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2 Minute Walk Test
Availability
Please visit this website for more information about the instrument: 2 Minute Walk Test
Classification
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure of walking endurance.
 
Supplemental - Highly Recommended: Spinal Cord Injury (SCI)
Recommendations for Use: Indicated for studies targeted at walking function where the intended population is more severely impaired and may be unable to walk 6 minutes.
 
Supplemental: Myotonic Dystrophy (DM)
 
Exploratory: Congenital Muscular Dystrophy (CMD), Facioscapulohumeral Muscular Dystrophy (FSHD), Mitochondrial Disease (Mito) and SCI-Pediatric (age 4-18)
Short Description of Instrument
The Two Minute Walk Test (2MWT) was designed to measure the distance an individual can walk without assistance during a two-minute period. The individual is instructed to walk the maximum distance possible in the 2 minutes provided, while being allowed to rest if needed. Individuals who are unable to walk without assistance should not be allowed to attempt this test. It measures the constructs of Aerobic Capacity, Functional Mobility and Gait.
Comments/Special Instructions
SCI-Pediatric-specific: Assistive devices can be used but should be kept consistent and documented.
 
NeuroRehab Specific: Measurement of walking endurance is a critical aspect of understanding a person's overall walking capacity. A performance-based measure is most suited to understanding capacity. The ideal measure would require limited equipment and be applicable across multiple populations.
 
Both the 2MWT and the Six Minute Walk Test (6MWT) are used as measures of functional capacity, but the briefer duration of the 2MWT may be less burdensome in busy settings when many people may need to be tested or many tests performed, or when attention span limits participation in prolonged activities (e.g., very young children or those with cognitive challenges), or for those with greater walking limitations (e.g., advanced multiple sclerosis). In contrast, when trying to discriminate subtle differences in walking ability amongst those with greater walking capacity, the 2MWT may be limited by a floor effect compared to the 6MWT.
 
Not needed for conditions with only upper limb impairment.
Scoring and Psychometric Properties
Scoring: Scoring is completed by recording the distance covered during the two-minute period.
Psychometric Properties:
    • Reliability:
        • Several studies have shown that the 2MWT is consistently reproducible (Butland et al., 1982; Selman et al., 2014; Leung et al., 2006;Bohannon et al., 2015)
    • Validity:
        • Construct validity:
            • The 2MWT has been shown to be strongly correlated with the 6MWT across multiple populations, such as Multiple Sclerosis and pulmonary disease.(Leung et al., 2006; Karle et al., 2020; Connelly et al., 2009)
            • Witherspoon et al. (2019) conducted a study in paediatric population with neuromuscular disorders and showed that the 2MWT had strong correlations with the 32-item Motor Function Measure (MFM32) (Trundell et al., 2020) as well as it can be used with 6MWT. (Witherspoon et al., 2019)
        • Concurrent validity:
            • Along with the Berg Balance Test, Timed Up and Go and 6MWT, the 2MWT has been shown to produce consistent results when tested in the same patients at the same time. (Connelly et al., 2009)
    • Responsiveness:
        • Sensitivity to change was shown in studies by Leung et al. (2006), Johnston et al. (2017) and Brooks et al. (2004)
Rationale/Justification
Strengths: The 2MWT may be preferred over the 6-Minute Walk Test (6MWT) because of its use in the aged population and in individuals with lower extremity amputations, cystic fibrosis, traumatic brain injury, and neurological disorders as a measure of endurance (Witherspoon et al., 2019). The 2MWT can assess a patient's walking speed and it correlates well with the 6-minute walk test (6MWT) (Kosak & Smith, 2005; Witherspoon et al., 2019).
 
Weaknesses: Individuals must be able to ambulate without physical assistance.
References
Key References:
Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed). 1982; 284(6329): 1607-8.
 
Two Minute Walk Test. Accessed 03 October 2023 from: https://www.physio-pedia.com/2_Minute_Walk_Test..
 
Additional Reference(s):
Bohannon RW, Bubela D, Magasi S, McCreath H, Wang YC, Reuben D, Rymer WZ, Gershon R. Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six-Minute Walk Test. BMC Res Notes. 2014 Apr 25;7:269.
 
