The 6-Minute Push Test (6-MPT) assesses cardiovascular fitness in people who are not ambulatory as a clinic-friendly approach. The 6-MPT is a field-based assessment of VO2 functional change, derived from the 6-MWT (Cowan et al. 2012).
Clinical Considerations
Following the American Thoracic Society’s 6MWT guidelines and instructions (Cowan et al. 2012), it involves the individual pushing a manual wheelchair over a flat surface, as far and hard as they can in 6 min (van der Westhuizen et al. 2017).
ICF Domain
Body Function ▶ Functions & Structures of the Cardiovascular, Haematological, Immunological and Respiratory Systems
Administration
- Clinician-administered.
- The 6-MPT is a self-paced test where participants may slow down and take breaks to rest as needed and resume propelling for whatever time remains.
Length
6 minutes
Equipment
- Stopwatch.
- Marking tape for set a fixed distance (30 m is recommended).
Scoring
- The assessor will count the number of laps completed to calculate the total distance covered in 6 minutes.
- Clinicians should record the heart rate before and after the VO2max.
Languages
N/A
Training Required
None.
Availability
Measurement Property Summary
# of studies reporting psychometric properties: 5
Interpretability
MCID: not established in SCI
SEM:
- Heart rate = 8.5 bpm
- Total distance = 21.9 m
- 6 min of work = 1.41 kg/km
MDC:
- Heart rate = 23.5 bpm
- Total distance = 60.7 m
- 6 min of work = 7.45 kg/km
(Damen et al. 2020; n=53 youth with spina bifida; 32 males, 11 females; mean age 13.7 years; injury level: 11 thoracic, 4 lumbar, 1 sacral)
Typical Values
Mean Distance (meters):
- Tetraplegia: 380.86
- Paraplegia: 692.92
(Van der Westhuizen, 2017; N = 60; mean age = 38.4 years; 81.66% of sample classified as ASIA A [complete injury])
Reliability – High
- High Test-retest Reliability:
- Peak Heart Rate: ICC = 0.81
- Total distance: ICC = 0.95
- 6 minutes of work: ICC = 0.97
(Damen et al. 2020; n=53 youth with spina bifida; 32 males, 11 females; mean age 13.7 years; injury level: 11 thoracic, 4 lumbar, 1 sacral)
- High Reliability:
- Whole sample: ICC = 0.97 (95% CI, 0.94–0.98)
- Participants with tetraplegia: ICC = 0.93 (95% CI, 0.80–0.98)
- Participants with paraplegia: ICC = 0.97 (95% CI, 0.93–0.99).
(Cowan et al. 2012; n=40; mean age 34 years; 63% paraplegia, 37% tetraplegia)
Validity – High
- High correlation with VO2peak: r = 0.58
- High correlation with respiratory exchange ratio: r = 0.70
- High correlation with peak exercise time: r = 0.70
- High correlation with peak workload: r = 0.66
(Baattaiah et al. 2017; n=15, mean age 34.5 years; 12 paraplegia, 3 tetraplegia; ASIA A-D)
- High correlation with RNLI: r = 0.637
(van der Westhuizen et al. 2017; n=60; 50 males, 10 females; mean age 38.4 years, ASIA A-D; 39 paraplegia, 21 tetraplegia)
- High correlation with heart rate recovery: r = 0.87
(Solanki et al. 2016; n=47; 38 males, 9 females; mean age 38.4 years; 35 paraplegia, 12 tetraplegia)
Responsiveness
No values were reported for the responsiveness of the 6-MPT for the SCI population.
Floor/Ceiling Effect
No values were reported for the presence of floor/ceiling effects in the 6-MPT for the SCI population.
Reviewers
Dr. Janice Eng, Dr. Carlos L. Cano-Herrera, Matthew Querée
Date Last Updated
31 December 2024
Baattaiah Baian A; Murray D; Cowan RE; Groah SL; Liungberg IH; Rounds AK; Guccione AA; Keyser RE. FACSM. Association of Six Minute Push Test Distance and Measures of Cardiorespiratory Fitness in Spinal Cord Injury. Medicine & Science in Sports & Exercise. 2017; 49: 409. DOI: 10.1249/01.mss.0000518002.99303.73
https://journals.lww.com/acsm-msse/fulltext/2017/05001/association_of_six_minute_push_test_distance_and.1197.aspx
Cowan RE, Callahan MK, Nash S. The 6-min Push Test Is Reliable and Predicts Low Fitness in Spinal Cord Injury. Medicine & Science in Sports & Exercise. 2012. DOI: 10.1249/MSS.0b013e31825cb3b6
https://journals.lww.com/acsm-msse/fulltext/2012/10000/the_6_min_push_test_is_reliable_and_predicts_low.21.aspx
Damen KMS, Takken T, de Groot JF, Backx FJG, Radder B, Roos ICPM, Bloemen MAT. 6-Minute Push Test in Youth Who Have Spina Bifida and Who Self-Propel a Wheelchair: Reliability and Physiologic Response. Phys Ther. 2020; 100: 1852-1861. doi: 10.1093/ptj/pzaa121.
https://pubmed.ncbi.nlm.nih.gov/32671398/
Solanki R, Chaudhari P, Bhise A. Cardio Respiratory Fitness Testing in Spinal Cord Injury Patients Using 6 Minute Push Test. Healthline Journal. 2016. 7.
https://www.healthlinejournal.org/index_pdf/204.pdf
van der Westhuizen L, Mothabeng DJ, Nkwenika TM. The relationship between physical fitness and community participation in people with spinal cord injury. South African Journal of Physiotherapy. 2017. 73 (1)
https://sajp.co.za/index.php/sajp/article/view/354
