The 6-minute walk test (6MWT) is a submaximal exercise test that measures the distance a patient can walk as fast as they can along a flat, hard, 30-meter (or longer) corridor in six minutes. It was standardized by the American Thoracic Society (ATS) in 2002 and updated in the 2014 ERS/ATS technical standard on field walking tests. Healthy adults typically walk about 736 m (2,415 ft) for men and 674 m (2,211 ft) for women aged 20 to 59, and about 599 m (1,965 ft) and 550 m (1,804 ft) from age 60 (McKay et al., 2017). The minimal important difference is about 30 m, with a plausible range of 25 to 33 m in chronic respiratory disease (ERS/ATS, 2014).
This page gives you a free 6MWT calculator (predicted distance, lower limit of normal, % predicted and change), norms by age in meters and feet, the standardized procedure and script, contraindications from the ERS/ATS standard, and MCID and MDC values by condition with their sources. It is part of SPRY's library of functional outcome measures. Last updated October 2026.
6-minute walk test calculator
Use the calculator to get the predicted 6MWD for a healthy adult of the same sex, age, height and weight, and compare the patient's result with it. You can enter height, weight and distance in either metric or imperial units.
6-minute walk test calculator: predicted distance, % predicted and change
Enter the patient's details and the distance walked. The calculator uses the Enright and Sherrill (1998) reference equations for healthy adults, reports the lower limit of normal (LLN), and compares a repeat test with the 30 m minimal important difference recommended by the ERS/ATS technical standard.
Clinical decision support only. The Enright equations were derived from 290 healthy adults aged 40 to 80 and explain about 40% of the variation in distance. The ERS/ATS standard advises using locally derived reference equations where available. Interpret results with the patient's history, symptoms and oxygen saturation.
Worked example: a 60-year-old man, 175 cm and 80 kg, has a predicted 6MWD of (7.57 × 175) − (5.02 × 60) − (1.76 × 80) − 309 = 574 m, and a lower limit of normal of 574 − 153 = 421 m. If he walks 450 m, he is at 78% of predicted and above the lower limit of normal.
6-minute walk test norms by age and gender
Normal values depend on age, sex, height, weight and the population studied, so there is no single "normal" distance. The tables below show published reference data in meters and feet. For an individual patient, the reference equations in the calculator account for height and weight too.
| Age group | Men, mean (SD) | Women, mean (SD) |
|---|---|---|
| 20–59 years | 736 m (2,415 ft), SD 88.3 m | 674 m (2,211 ft), SD 76.8 m |
| 60 years and older | 599 m (1,965 ft), SD 125.4 m | 550 m (1,804 ft), SD 115.0 m |
| 10–19 years | 748 m (2,454 ft), SD 103.9 m | 693 m (2,274 ft), SD 83.6 m |
| 3–9 years | 550 m (1,804 ft), SD 117.6 m | 556 m (1,824 ft), SD 119.4 m |
| Age group | Men | Women |
|---|---|---|
| 60–69 years | 572 m (1,877 ft) | 538 m (1,765 ft) |
| 70–79 years | 527 m (1,729 ft) | 471 m (1,545 ft) |
| 80–89 years | 417 m (1,368 ft) | 392 m (1,286 ft) |
| Age group | Boys | Girls |
|---|---|---|
| 3–5 years | 536.5 m (1,760 ft) | 501.9 m (1,647 ft) |
| 6–8 years | 577.8 m (1,896 ft) | 573.2 m (1,881 ft) |
| 9–11 years | 672.8 m (2,207 ft) | 661.9 m (2,172 ft) |
| 12–15 years | 697.8 m (2,289 ft) | 663.0 m (2,175 ft) |
| 16–18 years | 725.8 m (2,381 ft) | 664.3 m (2,179 ft) |
6MWT reference equations (Enright and Sherrill, 1998)
| Sex | Predicted 6MWD (meters) | Lower limit of normal |
|---|---|---|
| Men | (7.57 × height cm) − (5.02 × age) − (1.76 × weight kg) − 309 | Predicted − 153 m |
| Women | (2.11 × height cm) − (2.29 × weight kg) − (5.78 × age) + 667 | Predicted − 139 m |
These equations explain about 40% of the variability in distance. The ERS/ATS standard notes that predicted values vary widely between equations and recommends applying reference equations from a local population where possible. Always state which equation you used in the record.
Equipment and set-up
- Course: a flat, straight, hard-surfaced corridor of 30 m or more with little foot traffic, marked with a cone at each turnaround point.
- Measuring: measuring wheel or tape, stopwatch or timer, and a lap counter.
- Monitoring: pulse oximeter, blood pressure monitor, and the Borg dyspnea scale to rate breathlessness before and after the test.