Bohannon RW, Wang YC, Gershon RC. Two-minute walk test performance by adults 18 to 85 years: normative values, reliability, and responsiveness. Arch Phys Med Rehabil. 2015 Mar;96(3):472-7.
 
Brooks D, Davis AM, Naglie G. The feasibility of six-minute and two-minute walk tests in in-patient geriatric rehabilitation. Can J Aging. 2007 Summer;26(2):159-162.
 
Brooks D, Davis AM, Naglie G. Validity of 3 physical performance measures in inpatient geriatric rehabilitation. Arch Phys Med Rehabil. 2006;87(1):105-110.
 
Brooks D, Parsons J, Tran D, Jeng B, Gorczyca B, Newton J, Lo V, Dear C, Silaj E, Hawn T. The two-minute walk test as a measure of functional capacity in cardiac surgery patients. Arch Phys Med Rehabil. 2004 Sep;85(9):1525-1530.
 
Brooks D, Hunter JP, Parsons J, Livsey E, Quirt J, Devlin M. Reliability of the two-minute walk test in individuals with transtibial amputation. Arch Phys Med Rehabil. 2002;83(11):1562-1565.
 
Brooks D, Parsons J, Hunter JP, Devlin M, Walker J. The 2-minute walk test as a measure of functional improvement in persons with lower limb amputation. Arch Phys Med Rehabil. 2001;82(10):1478-1483.
 
Canning CG, Ada L, Johnson JJ, McWhirter S. Walking capacity in mild to moderate Parkinson's disease. Arch Phys Med Rehabil. 2006;87(3):371-375.
 
Connelly DM, Thomas BK, Cliffe SJ, Perry WM, Smith RE. Clinical utility of the 2-minute walk test for older adults living in long-term care. Physiother Can. 2009 Spring;61(2):78-87.
Ellis T, Katz DI, White DK, DePiero TJ, Hohler AD, Saint-Hilaire M. Effectiveness of an inpatient multidisciplinary rehabilitation program for people with Parkinson disease. Phys Ther. 2008;88(7):812-819.
 
Gijbels D, Dalgas U, Romberg A, de Groot V, Bethoux F, Vaney C, Gebara B, Medina CS, Maamâgi H, Rasova K, de Noordhout BM, Knuts K, Feys P. Which walking capacity tests to use in multiple sclerosis? A multicentre study providing the basis for a core set. Mult Scler. 2012;18(3):364-371.
 
Gijbels D, Eijnde BO, Feys P. Comparison of the 2- and 6-minute walk test in multiple sclerosis. Mult Scler. 2011;17(10):1269-1272.
 
Gijbels D, Alders G, Van Hoof E, Charlier C, Roelants M, Broekmans T, Eijnde BO, Feys P. Predicting habitual walking performance in multiple sclerosis: relevance of capacity and self-report measures. Mult Scler. 2010;16(5):618-626.
 
Hiengkaew V, Jitaree K, Chaiyawat P. Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Arch Phys Med Rehabil. 2012;93(7):1201-1208.
 
Johnston KN, Potter AJ, Phillips AC. Minimal important difference and responsiveness of 2-minute walk test performance in people with COPD undergoing pulmonary rehabilitation. Int J Chron Obstruct Pulmon Dis. 2017 Oct 9;12:2849-2857.
 
Karle V, Hartung V, Ivanovska K, Mäurer M, Flachenecker P, Pfeifer K, Tallner A. The Two-Minute Walk Test in Persons with Multiple Sclerosis: Correlations of Cadence with Free-Living Walking Do Not Support Ecological Validity. Int J Environ Res Public Health. 2020 Dec 4;17(23):9044.
 
Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev. 2005;42(1):103-107.
 
Lemay JF, Nadeau S. Standing balance assessment in ASIA D paraplegic and tetraplegic participants: concurrent validity of the Berg Balance Scale. Spinal Cord. 2010;48(3):245-250.
 
