The Six And Three Minute Walk Tests In Emergency Medicine

Today I reviewed Emergency Medicine Cases podcast BCE 77 Pulmonary Embolism Workup In Pregnancy, November 2018. It is outstanding. For additional resources on the subject please see my post, Pulmonary Embolus – A Great Two Part Course From Emergency Medicine Cases Posted on September 22, 2018.

In the course of the BCE 77 podcast, Dr. Elisha Targonsky stated that he asked the patient to perform a 3 minute walking test to see if she desaturated or if her heart rate inappropriately increased as another data point to see if the patient required a CT angiogram for pulmonary embolus.

Although Dr. Targonsky did not cite a specific reference, it seems likely that he is referring to Resource (1) below.

Below are some additional resources on various walking tests.


(1) Ambulatory vital signs in the workup of pulmonary embolism using a standardized 3-minute walk test [PubMed Abstract] [Full Text HTML] [Full Text PDF]. CJEM. 2015 May;17(3):270-8.

(2) Can You Diagnose PE With a Walk Test? from Emergency Medicine Literature of Note on June 17, 2015.

(2) Feasibility of a structured 3-minute walk test as a clinical decision tool for patients presenting to the emergency department with acute dyspnoea [PubMed Abstract]  . Emerg Med J. 2009 Apr;26(4):278-82. doi: 10.1136/emj.2008.059774.

(1) Feasibility of Serial 6-min Walk Tests in Patients with Acute Heart
Failure [PubMed Abstract] [Full Text PDF]. J Clin Med. 2017 Sep; 6(9): 84


(3) The Six Minute Walk Test from The Lung Foundation Australia Pulmonary Rehabilitation Tool Kit.

From The Six Minute Walk Test web page:

Standardisation of the six-minute walk test (6MWT) is very important.

At the commencement of PR, the 6MWT must be performed twice to account for a learning effect.  Please note that:

  • The best distance walked in metres is recorded.
  • If the two tests are performed on the same day, at least 30 minutes rest should be allowed between tests.  Debilitated patients may require tests to be performed on separate days, preferably less than one week apart.
  • The walking track should be the same layout for all tests for a patient:
    • The track may be a continuous track (oval or rectangular) or a point-to-point (stop, turn around, go) track.
    • The track should be flat, with minimal blind turns or obstacles.
    • The minimum recommended length for a centre-based walking track is 25m and could be marked in metre increments.
      Note: If you do not have access to a track of at least 25m, make sure you use the same track for all tests and be aware that with a shorter track the distance walked may be less due to the patient having to slow down and turn more often in the six minutes.
  • A comfortable ambient temperature and humidity should be maintained for all tests.
The information from the 6MWT can be used to prescribe the intensity of walking exercise (see Exercise Training section).

(4) Two-Minute Walk Test Performance by Adults 18 to 85 Years: Normative Values, Reliability,and Responsiveness [PubMed Abstract] [Full Text PDF]. Arch Phys Med Rehabil. 2015 Mar;96(3):472-7. doi: 10.1016/j.apmr.2014.10.006. Epub 2014 Oct 25.

(5) Six-Minute Walk Test Vs. Three Minute Step Test for Measuring Functional Endurance [PubMed Abstract] [Full Text HTML] [Full Text PDF]. J Strength Cond Res. 2015 Nov;29(11):3240-4.

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