- Comfort and safety: a chair at the start line, supplemental oxygen and emergency equipment close by, and staff trained in basic life support.
- Patient preparation: comfortable clothing and walking shoes, usual medications, a light meal, no vigorous exercise for 2 hours beforehand, and the patient's usual walking aid and oxygen.
Step-by-step 6MWT procedure
- Rest and baseline: have the patient sit near the start line for at least 10 minutes. Check contraindications, then record heart rate, blood pressure, SpO2 and Borg dyspnea and fatigue.
- Instruct and demonstrate: read the standardized script word for word and show how to turn around the cone without hesitation.
- Start: start the timer as the patient starts to walk. Do not walk with the patient.
- Encourage once a minute with the standard phrases only (below) and count laps.
- Stop at 6 minutes: say "Please stop where you are," mark the spot and have the patient sit.
- Post-test: record SpO2 and heart rate, Borg dyspnea and fatigue, the distance walked to the nearest meter, and the reason for any stop.
- Repeat for change over time: the ERS/ATS standard calls for two tests when you are measuring change, at least 30 minutes apart and after heart rate and SpO2 have returned to baseline, and you record the best distance.
Standard encouragement phrases
- After 1 minute: "You are doing well. You have 5 minutes to go."
- After 2 minutes: "Keep up the good work. You have 4 minutes to go."
- After 3 minutes: "You are doing well. You are halfway done."
- After 4 minutes: "Keep up the good work. You have only 2 minutes left."
- After 5 minutes: "You are doing well. You have only 1 minute to go."
Do not use other phrases such as "good job" or "excellent," and do not change your tone, because encouragement changes the distance walked.
Patient instructions (read verbatim)
"The object of this test is to walk as far as possible for 6 minutes. You will walk back and forth in this hallway. Six minutes is a long time to walk, so you will be exerting yourself. You will probably get out of breath or become exhausted. You are permitted to slow down, to stop, and to rest as necessary. You may lean against the wall while resting, but resume walking as soon as you are able. You will be walking back and forth around the cones. You should pivot briskly around the cones and continue back the other way without hesitation. Now I'm going to show you. Please watch the way I turn without hesitation."
Demonstrate the walk and turn, then say: "Are you ready to do that? I am going to use this counter to keep track of the number of laps you complete. I will click it each time you turn around at this starting line. Remember that the object is to walk AS FAR AS POSSIBLE for 6 minutes, but don't run or jog. Start now, or whenever you are ready." If the patient stops, say: "You can lean against the wall if you would like; then continue walking whenever you feel able."
When to stop the test
Stop the test immediately for chest pain, intolerable dyspnea, leg cramps, staggering, diaphoresis, a pale or ashen appearance, or profound desaturation (SpO2 below 80%). The timer keeps running if the patient pauses to rest. Document the stop and the reason.
Once you have administered the 6-minute walk test, the scoring should not live on a separate clipboard: score and track this measure inside your EMR. And once you are tracking one measure, it is worth seeing it alongside the rest of your caseload: track this across your whole caseload.
Contraindications to the 6-minute walk test
The 2014 ERS/ATS standard lists the following absolute and relative contraindications. Relative contraindications call for clinical judgment and, often, physician approval before testing.
| Type | Conditions |
|---|---|
| Absolute | Acute myocardial infarction (3–5 days); unstable angina; uncontrolled arrhythmias causing symptoms or hemodynamic compromise; syncope; active endocarditis; acute myocarditis or pericarditis; symptomatic severe aortic stenosis; uncontrolled heart failure; acute pulmonary embolus or infarction; thrombosis of lower extremities; suspected dissecting aneurysm; uncontrolled asthma; pulmonary edema; room-air SpO2 at rest ≤ 85%; acute respiratory failure; acute non-cardiopulmonary disorder that may affect exercise performance or be aggravated by it; mental impairment leading to inability to cooperate |
| Relative | Left main coronary stenosis or equivalent; moderate stenotic valvular heart disease; severe untreated arterial hypertension at rest (≥ 200 mmHg systolic or ≥ 120 mmHg diastolic); tachyarrhythmias or bradyarrhythmias; high-degree atrioventricular block; hypertrophic cardiomyopathy; significant pulmonary hypertension; advanced or complicated pregnancy; electrolyte abnormalities; orthopedic impairment that prevents walking |
Older protocols (ATS 2002) used a resting heart rate above 120 beats per minute, systolic pressure above 180 mmHg and diastolic pressure above 100 mmHg as relative cut-offs. Follow your facility's protocol and document the criteria you applied.
How to interpret 6MWT results
- Distance versus predicted: compare the distance with the predicted value and the lower limit of normal. A distance below the LLN (predicted minus 153 m in men or 139 m in women with the Enright equations) is below the normal range.
