6 Minute Walk Test

Dear all, Happy Australia Day and hope you all had a good weekend.

For the past week, I have been performing quite a number of 6 minute walk tests with patients in the wards. Think about 4 or 5 times already. The reason for doing the test was to determine whether they needed ambulatory oxygen and they had their ABGs taken prior to it without oxygen(off for 2 hours) and then the next day I would do the test at around the same time but with 2L/minute oxygen via nasal prongs.

Remember the time our tutors at Curtin demonstrated the 6MWT to us with a student "patient"? We were all standing along the corridor at random points and observing them do the test in a conducive environment. It looked kind of easy.

Not until I had to do it all by myself up in the noisy wards with grumpy dyspneic patients. There were so many things to do at one time. Holding the file with the instructions on one arm, around my neck was the stopwatch, slipping the Borg Scale underneath the file for easy sliding in and out to allow the patient to read, the other hand juggling between the pulse oximeter and pen for recording on a piece of paper on the file. Fully decked out. Sometimes, if the patient walked with a zimmer frame, the situation got worse as I also had to push the oxygen trolley along. Never done so much multi-tasking before.

And then before that, the environment had to be prepared. Clearing the route, chairs along the way, blood pressure machine at the start point and measuring the distance(not too bad for distance as the corridor walls were actually marked off at certain points).

The thing is, it takes so much effort to set up the environment, and every time I get the patient over, the chairs disappear mysteriously(which disrupts the distance I have already measured), and the BP machine rolls away on its own to some visible but far away location. Mind you, I informed the nurses that I was going to carry out the test and needed to route and equipment to stay the way it is.

During the test itself, despite obvious markers that the patient is doing a 6MWT, staff stroll by in front of the patient, stop and talk along the marked route and this really affects the performance of the test and results cos the patient stops to and wait and are unable to hear my instructions clearly.

Currently, I've tried sticking signs on the back of the chairs "6 Minute Walk Test in Progress, Do Not Remove. Thanks." which help occasionally and shifted to the quietest corridor corner I can find. Also got a PCA to help to push the oxygen trolley if the patient used a ZF. Guess it has helped quite a lot.

Wonder if you all encountered such problems along the way? Cos if you think about it, if you can't do a repeat test on the same day itself(patient gets too dyspneic and unwilling to perform it again due to that fear), with all that environmental distractions along the way and a planned discharge in less than 2 days(meaning you have exactly 2 days to do 2 6MWTs), is it a fair and accurate estimate on their exercise tolerance and oxygen demand?

Can 6MWT be an accurate guide under such conditions or is it accurate only under perfect conditions(which can be quite difficult to set up especially in the wards)? How much can these factors affect the results to render it completely inaccurate?