6 Minute Walk Test Score Sheet

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6 Minute Walk Test Score Sheet Patient should attempt to walk for six minutes however if he cannot the test does not require the full 6 minutes Document the total distance walked

American Thoracic Society ATS Guidelines for the Six Minute Walk Test Note Link must be opened in Google Chrome Submit this sheet and any other supporting documentation to your AME or to the FAA 6 Minute Walk Test Instructions General Information 1 individual walks without physical assistance for 6 minutes and the distance is measured 2 start timing when the individual is instructed to Go 3 stop timing at 6 minutes 4 assistive devices can be used but should be kept consistent and documented from test to test

6 Minute Walk Test Score Sheet

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6 Minute Walk Test Score Sheet
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Everything You Need To Know About The 6 minute Walk Test
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6 Minute Walk Test Worksheet PDF
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The 6 Minute Walk Test is a measure of performance that assesses the maximum distance a person can walk over 6 minutes and is used as a measure of submaximal aerobic capacity endurance and community ambulation Six Minute Walk Test Key Points The 6MWT must be performed twice to account for a learning curve Note consistency in administering the test is imperative If the two tests are performed on the same day at least 30 minutes rest should be allowed between tests

Clinical note for using the recording sheet You should record SpO2 and heart rate every minute You do not need to record dyspnoea every minute but there is space on the table above if you wish to Date Time Bronchodilator time since last dose Limiting factor to the test SOB Low SpO 2 Leg fatigue Other Distance WALK 1 BP Supplemental Document the amount of assistance using the 7 point ordinal scale described in the standardized administration protocol If a patient requires total assistance is unable to ambulate or requires assistance for limb swing or forward propulsion a score of 0 should be documented

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Clinical note for using the recording sheet You do not need to record SpO 2 heart rate and dyspnoea every minute but there is space on the table above if you wish to Description The 6 Minute Walk Test is a measure of endurance Patient Instructions I am going to measure how far you can walk in 6 minutes When I say go I want you to walk around the hallway track for 6 minutes Keep walking until I say stop or until you are too tired to go any further

6 Minute Walk Test Number of laps Distance of incomplete lap m Visit Date mm dd yyyy After 5 minutes With 15 seconds to go Timepoint Keep up the good work You have 4 minutes to go You are doing well You are halfway done After 1 minute After 2 minutes When timer rings After 3 minutes After 4 minutes Keep up the good work You have 2 minutes left You are doing Medical clearance provided for the patient to participate in exercise testing Contraindications to 6MWT Resting heart rate 120 beats min after 10 minutes rest relative contraindication Systolic blood pressure 180 mm Hg diastolic blood pressure 100 mm Hg relative contraindication

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 PDF Using The Six Minute Walk Test To Evaluate Walking Capacity In
6 MINUTE WALK TEST Score Sheet doc Tender Touch

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Patient should attempt to walk for six minutes however if he cannot the test does not require the full 6 minutes Document the total distance walked

Everything You Need To Know About The 6 minute Walk Test
SIX MINUTE WALK TEST 6MWT FAA RESULT SHEET

https://www.faa.gov/ame_guide/media/FAAResultSheet_6…
American Thoracic Society ATS Guidelines for the Six Minute Walk Test Note Link must be opened in Google Chrome Submit this sheet and any other supporting documentation to your AME or to the FAA


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6 Minute Walk Test Score Sheet - Six Minute Walk Test Key Points The 6MWT must be performed twice to account for a learning curve Note consistency in administering the test is imperative If the two tests are performed on the same day at least 30 minutes rest should be allowed between tests