- Oxygen saturation: record SpO2 at rest and at the end of the test, and stop for SpO2 below 80%.
- Symptoms: compare the Borg dyspnea and fatigue ratings before and after the test, and note heart rate recovery.
- Change over time: use the same course, the same encouragement and, for comparisons, the best of two tests. Judge change against the MCID and MDC for the population (tables below).
| Population | Threshold | Source |
|---|---|---|
| Pulmonary arterial hypertension (ESC/ERS risk strata) | Low risk above 440 m; intermediate 165–440 m; high risk below 165 m | ESC/ERS pulmonary hypertension guidelines, 2022 |
| COPD (BODE index points) | ≥ 350 m = 0 points; 250–349 m = 1; 150–249 m = 2; ≤ 149 m = 3 | Celli et al., N Engl J Med, 2004 |
| COPD | Distances below 200 m are associated with higher risk of hospitalization and mortality | Casanova et al., 2007, reported by the Shirley Ryan AbilityLab database |
| Subacute stroke (ambulation categories) | Household 100–135 m; most limited community 135–225 m; least limited community 225–312 m; unlimited community ≥ 312 m | Fulk et al., 2017 (n = 441) |
| Subacute stroke (walking independence) | 304 m (sensitivity 83.3%, specificity 90%) | Kubo et al., 2020 (n = 110) |
| Chronic stroke (fall risk) | Below 331.65 m is associated with higher fall risk | Regan et al., 2020 (n = 66) |
Minimal clinically important difference (MCID) and minimal detectable change (MDC)
The MCID is the smallest change patients experience as beneficial; the MDC is the smallest change that exceeds measurement error. Published values differ by condition, anchor and method. The ERS/ATS technical standard concluded that the MID for adults with chronic respiratory disease is about 30 m, and lies between 25 and 33 m.
| Population | MCID | Source |
|---|---|---|
| Chronic respiratory disease (COPD, ILD, PAH pooled) | 30 m (range 25–33 m) | ERS/ATS technical standard, 2014 |
| COPD | 54 m | Rasekaba et al., 2009 |
| Idiopathic pulmonary fibrosis | 24–45 m | du Bois et al., 2011 |
| Heart failure with reduced EF and iron deficiency | 14–15 m for "little improvement"; 20–24 m for moderate improvement | Khan et al., J Card Fail, 2023 (n = 760) |
| Older adults and stroke (geriatric sample) | 50 m | Perera et al., 2006 |
| Subacute stroke | 34.4 m (n = 22); 71 m or 65 m depending on anchor (n = 265) | Tang et al., 2012; Fulk and He, 2018 |
| Multiple sclerosis | 19.7 m improvement; 7.2 m deterioration | Oosterveer et al., 2022 (n = 118) |
| Population | MDC | Source |
|---|---|---|
| COPD | 54 m | Redelmeier et al., 1997 (n = 112) |
| Older adults | 58.21 m | Perera et al., 2006 (n = 100) |
| Osteoarthritis | 61.34 m | Kennedy et al., 2005 (n = 150) |
| Parkinsonism | 82 m | Steffen and Seney, 2008 (n = 37) |
| Alzheimer's disease | 33.47 m | Ries et al., 2009 |
| Chronic stroke | 34.37–60.98 m | Eng et al., 2004; Flansbjer et al., 2005 |
| Spinal cord injury | 45.8 m | Lam et al., 2008 |
Practical use: treat 30 m as a reasonable starting threshold for respiratory patients, use the larger condition-specific MDC when you need to be confident that a change is real, and pair the distance with a patient-rated anchor such as the Global Rating of Change scale.
Limitations and the learning effect
- Learning effect: pooled data from 13 COPD studies show a mean improvement of 26.3 m on the second 6MWT, which is why the ERS/ATS standard calls for two tests when measuring change and for using the best distance.
- Effort and encouragement: the test is submaximal and depends on the patient's effort, so standardize the script, the tone and the course.
- Course length: shorter corridors mean more turns and shorter distances, so keep the same course for repeat tests.
- Nonspecific: a low distance does not identify which system is limiting, so combine it with vitals, symptoms and other tests.
- Reference values: predictions differ between equations and populations, so state the equation used.
For related gait and balance measures, see the 10-Meter Walk Test, the gait speed calculator, the 30-Second Sit-to-Stand test, the Berg Balance Scale and the fall risk assessment.
