Six-minute-walk test in idiopathic pulmonary fibrosis: test validation and minimal clinically important difference. [Reference Equations for the 6-Minute Walk Test in Healthy Individuals.] Determining the minimal clinically important difference for the six-minute walk test and the 200-meter fast-walk test during cardiac rehabilitation program in coronary artery disease patients after acute coronary syndrome. Lack of Specificity of the 6-Minute Walk Test as an Outcome Measure for Patients with Systemic Sclerosis Six-minute walk test versus two-minute walk test in children with Duchenne muscular dystrophy: Is more time more information? Regression equations to predict 6-minute walk distance in middle-aged and elderly adults Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease. Validation and comparison of reference equations for the 6-min walk distance test Preliminary report of the 6-minute walk test as a predictor of radiation-induced pulmonary toxicity. Two- and 6-minute walk tests assess walking capability equally in neuromuscular diseases Six-minute walk test closely correlates to "real-life" outdoor walking capacity and quality of life in patients with intermittent claudication. Predicting outcomes from 6-minute walk distance in chronic obstructive pulmonary disease. The influence of alternative instruction on 6-min walk test distance. Course length of 30 metres versus 10 metres has a significant influence on six-minute walk distance in patients with COPD: an experimental crossover study. Repeat six-minute walk tests in patients with chronic heart failure: are they clinically necessary? Repeatability of the 6-minute walk test in adolescents and adults with cystic fibrosis. Use of the six-minute walk test poststroke: is there a practice effect?
RATIONALE The 6-minute-walk test ( 6MWT ) is a practical and clinical ly meaningful measure of exercise tolerance with favorable performance characteristics in various cardiac and pulmonary diseases . Performance characteristics in patients with idiopathic pulmonary fibrosis ( IPF ) have not been systematic ally evaluated . OBJECTIVES To assess the reliability , validity , and responsiveness of the 6MWT and estimate the minimal clinical ly important difference ( MCID ) in patients with IPF . METHODS The study population included all subjects completing a 6MWT in a clinical trial evaluating interferon gamma-1b ( n = 822 ) .  Six-minute walk distance ( 6MWD )  and other parameters were measured at baseline and at 24-week intervals using a st and ardized protocol . Parametric and distribution-independent correlation coefficients were used to assess the strength of the relationships between 6MWD and measures of pulmonary function , dyspnea , and health-related quality of life . Both distribution-based and anchor-based methods were used to estimate the MCID . MEASUREMENTS AND MAIN RESULTS Comparison of two proximal measures of 6MWD ( mean interval , 24 d ) demonstrated good reliability ( coefficient = 0.83 ; P < 0.001 ) . 6MWD was weakly correlated with measures of physiologic function and health-related quality of life ; however , values were consistently and significantly lower for patients with the poorest functional status , suggesting good construct validity . Importantly , change in 6MWD was highly predictive of mortality ; a 24-week decline of greater than 50 m was associated with a fourfold increase in risk of death at 1 year ( hazard ratio , 4.27 ; 95 % confidence interval , 2.57- 7.10 ; P < 0.001 ) . The estimated MCID was 24 - 45 m. CONCLUSIONS The 6MWT is a reliable , valid , and responsive measure of disease status and a valid endpoint for clinical trials in IPF The six-minute walk test ( 6MWT ) has been broadly used in clinical setting s. Several reference equations for prediction of the total distance walked during the test ( 6MWD ) are available in literature . The present review aim ed to critically discuss studies , published in Portuguese and English ( LILACS , SCIELO , MEDLINE , PUBMED ) , which evaluated normal values and created reference equations for predicting 6MWD in healthy subjects , comparing them with the results that were recently obtained in Brazilian individuals . Age , sex , weight , height and body mass index were the main demographic and anthropometric features more often correlated with 6MWD . The equations derived from these characteristics were able to explain between 25 and 66 % of the total variability in the 6MWD . Unfortunately , the foreign equations were not applicable to the Brazilian population . Even when the 6MWT was performed following strict st and ardization , the difference in 6MWT performance between foreign and Brazilian individuals remains , indicating the necessity of providing specific reference equations for each population and /or ethnic group . Accordingly , these equations developed in Brazil are probably the most appropriate for interpreting 6MWT performance in Brazilian patients with chronic diseases affecting the exercise capacity . Future studies are necessary with larger sample sizes ( e.g. multicentric ones ) and r and omized design for the reference values of the 6MWD to be considered reliable OBJECTIVE To estimate the minimal clinical ly important difference ( MCID ) for the 6-minute walk test ( 6MWT ) and the 200-m fast-walk test ( FWT ) in patients with coronary artery disease ( CAD ) during a cardiac rehabilitation program . DESIGN Prospect i ve study using distribution- and anchor-based methods . SETTING Out patients from a cardiac rehabilitation unit . PARTICIPANTS Stable patients with CAD ( N=81 ; 77 men ; mean±SD age , 58.1±8.7y ) enrolled 31±12.1 days after an acute coronary syndrome ( ACS ) . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES  6MWT and 200-m FWT results before and after an 8-week cardiac rehabilitation program and at the 6th and 12th sessions . Patients and physiotherapists who supervised the training were asked to provide a global rating of perceived change in walking ability while blinded to changes in walk test performances . RESULTS Mean change in 6MWT distance ( 6MWD ) in patients who reported no change was -6.5 m versus 23.3 m in those who believed their performance had improved ( P<.001 ) . This result was consistent with the MCID determined by using the distribution method ( 23 m ) . Considering a 25-m cutoff , positive and negative predictive values were 0.9 and .63 , respectively . Conversely , there was no difference in 200-m FWT performance between these 2 groups ( 0.1 vs -1.4s , respectively ) . There was poor agreement with the physiotherapist 's perceived change . CONCLUSIONS The MCID for 6MWD in patients with CAD after ACS was 25 m . This result will help physicians interpret 6MWD change and help research ers estimate sample sizes in further studies using 6MWD as an endpoint Objective . The 6-minute walk test ( 6MWT ) is an important prognostic tool in various cardiovascular diseases and has been considered as a surrogate endpoint . However , conflicting results have been reported in systemic sclerosis ( SSc ) . Our objective was to evaluate the relationships of the 6-min walking distance  ( 6MWD ) and organ damage in SSc . Methods . Eighty-seven consecutive patients with SSc were included and prospect ively investigated ; they underwent 6MWT in addition to conventional assessment of possible lung , heart , kidney , skin , and muscle involvement , and disease activity scoring , severity , and quality of life determination . Results . Twenty-six patients ( 30 % ) had an abnormal 6MWT and the mean 6MWD was 461.8 ± 103.0 m. When considering 6MWT as a binary variable — normal or abnormal — C-reactive protein ( CRP ) was the only independent variable associated with abnormal 6MWT . Considered as a continuous variable , the 6MWD was associated with measures of lung involvement and inflammation , with the activity and severity of disease , and also with quality of life ; nevertheless , calcinosis was the only independent factor associated in multivariate analyses with a trend for an association for CRP . Conclusion . The 6MWD relates to broad factors in SSc and these results raise doubts about the specificity of the 6MWD in this systemic disease , and its relevance to monitoring therapy BACKGROUND / PURPOSE The six minute walk test is a widely accepted primary outcome parameter in most studies in Duchenne muscular dystrophy ( DMD ) . To compare information obtained by the six minute walk distance ( 6MWD ) test and the two minute walk distance ( 2MWD ) in patients with DMD , a cohort of 13 voluntary DMD boys did a repeated six minute walking test . METHODS Patients had to be ambulatory with a physical disability according to Levels 1 - 3 on the Vignos-Scale for lower extremity . Measurements were taken at one minute intervals . Reliability was measured by intraclass correlation . RESULTS Test-retest reliability for 6MWD and 2MWD in two different age classes was very good for both subgroups . Test-retest-reliability was lower in patients with more advanced disability in both tests . Walking speed remained completely stable from time points 1 - 6 minutes in the whole study patient collective , which indicates that physical exhaustion is not reached after six minutes even in more disabled patients . CONCLUSION Thus the 6MWD in DMD patients does not give additional information as compared to a 2MWD Six-minute walk distance ( 6MWD ) is commonly used as a measure of functional exercise capacity in clinical practice and research . Regression equations to predict 6MWD in healthy individuals are available , but the equations predict distances that vary considerably for an individual . The aims of this study were to 1 ) measure 6MWDs in healthy Caucasian Australians aged 45 - 85 years ; 2 ) determine whether evidence exists for Australian-specific prediction equations for Caucasian individuals by comparing measured 6MWDs with predicted 6MWDs derived by using published regression equations ; and 3 ) develop regression equations for males and females . One hundred nine subjects ( 48 males ) completed the 6-minute walk test ( 6MWT ) . Measurements of height , leg length , weight , habitual physical activity , and peak heart rate ( HR ) achieved during the 6MWT were obtained . 