Ishigaki Tomoya, Kubo Hiroki, Yoshida Keishi, Shimizu Natsuki, Ogawa Tatsuya
Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Aichi, Japan.
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Hyogo, Japan.
Front Rehabil Sci. 2024 Apr 16;5:1384369. doi: 10.3389/fresc.2024.1384369. eCollection 2024.
We investigated the reliability and validity of the 2-min step test (2MST) for assessing the exercise endurance of individuals with stroke and lower-limb musculoskeletal disorders.
The participants were 39 individuals with stroke and 42 with lower-limb musculoskeletal disorders (mainly hip fractures) from the convalescent rehabilitation wards of four hospitals. The concurrent validity and congruence between the 2MST and the 6-min walk test (6MWT) and construct validity by hypotheses testing, including mobility and lower limb muscle strength, were also confirmed. A subset of participants (stroke-group, = 15; musculoskeletal-group, = 19) underwent a retest 2MST for our evaluation of relative and absolute reliability using the intraclass correlation coefficient (ICC) and Bland-Altman plot.
Both groups showed a moderate correlation between the 2MST and 6MWT ( = 0.55-0.60), but the congruence was not sufficient. The 6MWT was correlated with mobility in both groups and with muscle strength in the stroke group, whereas the 2MST did not show a significant correlation with mobility. The relative reliability was excellent in both groups (ICC > 0.9). In terms of absolute reliability, the width of the limit of agreement was 18.8% for the stroke group and 15.4% for the musculoskeletal group, relative to their respective sample means of 2MST. A fixed bias was identified in the stroke group, in which step counts increased by 6.5 steps upon retesting.
Our analyses revealed that the 2MST is a valid and reliable tool for assessing the exercise endurance of individuals with stroke or lower-limb musculoskeletal disorders. However, it is necessary to validate the absolute reliability observed herein by using a larger sample size. In addition, when assessing the exercise endurance of individuals with stroke, it may be necessary to consider the potential bias of an increased step count during retesting.
我们研究了2分钟阶梯试验（2MST）在评估中风患者和下肢肌肉骨骼疾病患者运动耐力方面的可靠性和有效性。
参与者包括来自四家医院康复病房的39名中风患者和42名下肢肌肉骨骼疾病患者（主要是髋部骨折）。还通过假设检验证实了2MST与6分钟步行试验（6MWT）之间的同时效度和一致性，以及包括活动能力和下肢肌肉力量在内的结构效度。一部分参与者（中风组，n = 15；肌肉骨骼组，n = 19）进行了2MST复测，以便我们使用组内相关系数（ICC）和布兰德-奥特曼图评估相对和绝对可靠性。
两组在2MST和6MWT之间均显示出中等程度的相关性（r = 0.55 - 0.60），但一致性不足。6MWT在两组中均与活动能力相关，在中风组中与肌肉力量相关，而2MST与活动能力未显示出显著相关性。两组的相对可靠性都很好（ICC > 0.9）。就绝对可靠性而言，相对于各自2MST的样本均值，中风组一致性界限的宽度为18.8%，肌肉骨骼组为15.4%。在中风组中发现了固定偏差，复测时步数增加了6.5步。
我们的分析表明，2MST是评估中风患者或下肢肌肉骨骼疾病患者运动耐力的有效且可靠的工具。然而，有必要使用更大的样本量来验证此处观察到的绝对可靠性。此外，在评估中风患者的运动耐力时，可能有必要考虑复测期间步数增加的潜在偏差。