Valores normales de la prueba de marcha de 6 minutos (resumen en español)
La prueba de marcha de 6 minutos (PM6M) mide la distancia que un paciente camina en 6 minutos en un pasillo plano de 30 m o más. En adultos sanos de 20 a 59 años, McKay et al. (2017) encontraron una media de 736 m en hombres y 674 m en mujeres, y de 599 m y 550 m a partir de los 60 años. Las ecuaciones de Enright y Sherrill calculan la distancia predicha: hombres = (7,57 × talla en cm) − (5,02 × edad) − (1,76 × peso en kg) − 309; mujeres = (2,11 × talla en cm) − (2,29 × peso en kg) − (5,78 × edad) + 667. El límite inferior de la normalidad es la distancia predicha menos 153 m en hombres y menos 139 m en mujeres. La diferencia mínima importante es de unos 30 m (25 a 33 m) en enfermedad respiratoria crónica. Use la calculadora de esta página.
Valores normais do teste de caminhada de 6 minutos (resumo em português)
O teste de caminhada de 6 minutos (TC6) mede a distância percorrida em 6 minutos em um corredor plano de 30 m ou mais. Em adultos saudáveis de 20 a 59 anos, McKay et al. (2017) relataram média de 736 m nos homens e 674 m nas mulheres, e de 599 m e 550 m a partir dos 60 anos. A diferença mínima importante é de cerca de 30 m (25 a 33 m) em doença respiratória crônica. Use a calculadora desta página para obter a distância prevista e o limite inferior da normalidade.
Frequently asked questions
What is the 6-minute walk test used for?
The 6-minute walk test measures functional exercise capacity. It is used to assess and monitor patients with COPD, interstitial lung disease, pulmonary hypertension, heart failure and other chronic conditions, to judge response to treatment or rehabilitation, and to help estimate prognosis.
What is a normal 6-minute walk distance by age?
In a pooled healthy sample (McKay et al., 2017), adults aged 20 to 59 walked a mean of 736 m (2,415 ft) for men and 674 m (2,211 ft) for women, and adults aged 60 and older walked 599 m (1,965 ft) and 550 m (1,804 ft). Community-dwelling older adults in the Steffen study walked 572 m (men) and 538 m (women) at 60 to 69, 527 m and 471 m at 70 to 79, and 417 m and 392 m at 80 to 89.
How do you calculate the predicted 6-minute walk distance?
With the Enright and Sherrill equations. Men: (7.57 x height in cm) - (5.02 x age) - (1.76 x weight in kg) - 309. Women: (2.11 x height in cm) - (2.29 x weight in kg) - (5.78 x age) + 667. The lower limit of normal is the predicted distance minus 153 m for men or 139 m for women.
What is the MCID for the 6-minute walk test?
The ERS/ATS technical standard concluded that the minimal important difference is about 30 m, within a range of 25 to 33 m, for adults with chronic respiratory disease. Other values include 54 m in COPD, 24 to 45 m in idiopathic pulmonary fibrosis, and 14 to 24 m in heart failure with reduced ejection fraction and iron deficiency, so use the value that matches your population.
How far should you walk in 6 minutes?
There is no single target. Compare the distance with the predicted value for the patient's sex, age, height and weight, and with the lower limit of normal. Healthy adults aged 20 to 59 walk roughly 670 to 740 m on average.
Should the 6-minute walk test be done twice?
When you are measuring change over time, the ERS/ATS standard says two tests must be completed, at least 30 minutes apart and after heart rate and SpO2 have returned to baseline, and the best distance is recorded. Pooled COPD data show a mean improvement of 26.3 m on the second test.
When should you stop the 6-minute walk test?
Stop immediately for chest pain, intolerable dyspnea, leg cramps, staggering, diaphoresis, a pale or ashen appearance, or SpO2 below 80%.
Can a patient use a walker during the 6-minute walk test?
Yes. Patients should use their usual walking aid and supplemental oxygen at the usual rate, and the aid should be documented so serial tests are comparable.
Is there a free 6-minute walk test calculator?
Yes. Use the calculator at the top of this page to get the predicted 6MWD, lower limit of normal, % predicted and the change from an earlier test, in meters or feet.
Sources and further reading
- Holland AE, et al. An official ERS/ATS technical standard: field walking tests in chronic respiratory disease. Eur Respir J, 2014;44:1428-1446
- StatPearls: 6-Minute Walk Test (NCBI Bookshelf)
- Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med, 1998;158:1384-1387
- Shirley Ryan AbilityLab Rehabilitation Measures Database: 6 Minute Walk Test (norms, MCID, MDC)
- du Bois RM, et al. Six-minute-walk test in idiopathic pulmonary fibrosis: test validation and minimal clinically important difference. Am J Respir Crit Care Med, 2011
- Khan A, et al. Minimal clinically important differences in 6-minute walk test in patients with HFrEF and iron deficiency. J Card Fail, 2023;29(5)
- BODE index (Celli BR, et al. N Engl J Med, 2004;350:1005-1012)
This page is educational and does not replace clinical judgment. Always interpret test results alongside the patient's history, examination and goals.
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