6MWD ( better of two tests ) was 682 ± 73 m ( mean ± SD ) and 643 ± 70 m in the males and females , respectively ( p<0.01 ) . Published regression equations underestimated 6MWDs in female subjects . Gender-specific regression equations using age and anthropometric data explained 40 % and 43 % of the variance in 6MWD in males and females , respectively . Validation of the regression equations in a prospect i ve subject cohort is required OBJECTIVE To establish the minimal important difference ( MID ) for the six-minute walk distance ( 6MWD ) in persons with chronic obstructive pulmonary disease ( COPD ) . DESIGN Analysis of data from an observational study using distribution- and anchor-based methods to determine the MID in 6MWD . SETTING Outpatient pulmonary rehabilitation program at 2 teaching hospitals . PARTICIPANTS Seventy-five patients with COPD ( 44 men ) in a stable clinical state with mean age 70 years ( SD 9 y ) , forced expiratory volume in one second 52 % ( SD 21 % ) predicted and baseline walking distance 359 meters ( SD 104 m ) . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Participants completed the  six-minute walk test  before and after a 7-week pulmonary rehabilitation program . Participants and clinicians completed a global rating of change score while blinded to the change in 6MWD . RESULTS The mean change in 6MWD in participants who reported themselves to be unchanged was 17.7 meters , compared with 60.2 meters in those who reported small change and 78.4 meters in those who reported substantial change ( P=.004 ) . Anchor-based methods identified an MID of 25 meters ( 95 % confidence interval 20 - 61 m ) . There was excellent agreement with distribution-based methods ( 25.5 - 26.5 m , kappa=.95 ) . A change in 6MWD of 14 % compared with baseline also represented a clinical ly important effect ; this threshold was less sensitive than for absolute change ( sensitivity .70 vs .85 ) . CONCLUSIONS The MID for 6MWD in COPD is 25 meters . Absolute change in 6MWD is a more sensitive indicator than percentage change from baseline . These data support the use of 6MWD as a patient-important outcome in research and clinical practice Exercise impairment as measured by the 6-min walk distance ( 6MWD ) test afflicts many patients with chronic obstructive pulmonary disease ( COPD ) and is known to predict mortality . Reference equations for the 6MWD in adults have been published but not yet vali date d. The present authors prospect ively followed 1,379 COPD patients for 55±30 months and tested the predictive value of the baseline 6MWD in metres , the 6MWD work ( kg·m−1 ) and as a percentage of predicted values the 6MWD in meters according to two reference equations . All-cause mortality was the validating outcome . The best threshold values were identified for each of the tests using receiver operating characteristic ( ROC ) curves . The threshold values obtained were : 350 m for the 6MWD , 25,000 kg·m−1 for the 6MWD work , and 67 and 54 % predicted for the two reference equations . All modalities of the testing were similar at predicting COPD mortality and correlated well with the 6MWD test . In conclusion , all modalities of testing predict mortality in chronic obstructive pulmonary disease equally well . In the 6-min walk distance test , a value < 350 m is associated with increased mortality and should be regarded as abnormal PURPOSE To assess the 6-minute walk test ( 6MWT ) as a predictor of  radiation therapy-induced lung injury ( RTLI ) .  