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How Should I Use the 10 Meter Walk Test (10MWT) in a Clinical Practice?

By phos-myolyn |

The 10 Meter Walk Test (10MWT) is one of the most widely used outcome measures in neurologic rehabilitation. It is quick to administer, requires little equipment, and provides a highly meaningful measure of walking speed, which has been described as the “sixth vital sign” because of its strong relationship with function, health status, and survival in adults (Middleton et al., 2015).

In this article we will discuss:

Part I: Which Patient Populations Are Appropriate to Assess With the 10MWT?

Within neurologic physical therapy practice, the 10MWT can be used with nearly any ambulatory patient who has goals related to improving walking ability. It has been validated across many neurological populations, including:

The test measures walking speed in meters per second (m/s), which is strongly associated with functional mobility, community participation, and quality of life (Schmid et al., 2007).

Assistive devices and orthotics

Patients may use any assistive device or bracing required for safe ambulation, including walkers, canes, ankle–foot orthoses, or other orthotic supports. However, consistency is essential.

For example:

Always document the assistive device and bracing used during the test.

Providing assistance during the test

If the patient requires assistance for balance or safety, provide the minimum assistance necessary but document the highest level of assistance required during the trial.

Example:

If the patient was primarily standby assist but required minimal assist once to prevent loss of balance, the test should be documented as minimal assist.

When the 10MWT should not be used

The 10MWT is not recommended when the therapist must assist with forward propulsion, such as helping advance a hemiparetic limb.In these cases, walking speed becomes heavily influenced by the therapist’s timing and assistance, which reduces the reliability of the measure.

Part II: How to Correctly Administer the 10MWT

Standardized administration is important to ensure reliable and comparable results over time.

Establish the testing environment

Create a 10-meter walkway (32.8 ft) and mark the following points:

The middle 6 meters are timed to eliminate the effects of acceleration and deceleration.

Test administration

It is recommended to perform:

For some patients early in rehabilitation or with medical limitations, it may be appropriate to perform only the self-selected velocity trials. Record the average of the two trials and report the final value in meters per second (m/s), by dividing 6 by the time in seconds.

Timing

Start the timer when any part of the leading foot crosses the 2-meter mark and stop the timer when the leading foot crosses the 8-meter mark.

Therapist positioning

To avoid unintentionally pacing the patient:

For safety reasons, these recommendations may need modification.

If the patient is not yet ambulatory

If the patient cannot walk at evaluation but is expected to regain walking ability, it is acceptable to document a baseline gait speed of 0.0 m/s.

Patient Instructions

Self-selected velocity (SSV):

“When I say go, walk at your comfortable walking pace until I say stop.”

Fast velocity (FV):

“When I say go, walk at your fastest safe walking speed until I say stop.”

Part III: Normative Values, MDC, and MCID

Understanding normative values and meaningful change thresholds helps clinicians interpret results and write realistic goals.

Age-Matched Normative Walking Speeds

Average self-selected walking speeds for healthy adults are shown below (Bohannon & Williams Andrews, 2011).

Age
Men (speed in meters/sec)
Women (speed in meters/sec)
20s
1.358
1.341
30s
1.433
1.337
40s
1.434
1.390
50s
1.433
1.313
60s
1.339
1.241
70s
1.262
1.132
80s/90s
0.968
0.943

Interpreting Gait Speeds

Walking speed provides meaningful insight into a patient’s functional mobility.

For individuals after stroke, the following thresholds are commonly used (Perry et al., 1995):

Gait Speed
Functional Classification
<0.4m/s
Household ambulator
0.4-0.8m/s
Limited community ambulator
>0.8m/s
Community ambulator

Although developed in stroke populations, these thresholds are often applied broadly across neurological diagnoses.

Faster walking speeds have been associated with greater independence, higher community participation, and improved quality of life (Schmid et al., 2007).

Predicting Functional Outcomes Based on Walking Speed

Walking speed is more than just a measure of mobility. Research has shown that gait speed is strongly associated with important health and functional outcomes, including independence, fall risk, hospitalization, and mortality.

Because of these strong relationships, gait speed has been described as the “sixth vital sign” in adults. In a widely cited paper, Andrew Middleton, Stacey Fritz, and Mary Lusardi summarized evidence linking specific walking speed ranges with predicted functional outcomes.

A chart titled "Walking Speed" relates walking speed (in meters/second) to functional status, independence, and health risks, using labeled horizontal bars ranging from "Extremely frail" to "Community ambulator.

