Related Experiment Video
Updated: Mar 10, 2026
Author Spotlight: Developing Low-Tech Balance Assessment Methods for Broad-Spectrum Healthcare Applications
Published on: September 1, 2023
Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review
Lucas de Assis Pereira Cacau1,2,3, Valter Joviniano de Santana-Filho1,2, Luana G Maynard1,3
1Departamento de Fisioterapia e Pós-Graduação em Ciências da Saúde da Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil.
Insights
This systematic review compared six-minute walk test reference values and equations in children and adolescents. Reference values varied significantly, highlighting the need for country-specific data for accurate clinical interpretation.
Area of Science:
- Pediatric Exercise Physiology
- Clinical Biomechanics
Background:
- The six-minute walk test (6MWT) is a common functional assessment in children and adolescents.
- Standardized reference values and predictive equations are crucial for accurate interpretation of 6MWT results in pediatric populations.
- Existing literature shows variability in 6MWT reference values across different studies and countries.
Purpose of the Study:
- To systematically review and compare available reference values and predictive equations for the six-minute walk test in healthy children and adolescents.
- To identify gaps in the literature regarding 6MWT standardization in pediatric populations.
Main Methods:
- A systematic review was conducted following PRISMA guidelines.
- Searches were performed in multiple databases (PubMed, EMBASE, Cochrane, LILACS, etc.) up to June 2015.
- Twelve studies meeting inclusion criteria were analyzed for reference values and equations for the 6MWT in healthy children/adolescents.
Main Results:
- Twelve studies were included, with 7 reporting descriptive data and 6 providing reference equations for the 6MWT distance.
- Significant variation in 6MWT reference values was observed across different countries and studies.
- Most included studies followed American Thoracic Society guidelines, but none reported sample size calculations.
Conclusions:
- Substantial variability exists in six-minute walk test reference values for children and adolescents globally.
- While available equations consider key variables like height, age, and weight, not all studies provide them.
- Encouraging the establishment of country-specific 6MWT reference values is essential for precise clinical interpretation and research in pediatrics.
Objective:
The aim of the study is to compare the available reference values and the six-minute walk test equations in healthy children/adolescents. Our systematic review was planned and performed in accordance with the PRISMA guidelines. We included all studies that established reference values for the six-minute walk test in healthy children/adolescents.
Methods:
To perform this review, a research was performed in PubMed, EMBASE (via SCOPUS) and Cochrane (LILACS), Bibliographic Index Spanish in Health Sciences, Organization Collection Pan-American Health Organization, Publications of the World Health Organization and Scientific Electronic Library Online (SciELO) via Virtual Health Library until June 2015 without language restriction.
Results:
The initial research identified 276 abstracts. Twelve studies met the inclusion criteria and were fully reviewed and approved by both reviewers. None of the selected studies presented sample size calculation. Most of the studies recruited children and adolescents from school. Six studies reported the use of random samples. Most studies used a corridor of 30 meters. All studies followed the American Thoracic Society guidelines to perform the six-minute walk test. The walked distance ranged 159 meters among the studies. Of the 12 included studies, 7 (58%) reported descriptive data and 6 (50%) established reference equation for the walked distance in the six-minute walk test.
Conclusion:
The reference value for the six-minute walk test in children and adolescents ranged substantially from studies in different countries. A reference equation was not provided in all studies, but the ones available took into account well established variables in the context of exercise performance, such as height, heart rate, age and weight. Countries that did not established reference values for the six-minute walk test should be encouraged to do because it would help their clinicians and researchers have a more precise interpretation of the test.
