Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 7 , ISSUE 2 ( July-December, 2018 ) > List of Articles


Six-Minute Walk Test as a Guide for Walking Prescription for Patients with Chronic Obstructive Pulmonary Diseases

Baskaran Chandrasekaran, Kalyan Chakravarthy Reddy

Keywords : Benefits, ground walk, prescription, six-minute walk distance, six.minute walk test, treadmill walk

Citation Information : Chandrasekaran B, Reddy KC. Six-Minute Walk Test as a Guide for Walking Prescription for Patients with Chronic Obstructive Pulmonary Diseases. Indian J Respir Care 2018; 7 (2):73-76.

DOI: 10.4103/ijrc.ijrc_19_17

License: CC BY-NC-SA 4.0

Published Online: 02-12-2022

Copyright Statement:  Copyright © 2018; Indian Journal of Respiratory Care.


Exercise training in chronic respiratory disorders such as chronic obstructive pulmonary disease (COPD) is an essential component of pulmonary rehabilitation, but physical activity for maintenance of benefits in COPD after outpatient/inpatient rehabilitation is a neglected one. The dosage of walking is not “prescribed” properly by health-care providers for maintenance of muscle mass and improving quality of life. If the ground or treadmill walking is appropriately dosed and prescribed based on 6-min walk test (6MWT), the unsupervised ground walking may be a useful alternative to supervised aerobic fitness programs for achieving fitness benefits. This article provides an overview of dosing and measuring the walking program (either ground or treadmill) objectively to novice therapists and primary care physicians based on the 6MWT to COPD patients.

  1. Sanseverino MA, Pecchiari M, Bona RL, Berton DC, de Queiroz FB, Gruet M, et al. Limiting factors in walking performance of subjects with COPD. Respir Care 2018;63:301-10.
  2. Spruit MA, Pitta F, McAuley E, ZuWallack RL, Nici L. Pulmonary rehabilitation and physical activity in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015;192:924-33.
  3. Shin KC. Physical activity in chronic obstructive pulmonary disease: Clinical impact and risk factors. Korean J Intern Med 2018;33:75-7.
  4. Burtin C, Langer D, van Remoortel H, Demeyer H, Gosselink R, Decramer M, et al. Physical activity counselling during pulmonary rehabilitation in patients with COPD: A Randomised Controlled Trial. PLoS One 2015;10:e0144989.
  5. Fabre C, Chehere B, Bart F, Mucci P, Wallaert B, Grosbois JM, et al. Relationships between heart rate target determined in different exercise testing in COPD patients to prescribed with individualized exercise training. Int J Chron Obstruct Pulmon Dis 2017;12:1483-9.
  6. Mador MJ, Modi K. Comparing various exercise tests for assessing the response to pulmonary rehabilitation in patients with COPD. J Cardiopulm Rehabil Prev 2016;36:132-9.
  7. Celli B, Tetzlaff K, Criner G, Polkey MI, Sciurba F, Casaburi R, et al. The 6-minute-walk distance test as a chronic obstructive pulmonary disease stratification tool. Insights from the COPD biomarker qualification consortium. Am J Respir Crit Care Med 2016;194:1483-93.
  8. Morales-Blanhir JE, Palafox Vidal CD, Rosas Romero Mde J, García Castro MM, Londoño Villegas A, Zamboni M, et al. Six-minute walk test: A valuable tool for assessing pulmonary impairment. J Bras Pneumol 2011;37:110-7.
  9. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111-7.
  10. Chen H, Liang BM, Tang YJ, Xu ZB, Wang K, Yi Q, et al. Relationship between 6-minute walk test and pulmonary function test in stable chronic obstructive pulmonary disease with different severities. Chin Med J (Engl) 2012;125:3053-8.
  11. Chetta A, Zanini A, Pisi G, Aiello M, Tzani P, Neri M, et al. Reference values for the 6-min walk test in healthy subjects 20-50 years old. Respir Med 2006;100:1573-8.
  12. Marinho PE, Raposo MC, Dean E, Guerra RO, de Andrade AD. Does verbal encouragement actually improve performance in the 6-minute walk test? Physiother Theory Pract 2014;30:540-3.
  13. Zainuldin R, Mackey MG, Alison JA. Prescription of walking exercise intensity from the 6-minute walk test in people with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2015;35:65-9.
  14. Pomidori L, Contoli M, Mandolesi G, Cogo A. A simple method for home exercise training in patients with chronic obstructive pulmonary disease: One-year study. J Cardiopulm Rehabil Prev 2012;32:53-7.
  15. Kirkham AA, Pauhl KE, Elliott RM, Scott JA, Doria SC, Davidson HK, et al. Utility of equations to estimate peak oxygen uptake and work rate from a 6-minute walk test in patients with COPD in a clinical setting. J Cardiopulm Rehabil Prev 2015;35:431-8.
  16. Leung RW, Alison JA, McKeough ZJ, Peters MJ. Ground walk training improves functional exercise capacity more than cycle training in people with chronic obstructive pulmonary disease (COPD): A randomised trial. J Physiother 2010;56:105-12.
  17. Andrianopoulos V, Holland AE, Singh SJ, Franssen FM, Pennings HJ, Michels AJ, et al. Six-minute walk distance in patients with chronic obstructive pulmonary disease: Which reference equations should we use? Chron Respir Dis 2015;12:111-9.
  18. Durheim MT, Smith PJ, Babyak MA, Mabe SK, Martinu T, Welty-Wolf KE, et al. Six-minute-walk distance and accelerometry predict outcomes in chronic obstructive pulmonary disease independent of Global Initiative for Chronic Obstructive Lung Disease 2011 Group. Ann Am Thorac Soc 2015;12:349-56.
  19. Zanini A, Aiello M, Adamo D, Casale S, Cherubino F, Della Patrona S, et al. Estimation of minimal clinically important difference in EQ-5D visual analog scale score after pulmonary rehabilitation in subjects with COPD. Respir Care 2015;60:88-95.
  20. Holland AE, Hill CJ, Rasekaba T, Lee A, Naughton MT, McDonald CF, et al. Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2010;91:221-5.
  21. Güngör G, Karakurt Z, Adigüzel N, Aydin RE, Balci MK, Saltürk C, et al. The 6-minute walk test in chronic respiratory failure: Does observed or predicted walk distance better reflect patient functional status? Respir Care 2013;58:850-7.
  22. Carter R, Holiday DB, Nwasuruba C, Stocks J, Grothues C, Tiep B, et al. 6-minute walk work for assessment of functional capacity in patients with COPD. Chest 2003;123:1408-15.
  23. Richter MJ, Milger K, Tello K, Stille P, Seeger W, Mayer E, et al. Heart rate response during 6-minute walking testing predicts outcome in operable chronic thromboembolic pulmonary hypertension. BMC Pulm Med 2016;16:96.
  24. Roberts MM, Cho JG, Sandoz JS, Wheatley JR. Oxygen desaturation and adverse events during 6-min walk testing in patients with COPD. Respirology 2015;20:419-25.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.