyspnea (Borg) _______
Fatigue (Borg) ________                             Fatigue (Borg) ________
Stopped or paused before 6 minutes completed? No     Yes, reason___________
_________________________________________________________________
Other symptoms at the end of test:   angina   dizziness hip, knee, calf pain
other ______________________________
Number of laps__________(x100 meters) + final partial lap________meters= total
distance walked in 6 minutes: ______________ meters
Comments:
Technician: __________________________________
             RATE OF PERCEIVED DYSPNEA
0   Not at all
1   Very Slight
2   Slight
3   Moderate
4   Somewhat Hard
5   Severe
7   Very Severe
10 Very, very severe
               RATE OF PERCEIVED EXERTION
0 Not at all
1 Very light
2 Light
4 Somewhat Hard
6 Hard
7 Very hard
9 Extremely hard
10 Maximum exertion