• Each subject should be screened by a member of the cardiac rehabilitation team for any exclusion criteria before proceeding.

• Place two cones exactly 9 metres apart, thus allowing the subjects to walk 10 metres when they go round the cone at each end of each shuttle.

• Subjects then listen to the instructions on the audio cassette. These should be repeated verbally to ensure they understand what is expected during the test.

• Subjects walk around the 10-metre course aiming to be turning at the first marker cone when the first audio signal is given, and turning at the second cone at the end of the next audio signal.

• Subjects should be accompanied around the first level of the test to help them keep pace with the audio signals. Thereafter the operator stands mid-way between the two marker cones offering advice on completion of a level: 'Walk a bit faster now if you can.'

• Progression to the next level of difficulty is indicated by a triple bleep which lets the subject know that an increase in walking speed is required.

• The full test comprises 12 levels each of one minute duration with walking speeds that rise incrementally from 1.2 miles per hour (1.9 km per hour) to 5.3 miles per hour (8.5 km per hour).

• The test is completed at 12 minutes or if one of the termination criteria are met.

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