METHODS AND MATERIAL S The 6MWT is a simple , economical , and reproducible test that measures both how far a person can walk in 6 min and any associated changes in vital signs . As part of a prospect i ve trial to study RTLI , a pre-RT 6MWT was performed in 41 patients . The predictive capacities of pre-RT 6MWT , forced expiratory volume in 1 s ( FEV1 ) , and single-breath diffusing capacity for carbon monoxide ( DLCO ) for the development of RTLI were assessed with receiver operating curve ( ROC ) techniques . To evaluate the 6MWT , alone or with mean lung dose ( MLD ) of radiation , as a predictor of RTLI , the rates of RTLI in patient subgroups defined by 6MWT results were compared by using Fisher 's exact test . RESULTS Thirty-one patients with > or =3 months ' follow-up were evaluable . The median baseline 6MWT result was 1400 ft . Of 31 patients , 7 developed Grade > or = 2 RTLI . Of 15 patients with an MLD > 18 Gy ( the median ) , 5 developed RTLI , compared with 2 of 16 with MLD < or = 18 Gy ( p = 0.22 ) . Among those with an MLD < or = 18 Gy , the RTLI rates were 0 of 8 and 2 of 8 for 6MWT results > or = 1400 ft or < 1400 ft , respectively , p = 0.46 . The ROC area under the curve for individual metrics was as follows : FEV1 0.66 , MLD 0.70 , DLCO 0.61 , and 6MWT 0.47 . Combining FEV1 with 6MWT increased the ROC to 0.71 , suggesting that the ratio might be a better predictor than the individual values . Patients with a high 6MWT/FEV1 ratio had a lower rate of RTLI than those with a relatively low ratio . CONCLUSIONS The 6MWT might provide prognostic information beyond pulmonary function tests and dosimetric parameters in predicting RTLI . Additional work is needed to better assess the utility of these functional metrics Objective : This method ologic study investigates if the 2-minute walk test ( 2MWT ) can be a valid alternative to the 6-minute walk test ( 6MWT ) to describe walking capability in patients with neuromuscular diseases . Methods : Patients ( n = 115 ) with different neuromuscular diseases were invited to participate on 2 test days , each consisting of 1 2MWT and 1 6MWT separated by a minimum 30-minute period of rest . The order of the walk tests was r and omly assigned via sealed envelopes . A group of 38 healthy controls completed 1 6MWT . Results : The mean walking distance for the 2MWT was 142.8 meters and for the 6MWT 405.3 meters . The distance walked in the 2MWT  was highly correlated to the distance walked in the 6MWT ( r = 0.99 , p < 0.001 ) . There was a significant decrease in walking speed from the first to last minute in the 6MWT , both among patients and healthy controls , which was not evident in the 2MWT . Results were consistent across diagnoses and levels of disease severity . Conclusion : The 2MWT is a potential alternative to the 6MWT to describe walking capability among patients with neuromuscular diseases during clinical trials OBJECTIVE We used outdoor walking distance measured during 40 minutes as " real-life " outdoor walking capacity in 49 patients with intermittent claudication ( IC ) . The outdoor walking distance was measured by a global positioning system application for a smartphone . The relationships of self-reported maximum walking distance ( SR-MWD ) , the MWD on a grade d treadmill test , and the 6-minute maximum walk distance ( 6MWD ) vs outdoors walking capacity were investigated . Also studied were the associations of SR-MWD , MWD , and 6MWD with health-related quality of life assessed with the disease-specific instrument the  Vascular Quality of Life Question naire ( VascuQoL ) . METHODS In this prospect i ve observational cohort study , 49 IC patients underwent an  outdoor walking capacity test for 40 minutes , and MWD and 6MWD were measured . SR-MWD was recorded , and all subjects completed the VascuQoL question naire . Associations between the different walk estimates and outdoor walking capacity and health-related quality of life were investigated by correlation analysis ( Spearman ρ ) . RESULTS Outdoor walking distance during 40 minutes was a median 2495 m ( range , 1110 - 3300 m ) . SR-MWD correlated moderately and MWD correlated strongly to outdoor walking capacity ( r = 0.56 and r = 0.65 ; P < .001 , respectively ) . The 6MWD test showed the largest correlation to the outdoor walking capacity ( r = 0.78 ; P < .001 ) . The 6MWD was the only test that showed correlations with the VascuQoL sum score ( r = 0.53 ; P < .01 ) and all of the domain scores , whereas SR-MWD and MWD showed weak correlations to the VascuQoL. CONCLUSIONS The distance walked during the 6-minute walk test is closely correlated to outdoor walking capacity and health-related quality of life in IC patients . Our data support the use of 6MWD for routine clinical evaluation of walking capacity in IC patients BACKGROUND Exercise tolerance is an important clinical aspect of chronic obstructive pulmonary disease that can be easily and reliably measured with the 6-minute walking test ( 6MWT ) . To improve the utility of the 6MWT for patient and health care system management , the interpretation of the functional status measure in relation to death and hospitalization should be eluci date d. METHODS Three-year , prospect i ve , multicenter observational study to evaluate the predictive power of 6MWD for death or exacerbation-related hospitalization and to evaluate the factors that help determine 6MWD . RESULTS We measured 6MWD at baseline and annually in 2110 patients with clinical ly stable Global Initiative for Obstructive Lung Disease ( GOLD ) stage II-IV COPD and recorded exacerbation-related hospitalizations and all-cause mortality .  