2 Minute Walk Test

Question 1

Objective

Answer 1

• Measure of self-paced walking ability and functional capacity, particularly for those who cannot manage the 6 minute walk test or 12 minute walk test.

Question 2

Intended Population

Answer 2

• Has been an outcome measure for patients with a variety of conditions and in multiple populations including,
• Functionally restrictive conditions such as cystic fibrosis
• Lower limb amputation
• Paediatric neuromuscular disorders
• Adult neuromuscular disease such as multiple sclerosis
• Cardiac diseases
• Pulmonary diseases such as COPD
• Elderly, including those in long term care.
• General paediatrics.

Question 3

General Information

Answer 3

• Person is encouraged to walk as fast as they can, safely, without assistance for two minutes and the distance is measured.
• Start timing when the individual is instructed to ‘go’.
• Stop timing at 2 minutes.
• Assistive devices can be used but should be kept consistent and documented from test to test.
• If physical assistance is required to walk, the test should not be performed.
• Measuring wheel is helpful to determine distance walked.
• Person should walk at the fastest speed possible.
• Rest breaks are allowed if needed.

Question 4

Equipment

Answer 4

• A clear ‘out and back’ course such as a hallway with cones or similar to mark an approximately 15m.
• Stopwatch
• Pen and paper to record distance walked.

Question 5

Instructions and Guidelines

Answer 5

• Before starting the test, observer gives initial instructions:
• “Cover as much ground as possible over 2 minutes. Walk continuously if possible, but do not be concerned if you need to slow down or stop to rest. The goal is to feel at the end of the test that more ground could not have been covered in the 2 minutes”.
• The observer provides encouragement after the first minute of the person walking.
• The 2MWT requires two practice walks before it is measured due to a training effect.

Question 6

Psychometric Properties

Answer 6

• Reliability – 2MWT is consistently reproducible.
• Construct Validity – strongly correlated with the 6MWT across multiple populations (MS, Pulmonary Disease, and older adults). In a paediatric population with neuromuscular disorders showed that the 2MWT had strong correlations with Motor Function Measure-32 and timed function tests and can be used interchangeably with the 6MWT.
• Concurrent Validity – shown to produce results consistent with those of the Berg Balance Scale, Timed up and Go, and 6MWT when tested in the same patients at the same time.
• Responsiveness – one study showed minimum detectable change for distance walked in 2MWT was 42.5m in adults 18-85 years. In subjects with COPD undergoing pulmonary rehabilitation, a clinically meaningful change of 5.5m in distance walked has been reported. A study of subjects post coronary artery bypass grafts demonstrated that the 2MWT was sensitive to change but could not discriminate between those who developed cardiac or respiratory complications and those who did not.

Question 7

Normative Data

Answer 7

• Many factors can influence the distance that a participant is able to walk for the 2MWT. A strong inverse relationship has been found in adults between a participant’s age and the distance they are able to walk. Generally, as a participant gets older, the distance they walk decreases. Across all ages, males tend to walk farther than females. Participants height, weight, age, and gender were all predictive of distance walked. It was further determined that BMI was a better predictor of distance walked than height or weight alone.

Question 8

Clinical Significance of 2MWT

Answer 8

• Valuable tool for tracking progress and tailoring interventions.
• It brevity makes it suitable for patients with limited endurance or significant fatigue.
• It can help assess recovery trajectories in conditions such as post-stroke rehabilitation, post-surgical recovery, or chronic illness.
• The 2MWT provides clinicians with an objective measure to evaluate the effectiveness of interventions, set functional goals, and motivate patients through tangible progress tracking.

Question 9

Paediatric Population

Answer 9

• Shorter duration, objective, easily administered, and provides a standardised evaluation of functional capacity in populations with reduced ambulatory capability in adults with neuromuscular disease. This format of the test helps in neurologically affected children with behavioural problems, limited ambulatory capacity, lower muscular strength, and increased fatigue levels, and lower cognition levels to test their functional capacity.
• It is an easy-to-implement measure to establish a baseline level of impairment, monitor disease progression, and evaluate the effectiveness of current therapeutic interventions in children with significant illness.

Question 10

Adult Population

Answer 10

• It can be used in the aged population, individuals with lower extremity amputations, cystic fibrosis, traumatic brain injury, and neurological disorders as a measure of endurance.
• It can be used as a measure of gait speed, and aerobic capacity in patients who are unable to complete 6MWT.