The 2 min step test: A reliable and valid measure of functional capacity in older adults post coronary revascularisation

Abstract

Purpose Exercise training is the central component in Cardiac Rehabilitation (CR). A baseline assessment of aerobic capacity is paramount for exercise prescription and safety. The Two‐Minute Step Test (2MST) has been used to measure aerobic capacity in healthy older adults. However, the reliability and validity of the 2MST in older adults post‐coronary revascularisation (CRV) is unknown. Methods A prospective observational study was conducted in a single CR centre. Two 2MSTs and one six‐minute walk test (6MWT) were completed in a single session. The 2MST measurements were recorded by two raters for each individual. The six‐minute walk distance (6MWD) and 2MST steps recorded by both raters were analysed to determine the relationship and agreement between measurements. Results Thirty one participants with a median (IQR) age of 66 (62,73) years old were included in the study post CRV. Strong positive correlations were found between steps achieved during the 2MSTs and the 6MWD (r = 0.87, 95% CI 0.82–0.91, p < 0.0001). Excellent inter‐rater reliability was demonstrated between raters during the 2MSTs (ICC = 0.999–1.000, p = 0.000). Excellent relative test‐retest reliability was demonstrated in both 2MSTs recorded by both raters (ICC = 0.927–0.934, p = 0.000). However, absolute test‐retest reliability may have been limited by a learning effect between repeated 2MSTs. Conclusions The results of this study indicate that the 2MST may be used as an alternative to the 6MWT as an outcome measure for aerobic capacity in older adults post‐CRV. However, a practice trial is recommended at baseline to account for a learning effect.

APTA Cross Sections and Academies Recommendations for COVID-19 Core Outcome Measures

“…Interrater reliability Excellent interrater reliability (ICC = 0.999-1.000, P < .0001). 57 Test cognitive decline is expected to have resolved), 17 with a decline in condition during postacute care, or at discharge from all physical therapy services when a prior deficit was noted, and the patient is not receiving skilled care from another specialist for cognitive impairments. This frequency schedule has a primary goal to ensure that the therapist is properly adapting the plan of care to the current capabilities of the patient while working to ensure that physical therapists are identifying and referring patients appropriately when cognitive decline may indicate underlying neurologic pathology.…”

Reliability and validity of clinical tests of cardiorespiratory fitness: A systematic review and meta-analysis

“…One study assessed validity of the 2MST, finding a moderate correlation (r=0.54) with GXT performance, in a population of 36 Australian adults (120). The 2MST has demonstrated strong reliability (ICC>0.9) in two studies of 68 participants (121, 122)…”

Can resistance prehabilitation training bring additional benefits in valvular cardiac surgery? protocol for a randomized controlled trial

“…Exercise capacity and endurance will be collected before surgery, that is, at the time of the first appointment with Physiotherapy, and one month after surgery. The tests used will be: Aerobic capacity: will be assessed by the 2-minutes Step Test, a valid tool to assess functionality in patients with cardiac pathology after surgery and sensitive to assess perioperative changes, which also has excellent inter-examiner reliability [ 44 ]. Following the protocol established by Jones and Rikli [ 45 ], implemented in 2022 by Chow et al in revascularised individuals [ 44 ], it evaluates the number of repetitions of knee lifting (between patella and iliac crest) that each participant is able to perform in two minutes.…”

“…The tests used will be: Aerobic capacity: will be assessed by the 2-minutes Step Test, a valid tool to assess functionality in patients with cardiac pathology after surgery and sensitive to assess perioperative changes, which also has excellent inter-examiner reliability [ 44 ]. Following the protocol established by Jones and Rikli [ 45 ], implemented in 2022 by Chow et al in revascularised individuals [ 44 ], it evaluates the number of repetitions of knee lifting (between patella and iliac crest) that each participant is able to perform in two minutes. If a person requires technical assistance to perform the test, a stable chair will be placed close to him/her to limit the risk of falling.…”