During the study , 200 patients died and 650 were hospitalized .  Using receiver operating characteristics , the best predictive thresholds of the 6MWD were 334 m for increased risk of death and 357 m for exacerbation-related hospitalization ( area under the curve 0.67 and 0.60 respectively ) ; however , the discriminatory thresholds , especially for mortality , were influenced by age . The mean ( SE ) 6MWD declined by 1.6 ( 1.2 ) m per year in GOLD II , 9.8 ( 1.3 ) m per year in GOLD III , and 8.5 ( 2.4 ) m per year in GOLD IV . CONCLUSION The 6MWD provides prognostic information that may be useful for identifying high-risk patients with COPD BACKGROUND The goal of the 6-min walk test ( 6MWT ) is to enable patients to walk " as far as possible " as a measure of their functional ability . The impact of the specific walk instructions on patient 6MWT performance is unknown . METHODS Patients with pulmonary arterial hypertension ( PAH ) , idiopathic pulmonary fibrosis ( IPF ) , and other forms of interstitial lung disease ( ILD ) were recruited to perform four identical 6MWTs with one differing instructional phrase . The st and ard instruction to walk " as far as possible " was substituted in r and om order with " as fast as possible , " " at your normal pace , " or " at a leisurely pace . " RESULTS Twenty-four patients ( 10 with PAH , eight with IPF , six with other ILD ) were enrolled and completed all four 6MWTs . Patients attained the greatest distance with the fast instruction , exceeding the st and ard instruction distance by a mean of 52.7 m ( P < .001 ) . The mean difference between the fast and st and ard walks was 41.5 m in the PAH group , 66.5 m in the IPF group , and 53 m in the other ILD group . CONCLUSIONS Patients do not walk as far as they are able with the st and ard American Thoracic Society instruction for 6MWT . Changing the wording from " far " to " fast " may facilitate a better effort and greater distance during the test . It is possible that this modified 6MWT instruction may result in improved accuracy and reproducibility , thereby enhancing its clinical and research trial usefulness QUESTIONS Do patients with chronic obstructive pulmonary disease ( COPD ) achieve a different distance on the six minute walk test ( 6MWT ) conducted on a 10 m course versus on a 30 m course ? When assessing the distance on a 6MWT conducted on a 10 m course , is it valid to use existing reference equations that were generated on longer courses ? DESIGN A r and omised double-crossover experimental study . PARTICIPANTS Forty-five patients with COPD in primary physiotherapy care . INTERVENTION All patients performed a 6MWT twice over a 10 m course and twice over a 30 m course . The 6MWTs were performed in accordance with the American Thoracic Society guidelines . OUTCOME MEASURES 6MWD was assessed and predicted distance was calculated based on a range of reference equations . RESULTS The 6MWD on the 10 m course was 49.5 m shorter than on the 30 m course , which was statistically significant ( 95 % CI 39.4 to 59.6 ) . By using existing reference equations for a 6MWT conducted on the 10 m course , the predicted distance is highly overestimated ( with a range of 30 % to 33 % ) and the average distance as a percentage of the predicted value is 8%pred lower compared to a 6MWT conducted on the 30 m course , result ing in a worse representation of a COPD patient 's functional exercise capacity . CONCLUSION This study shows that the impact of course length on the 6MWD and on the use of reference equations in patients with COPD is substantial and clinical ly relevant ( based on the most conservative published minimum clinical ly important difference ) . Therefore , existing reference equations established for a 6MWT conducted over a 30 m ( or longer ) course can not be applied to predict the distance achieved on the 6MWT on a 10 m course , which is frequently used in primary care physiotherapy practice s for patients with COPD Background : Owing to a reported learning effect in patients with chronic cardiopulmonary disease , performance of at least two six-minute walk tests ( 6MWT ) are recommended as st and ard practice . Patients with chronic heart failure ( CHF ) are typically elderly and frail and it is unknown whether current guidelines are practical in a clinical setting . Aims : The aim of this study was to determine whether repeat performance of 6MWTs in patients with CHF is related to between-test interval or baseline performance . Methods : This was a multisite observational study enrolling participants entering into heart failure rehabilitation programmes . Participants performed two 6MWTs with