Table from Middleton, Fritz, & Lusardi (2015) summarizing the relationship between gait speed and functional outcomes.

Minimal Detectable Change (MDC) and Minimally Clinically Important Difference (MCID)

Both values help clinicians determine whether an intervention is producing true improvement.

Stroke

Traditional values used in clinical practice:

MDC

MCID

More recent research suggests MDC values may vary depending on baseline walking speed and provided the following MDCs based on a patient’s gait speed classification as low, moderate, or higher speed. (Hosoi et al., 2023):

Gait Speed SSV MDC FV MDC
Low (<0.4m/s) 0.05m/s 0.04m/s
Moderate (0.4-0.8m/s) 0.11m/s 0.12m/s
High (>0.8m/s) 0.21m/s 0.19m/s

This classification is helpful because individuals with very low baseline walking speeds may show meaningful progress with smaller improvements in gait speed.

Spinal Cord Injury

For individuals with spinal cord injury:

MDC (SSV)
≈ 0.06–0.105 m/s

MCID (SSV)
≈ 0.06–0.15 m/s

In individuals within the first year after injury, MDC values closer to 0.13 m/s have been reported.

There is currently limited research on fast walking speed (FV) changes in SCI.

Multiple Sclerosis

For individuals with EDSS scores 0–6.5:

MDC (SSV and FV)
≈ 0.26 m/s

Other outcome measures commonly used to assess walking in MS include:

These tools may provide additional insight into mobility limitations.

Brain Injury

MDC:
≈ 0.05 m/s

MCID:

Parkinson’s Disease

MDC

Sample 10MWT Goals in Neurologic Rehabilitation

When writing goals based on the 10MWT, it is helpful to include:

When writing goals, consider the available MDC and MCID values. MDC can help guide shorter-term goals that reflect measurable change, while MCID may be better suited for longer-term goals focused on meaningful functional improvement.

Below are several examples across different clinical scenarios.

Example 1: Improving Household Mobility

Goal: Patient will increase 10MWT Self Selected Velocity from 0.28 m/s to 0.40 m/s using a bilateral platform rolling walker with up to minimal assistance in order to improve household mobility and functional independence within 4 weeks.

Example 2: Transitioning to Community Ambulation

Goal: Patient will increase 10MWT Self Selected Velocity from 0.55 m/s to 0.75 m/s using a single-point cane and R AFO with no more than standby assist to increase safety and access when ambulating in less-crowded community environments within 6 weeks.

Example 3: Advancing Community Ambulation

Goal: Patient will increase10MWT Fast Velocity from 0.72 m/s to ≥0.90 m/s without an assistive device independently in order to progress toward safely crossing streets for community mobility and return to work activities within 6 weeks.

Key Takeaways

The 10MWT is a valuable tool because it is:

When used consistently and interpreted with appropriate MDC and MCID values, it can help clinicians:

References

Bohannon, R. W., & Williams Andrews, A. (2011). Normal walking speed: A descriptive meta-analysis. Physiotherapy, 97(3), 182–189. https://doi.org/10.1016/j.physio.2010.12.004

Hosoi, Y., Yoshida, T., Yamamoto, S., et al. (2023). Minimal detectable change for the 10-meter walk test based on gait speed classification in individuals with stroke. Journal of Clinical Medicine, 12(14), 4687. https://doi.org/10.3390/jcm12144687

Middleton, A., Fritz, S. L., & Lusardi, M. (2015). Walking speed: The functional vital sign. Journal of Aging and Physical Activity, 23(2), 314–322. https://doi.org/10.1123/japa.2013-0236

Perry, J., Garrett, M., Gronley, J., & Mulroy, S. (1995). Classification of walking handicap in the stroke population. Stroke, 26(6), 982–989. https://doi.org/10.1161/01.STR.26.6.982

Schmid, A., Duncan, P. W., Studenski, S., et al. (2007). Improvements in speed-based gait classifications are meaningful. Stroke, 38(7), 2096–2100. https://doi.org/10.1161/STROKEAHA.106.475921

Academy of Neurologic Physical Therapy. (2026). 10 Meter Walk Test: Core outcome measure pocket guide. https://neuropt.org

Shirley Ryan AbilityLab. (n.d.). 10 Meter Walk Test.https://www.sralab.org/rehabilitation-measures/10-meter-walk-testSCIRE Project. (n.d.). 10 Meter Walk Test.https://scireproject.com/outcome/10-meter-walk-test/