Background The six-minute walk test (6MWT) is a cornerstone measure of functional capacity, yet its standard corridor-based protocol demands a 30 m hallway, trained staff, and scripted encouragement. These logistical barriers limit accessibility and add cost. Efforts to overcome these limitations with smartphone sensors have fallen short: several studies report 8–40 percent under-estimation and a hard 500 m ceiling in the Apple Watch/iPhone algorithm. Dedicated inertial wearables, placed on a stable limb segment and sampled at high frequency, may achieve clinic-grade accuracy with few environment and logistical constraints.

Objective To establish whether the Ambulosono thigh-mounted sensor provides equivalent time-scaled 6MWT distance in supervised and unsupervised environments, and to determine whether auditory cues—silence, American Thoracic Society (ATS) verbal encouragement, or rhythmic music—affect performance.

Methods Seventy-six healthy university students performed up to three 6MWTs in two settings: (1) a supervised 12 ± 2 m indoor lane and (2) a self-selected 10–20 m route at home or on campus. Ambulosono recorded all-step walking distance, already rescaled to an exact six minutes by the accompanying mobile application. Duplicate trials within a Setting × Auditory-Condition cell were averaged, yielding 117 unique subject-records. Independent Welch t-tests compared structured and naturalistic distances within each auditory condition; effect size was expressed as Cohen d. Distance distributions were visualised with box-plots, over-laid histograms, and violin plots. Group means were benchmarked against contemporary reference values.

Results Scaled 6-min distance ranged from 388 to 481 m across the six Setting × Condition groups. Structured trials exceeded naturalistic trials by 37 m (music), 52 m (verbal), and 61 m (silent); however, none of these differences reached statistical significance (all p > 0.05; d ≤ 0.70) and all lay within Ambulosono’s validated ±5 percent systematic error band. Distance distributions overlapped almost completely. Every group mean fell inside the 400–520 m reference band reported for 18-to 25-year-old walking on 10–20 m lanes who have similar anthropomorphic features and ethic background.

Conclusions After rigorous time normalisation, Ambulosono delivers environment-independent 6MWT distance in healthy young adults and meets modern short-lane normative values. These findings support the use of dedicated wearables for remote functional-capacity monitoring and underscore the current limitations of smartphone-only solutions.

The authors have declared no competing interest.

This research was supported by CIHR, Alberta Innovation and Ministry of Mental Health and University of Calgary Endowment Fund

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Written, informed consent was obtained from every participant in accordance with the Declaration of Helsinki, and the protocol was approved by the University of Calgary Research Ethics Board (REB13-0009).

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