The Six Minute Walk Test - A Measurable, Simple Assessment of Health?



  • Defining “health” isn’t easy, but some definitions do revolve around function, and there are few things more functionally important than walking.

    There is a test which shows up in medicine called the 6 Minute Walk test. ( 6MWT). I’ve seen it used in chronic respiratory disease evaluation, rheumatology, obesity, etc, so there is a fair amount of literature on it.

    It’s basically a measure of how far one can walk on a flat surface in 6 minutes. Since it is self paced, it’s a relatively safe test, and, most importantly for Citizen Health, it could be a very “mobile friendly, non fungible” test.

    Anyway, here’s one article to look at for obesity. https://www.ncbi.nlm.nih.gov/pubmed/23404845 .

    I am aware of its limitations - such as for people with certain disabilities - but I think there may be some power to the idea of relating health to a natural function.

    Also, I believe there is some evidence that the change in function may be more important than the absolute function for a health improvement measurement - that is, extending you 6MWT by 100 yards could be very important to a feeling of improvement for one’s health in a patient with significant disease.

    Thoughts?



  • Yes, I would agree allowing for small meaningful goals when trying to implement exercise is most successful. Walking is basic and meaningful in predicting health as are most functional movement tests. We like to say “movement is a window into health.”

    At the organization I am associated with, Academy of Prevention and Health Promotion Therapies, we recommend choosing some form of cardio respiratory fitness test to help determine overall health. We like the 12 min run- walk test or the YMCA 3 min step test. Both are good indicators of CRF which help predicts health. 10 METS is usually a good indicator of health. One can build from whatever the clients start point is.

    There are other tests can can determine health for older populations etc but for the general adult population the above mentioned work pretty well. From there exercise can be dosed out according to client’s health.



  • Definitely agree with these sentiments! I have grown really fond of the 12 minute walk/run test for assessment of cardiorespiratory fitness, the ease in calculating out METs to give a solid meaningful number for clients to sink their teeth into and set goals off of has been great. Walking & running are both fundamental human movements and we can gain a great deal of insight from watching them in the process. I also really like monitoring HR during and CRF test and correlating that to the person’s RPE to get a gauge of how finely tuned their self-assessment system is in monitoring their intensity. This lets me whether they will be able to self monitor their own exertion level during exercise or if using an external device to “retrain” the system would be of benefit. I think the 6 minute walk test is a great scaling option for those who can’t tolerate the 12 minute test. Great thoughts and look forward to continued discussion, thanks fellow APHPT’er Perry for inviting me in to the conversation!



  • Excellent ideas. I would point out that raw data for the relationships between steps and heart rate and intensity, may already be contained in FitBit data sets. Why look at 6 minutes and 12 minutes on data, when you could look at 3 years of data and data over time?

    But I often wonder about the relationship between fitness versus health. Fitness I see as highly measurable from the standpoint of function. Health is more tricky if you believe there is a subjective component.



  • @mattrmd unsure if I follow your comment fully but the 12 min run/walk has been linked to all cause mortality. I view movement as a window into health, not necessarily fitness. Health is definitely a construct with movement as one of the major subcontracts to measure. The question, I think that you well posed to the community, is what test of movement is most meaningful to health? I'm unsure as a medical community we have that answer yet. To date, we like the 12 min walk/run test as a movement measure to indicate CRF therefore health. Grip strength has been related to mortality as well so grouping these two tests together (with others as you intimate the "subjective") could help indicate health.