Leung AS, Chan KK, Sykes K, Chan KS. Reliability, validity, and responsiveness of a 2-min walk test to assess exercise capacity of COPD patients. Chest. 2006 Jul;130(1):119-25.
 
Light KE & Bebrman AL. The 2-minute walk test: a tool for evaluating walking endurance in clients with Parkinson's disease. J Neurol Phys Ther. 1997;21(4):136-139.
 
Merlini L, Bertini E, Minetti C, Mongini T, Morandi L, Angelini C, Vita G. Motor function-muscle strength relationship in spinal muscular atrophy. Muscle Nerve. 2004;29(4):548-552.
 
Miller PA, Moreland J, Stevenson TJ. Measurement properties of a standardized version of the two-minute walk test for individuals with neurological dysfunction. Physiother Can. 2005;54(4):241-248.
 
Personius KE, Pandya S, King WM, Tawil R, McDermott MP. Facioscapulohumeral dystrophy natural history study: standardization of testing procedures and reliability of measurements. The FSH DY Group. Phys Ther. 1994;74(3):253-263.
 
Resnik L, Borgia M. Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error. Phys Ther. 2011;91(4):555-565.
 
Reuben DB, Magasi S, McCreath HE, Bohannon RW, Wang YC, Bubela DJ, Rymer WZ, Beaumont J, Rine RM, Lai JS, Gershon RC. Motor assessment using the NIH Toolbox. Neurology. 2013;80(11 Suppl 3):S65-S75.
 
Rossier P, Wade DT. Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment. Arch Phys Med Rehabil. 2001;82(1):9-13.
 
Salavati M, Mazaheri M, Khosrozadeh F, Mousavi SM, Negahban H, Shojaei H. The Persian version of locomotor capabilities index: translation, reliability and validity in individuals with lower limb amputation. Qual Life Res. 2011;20(1):1-7.
 
Scalzitti DI, Harwood KJ, Maring JR, Leach SJ, Ruckert EA, Costello E. Validation of the 2-Minute Walk Test with the 6-Minute Walk Test and other functional measures in persons with multiple sclerosis. Int J MS Care. 2018;20(4):158-163.
 
Schenkman M, Ellis T, Christiansen C, Barón AE, Tickle-Degnen L, Hall DA, Wagenaar R. Profile of functional limitations and task performance among people with early- and middle-stage Parkinson disease. Phys Ther. 2011;91(9):1339-1354.
 
Selman JP, de Camargo AA, Santos J, Lanza FC, Dal Corso S. Reference equation for the 2-minute walk test in adults and the elderly. Respir Care. 2014 Apr;59(4):525-30.
 
Stewart DA, Burns JMA, Dunn SG, Roberts MA. The two-minute walking test: a sensitive index of mobility in the rehabilitation of elderly patients. Clin Rehabil. 1990; 4(4):273-276.
 
Trundell D, Le Scouiller S, Gorni K, Seabrook T, Vuillerot C; SMA MFM Study Group. Validity and Reliability of the 32-Item Motor Function Measure in 2- to 5-Year-Olds with Neuromuscular Disorders and 2- to 25-Year-Olds with Spinal Muscular Atrophy. Neurol Ther. 2020 Dec;9(2):575-584.
 
White DK, Wagenaar RC, Ellis TD, Tickle-Degnen L. Changes in walking activity and endurance following rehabilitation for people with Parkinson disease. Arch Phys Med Rehabil. 2009;90(1):43-50.
 
Witherspoon JW, Vasavada R, Logaraj RH, Waite M, Collins J, Shieh C, Meilleur K, Bönnemann C, Jain M. Two-minute versus 6-minute walk distances during 6-minute walk test in neuromuscular disease: Is the 2-minute walk test an effective alternative to a 6-minute walk test? Eur J Paediatr Neurol. 2019 Jan;23(1):165-170.
 
NeuroRehab Specific Reference:
Moore JL, Potter K, Blankshain K, Kaplan S, O'Dwyer LC, Sullivan JE. A Core Set of Outcome Measures for Adults with Neurologic Conditions Undergoing Rehabilitation, Journal of Neurologic Physical Therapy: July 2018;42(3):174-220.
 
Document last updated October 2024