r and omly allocated inter-test intervals between 15 and 90 minutes . Distance walked in the second test was compared with the first test using a paired t test . Results : Eighty-eight participants ( 45 females , age 65 ± 14 years ) with stable CHF were enrolled . Mean distance walked increased from 301 metres in test 1 to 313 metres in test 2 ( p < 0.001 ) . No significant change was recorded between test 1 and test 2 for those whose baseline distance was < 300 metres . The interval between tests had no significant effect on the distance walked . Conclusion : The change in 6MWT distance was significantly associated with better baseline performance but not with the interval between tests OBJECTIVE To determine the repeatability of the 6-minute walk test ( 6MWT ) in adolescents and adults with cystic fibrosis ( CF ) . METHODS This was a prospect i ve cross-sectional study . We included consecutive patients ages > or=15 years attending an adult CF program . The patients underwent the 6MWT , pulmonary function tests , and clinical evaluation . The second 6MWT was performed following a rest period of 60 min . RESULTS Thirty-one patients were included . The mean+/-SD age was 23.5+/-6.7 y , and the mean FEV1 was 61+/-28 % of predicted . The mean+/-SD walked distance in the first 6MWT was 583.6+/-68.6 m and in the second 6MWT was 590.0+/-72.2 m. The mean difference between the first and second 6MWT was -6.5 m , with limits of agreement between -74.9 m and 61.9 m , and the coefficient of variation was 4.3 % . The mean oxygen desaturation in the first 6MWT was 2.5+/-4.5 % , and in the second test it was 1.8+/-4.0 % . The mean difference between the first and second test was 0.6 % , and the coefficient of variation was 104 % . CONCLUSIONS Although the 6MWT distance was reproducible , the wide limits of agreement exceeded the minimum important difference for this test . These findings indicate that , in the routine evaluation of CF patients , at least two 6MWTs are required on any testing occasion to obtain a reliable estimate of the 6MWT distance OBJECTIVES To determine whether a practice effect occurs across 2 trials of the six-minute walk test ( 6MWT ) among community-dwelling people within 1 year poststroke and to identify characteristics distinguishing people who show a practice effect from those who do not . DESIGN Secondary analysis of scores on 2 trials of the 6MWT administered approximately 30 minutes apart at baseline in a r and omized controlled trial . SETTING General community . PARTICIPANTS People ( N=91 ) living in the community with a residual walking deficit within the first year of a first or recurrent stroke . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURE Distance walked on the 6MWT .  RESULTS Mean 6MWT scores + /- SD for trials 1 and 2 were 196+/-119 m and 197+/-126 m , respectively ( n=83 ) . The mean difference in 6MWT performance across trials was 0+/-35 m ( 95 % confidence interval [ CI ] , -7 to 8 m ) . The Pearson correlation coefficient between 6MWT distances was .96 ( P<.001 ) , and the intraclass correlation coefficient was .98 ( 95 % CI , .97-.99 ) . The Bl and -Altman plot showed no clear pattern . Participants whose improvement was equal to or greater than the minimal detectable change of 29 m between trials ( 14 % ) did not significantly differ from those in the rest of the study sample ; however , they tended to be younger ( P=.05 ) and more likely to have a mild or moderate gait deficit ( P=.06 ) . CONCLUSIONS Findings do not support a practice effect across 2 trials of the 6MWT in individuals within 1 year poststroke . Thus , a practice walk does not appear necessary . Further research is recommended to evaluate the influence of young age , acute stroke , and mild-to-moderate gait deficit on practice effects
The 6MWD is usually negatively associated with a higher Body Mass Index , increased cigarette consumption , higher doses of antipsychotic medication and lower physical self-worth in individuals with schizophrenia .
The 6MWT demonstrates high reliability .
IMPLICATION S FOR REHABILITATION The Six-Minute Walk Test reliably assesses the functional exercise capacity in patients with schizophrenia .
The impact of therapeutic interventions on patients , as measured by the 6MWT , can not be confirmed .
PURPOSE The six-minute walk test ( 6MWT ) is a sub-maximal exercise test measuring the distance that a patient can walk quickly in a period of 6 minutes ( 6MWD ) .
The objectives of this systematic review are to evaluate the 6MWT 's suitability for measuring the impact of an intervention , to compare the 6MWD walked by patients with schizophrenia with data for the general population or matched controls , to identify the determinants of 6MWD and to examine the measurement properties and quality procedures of the 6MWT .