Six-Minute Arm Test (6-MAT)

Download Clinical Summary PDF

Tool Description

  • Assesses cardiovascular fitness in people with SCI
  • Involves 6 minutes of sub-maximal arm ergometry at a constant power output. This single stage test is simple and quick to administer clinically.

ICF Domain:

Body Function – Subcategory: Functions & Structures of the Cardiovascular, Haematological, Immunological and Respiratory Systems

Number of Items:


Brief Instructions for Administration & Scoring


  • Clinician-administered
  • Clinicians can determine the appropriate power output through use of published guidelines.
  • Baseline outcome variables of heart rate and ratings of perceived exertion are determined by recording the client’s exercising heart rate during the final 30 seconds of the test, and recording their RPE (Borg’s rating of perceived exertion) at the end of the test.
  • Should be re-administered at the same PO for follow up tests, including those to assess changes resulting from cardiovascular fitness interventions.
  • Takes 6 minutes to administer.


  • Arm ergometer
  • Heart rate monitor
  • RPE scale


  • scores over several administrations are compared to assess changes resulting from cardiovascular fitness interventions.


MCID: not established in SCI
SEM: Heart rate SEM = 7.12 beats/min (95% CI, during 6-MAT) (Hol et al. 2007)
VO2 SEM = 1.62 mL/kg/min (95% CI, during 6-MAT) (Hol et al. 2007)
MDC: Heart rate MDC = 19.74 beats/min
VO2 MDC = 4.49 mL/kg/min

  • Normative data not established for SCI population
  • Published data is available for comparison for the SCI population (see the Interpretability section of the Study Details sheet).
  • Used after a fitness intervention or as a follow up measure, 6-MAT results can determine changes in fitness level.
  • Decrease in heart rate and/or RPE may indicate an increase in cardiovascular fitness, whereas an increase in heart rate and/or RPE may indicate a decrease in cardiovascular fitness.



Training Required:



See the 'how-to' page of this tool.

Clinical Considerations

  • The 6-MAT is a practical, easy to complete test that can be administered to all fitness levels.
  • The test was designed specifically for individuals with SCI.

Measurement Property Summary

# of studies reporting psychometric properties: 2


  • The 6-MAT was performed twice, 1 week apart. Test-retest reliability was high for both heart rate (ICC=0.90) and VO2 (ICC=0.81).

[Hol et al. 2007]


  • High correlation between VO2 peak and:
    • 6-MAT VO2 (r=0.92),
    • 6-MAT power output (r=0.73)
    • 6-MAT heart rate (r=0.63).

[Hol et al. 2007, Totosy de Zepetnek et al. 2016]

No values were reported for the responsiveness of the 6-MAT for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the 6MAT for the SCI population.


Dr. Janice Eng, Marzena Zhou, Joanne Chi

Date Last Updated:

July. 7, 2019

Download the measure

Download Worksheet:

Worksheet Document

Heart rate measurements are continually recorded throughout the study.  Blood pressure should be measured before and after the test.

Before the study commences, ask your subjects to empty their bladders to minimize any episodes of autonomic dysreflexia.

Subjects are asked to complete a single, 6-minute stage of submaximal exercise on a standard arm cycle ergometer. The power output (PO) is selected for each individual based on their manual muscle strength, ASIA motor score and physical activity level (see table below). The aim is to attain a steady heart rate of 60%-70% of age-predicted maximum heart rate or a rating of 11-15 on the Borg RPE scale.


PO selection:

For subjects with tetraplegia:

Set PO to 10W if: Power wheelchair user OR ≤ grade 4 wrist extension
Set PO to 15W if: Manual wheelchair user
Set PO to 20W if: Manual wheelchair user AND grade 5 wrist extension AND physically active (engaged in physical activity at least 3 times a week as measured by PASIPD)

For subjects with paraplegia:

Set PO to 30W if: female – inactive
Set PO to 40W if: female – active OR male – inactive
Set PO to 50W if: female – competitive athlete OR male: active
Set PO to 60W if: male – competitive athlete

An increase of 5 W/min for individuals with tetraplegia and 10 W/min for paraplegia are provided.  The final steady-state heart rate is averaged over the last 30 sec of the 6 minute test.





Equipment Needed


Totosy de Zepetnek JO, Au JS, Hol AT, Eng JJ, MacDonald MJ. Predicting peak oxygen uptake from submaximal exercise after spinal cord injury. Appl Physiol Nutr Metab. 2016; 41(7):775-781.

Hol AT, Eng JJ, Miller WC, Sproule S, Krassioukov AV. Reliability and Validity of the Six-Minute Arm Test for the Evaluation of Cardiovascular Fitness in People With Spinal Cord Injury. Arch Phys Med Rehabil 2007; 88:489-95.