6 MWT

I am currently on my cardio placement. This week, I had the chance to perform a 6MWT on a patient for the first time. The patient was an 80 y/o male, who was admitted due to an exacerbation of his COPD.

I read up on the 6MWT and came well prepared. After discussion with my supervisor, I was ready to go! The patient was ambulating independently, and was breathing on room air. So, the equipment I needed was an oximeter, chairs stationed along the corridor, a stop watch, a pen and the 6MWT recording sheet.

As with any first time attempts, there is bound to be some hiccups along the way. Which was true in this case.

First, the usual corridor used for the 6MWT could not be utilized. The reason being, that the distance markers were removed, as the walls were painted in the morning. So, I was allowed to use the main corridor on the ward, which has a lot of traffic.

After going through the standard instructions, the test began. I did the usual measurements (heart rate, SpO2, dyspnoea), and the patient commenced walking. During the first few minutes, the patient became distracted by the surroundings/people. Once, he stopped a few meters prior to the end of the corridor, turned around and walked back. The patient then told me that he did not want to go to the end of the corridor as the consultant was there talking to another doctor. The patient felt that he might get me into trouble with the consultant, if we were to walk to where the consultant was standing. At that time, I was puzzled as to why the patient did that, as I was focused on performing the 6 MWT well. I then reminded the pt that he was doing a test, and needed to walk to the end of the corridor, which he did after some prompting.

In addition, the patient and I also had to dodge other patients, staff and family members walking along the corridor. Towards the end of the test, a bed was pushed down the corridor. As such, we had to move out of the way so the bed could pass. The patient took a seat on the chair nearby, while the bed passed by. Throughout the 6MWT, I felt that it was difficult to handle the extra traffic, while trying to cope with giving instructions to the patient at the appropriate times, reading off the oximeter, looking at the stop watch and writing notes.

Due to the above described incidents, it made the results of the test unreliable. The results did not show the true measure of the distance the patient could have covered.

On reflection, I realized that I should have done the 6MWT in a quiet corridor, as suggested in uni! Or could have done the 6MWT at a quieter time, eg: at the start of the day. Additionally, a clear explanation should be provided to the patient prior to commencing the test. Emphasize should be placed on the fact that the 6MWT is a test of the distance he could cover in 6 minutes (therefore, he has to try his best), and to stop only when a rest in required. I have definitely learnt a lot from this experience and will apply it onto the next 6MWT I perform either on this patient or other patients.