Reliability and validity of six-minute step test in patients with heart failure

Marinho, Rodolfo; Jürgensen, Soraia Pilon; Arcuri, Juliano Ferreira; Goulart, Cássia da Luz; Santos, P.B. dos; Roscani, Meliza Goi; Mendes, Renata Gonçalves; Oliveira, Cláudio Ricardo de; Caruso, F.; Silva, Audrey Borghi

doi:10.1590/1414-431x2020e10514

Cited by 8 publications

(18 citation statements)

References 33 publications

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“…(5)(6)(7) O TD6 tem a vantagem de ser um teste barato e de fácil execução, que necessita de pouco espaço para ser realizado e é prático para usuários de oxigenoterapia em longo prazo, testado e comprovadamente confiável e válido em diferentes populações clínicas. (6,(8)(9)(10)(11)(12) No entanto, é difícil interpretar os resultados do teste sem valores normativos e equações de referência bem estabelecidas.…”

Section: Introductionunclassified

Normative values and reference equation for the six-minute step test to evaluate functional exercise capacity: a multicenter study

Albuquerque1

Corso²,

Amaral

et al. 2022

J Bras Pneumol.

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Objective: To establish normative values and a reference equation for the number of steps climbed during the six-minute step test (6MST) in healthy adults, and to assess the reliability of the test and of the equation. Methods: This was a multicenter cross-sectional study involving 468 healthy volunteers (age range: 18-79 years) recruited from the general community in six research laboratories across different regions of Brazil, which is a country with continental dimensions. The 6MST was performed twice (30-min interval), and clinical, demographic, and functional variables were evaluated. An independent sample of 24 volunteers was evaluated to test the reference equation a posteriori. Results: The number of steps had excellent test-retest reliability (intraclass correlation coefficient = 0.96 [95%CI: 0.95-0.97]), and the mean number of steps was 175 ± 45, the number being 14% greater in males than in females. The best performance on the test was correlated with age (r = -0.60), sex (r = 0.28), weight (r = 0.13), height (r = 0.41), BMI (r = -0.22), waist circumference (r = -0.22), thigh circumference (r = 0.15), FVC (r = 0.54), and physical activity level (r = 0.17; p < 0.05 for all). In the regression analysis, age, sex, height, and weight explained 42% of the variability of the 6MST. Normative values were established for the 6MST according to age and sex. There was no difference between the 6MST values from the independent sample and its predicted values (157 ± 29 steps vs. 161 ± 25 steps; p = 0.47; 97% of predicted values). Conclusions: The normative values and the reference equation for the 6MST in this study seem adequate to accurately predict the physical functional performance in adults in Brazil.

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Section: Introductionunclassified

Normative values and reference equation for the six-minute step test to evaluate functional exercise capacity: a multicenter study

Albuquerque1

Corso²,

Amaral

et al. 2022

J Bras Pneumol.

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“…Seventeen papers failed to meet the inclusion criteria (see Supplemental Material for a summary of the excluded papers), leaving 15 papers to be included. 22,27,[36][37][38][39][40][41][42][43][44][45][46][47][48] Two papers 22,36 had the same sample and were, therefore, reported as a single study (Figure 3). Therefore, 14 studies were analyzed in this systematic review.…”

Section: Flow Of Trials Through the Reviewmentioning

confidence: 99%

“…The mean age of the participants ranged from 35 to 68 years old across studies. Five studies included participants with chronic obstructive pulmonary disease, 22,36,[37][38][39][40] three studies included participants with obesity, [41][42][43] two studies included participants with obstructive sleep apnea, 44,45 and the remaining four studies included participants with pulmonary resection, 46 stroke, 47 heart failure, 27 and cardiac diseases 48 (Table 1).…”

Section: Characteristics Of Included Trialsmentioning

confidence: 99%

Procedures and measurement properties of the 6-min step test: A systematic review with clinical recommendations

Boening,

Scianni,

Martins

et al. 2024

Clin Rehabil

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Objective To provide information regarding the procedures, safety, tolerability, and measurement properties of the 6-min step test. Data sources MEDLINE, EMBASE, CINAHL, and SPORTDiscus (from inception until January 2024). Review methods Studies that examined adults with acute or chronic diseases, and outcomes related to procedures, safety, tolerability, or measurement properties of the 6-min step test were included. Outcome data were summarized and combined in meta-analyses. The quality of included studies was assessed by the Consensus-based Standards for the selection of health Measurement Instruments checklist, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. Results Fourteen studies, involving 847 participants, were included. All studies performed the 6-min step test in 6 min; however, some studies varied the step height and the use of upper limb support. The test appears to be safe and well tolerated by individuals. Moderate- to high-quality evidence demonstrated appropriate results for test-retest reliability (4 studies; Intraclass correlation coefficient 0.96; 95% CI 0.91–0.98; n = 125), criterion validity (4 studies; r = 0.53; 95% CI 0.30–0.71; n = 307), and construct validity (4 studies; r = 0.63; 95% CI 0.52–0.73; n = 233). Conclusion This review provides recommendations for applying the 6-min step test in clinical and research settings. No adverse events were reported, and the test appears to be well tolerated. Adequate results were found for test-retest reliability, criterion validity, and construct validity. Review Registration PROSPERO (CRD42022347744).

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“…Fifteen studies analysed the incremental shuttle walk test (ISWT) (18,37,56,58,68,88,89,90,91,92,93,94,95,96,97). The 1-minute sit to stand(1mSTS) was studied in eight papers, the 6-minute step test (6MST) in seven, 'timed up and go test' (TUGT) in six, and the Siconolfi step test (SST) in five (70,80,86,87,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114). Seven tests were studied in three papers, five tests were studied twice and fifty once.…”

Section: Sub-maximal Test Characteristicsmentioning

confidence: 99%

“…Two studies correlated GXT performance with 6MST performance to determine validity, Giacomantonio et al found a strong correlation with GXT of r=0.88 in a population of 28 participants with two or more CVD risk factors, whereas Marinho et al found a weaker r=0.59 in 27 heart failure with reduced ejection fraction (HFrEF) patients(64,109). Five studies of a total of 194 participants found good reliability, ICC = 0.97 across varied populations of healthy adults, an obstructive sleep apnoea cohort, patients with COPD and the above CVD and HFrEF cohort (Figure9)(64,72,105,108,109).3.6.2.4 YMCA step test (YMCAST)…”

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confidence: 99%

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

Harkin

Cousins

Locke

et al. 2023

Preprint

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Introduction: Insufficient physical activity is a significant contributor to non-communicable disease amongst the global population. Insufficient physical activity is directly linked with reduced cardiorespiratory fitness (CRF). CRF is as strong a predictor of mortality as well-established risk-factors such as smoking, hypertension, dyslipidaemia, and type 2 diabetes mellitus, however, it remains the only major risk factor not routinely assessed in primary health care settings. The aim of this review was to assess the validity and reliability of existing submaximal tests of CRF which can be employed in a standard medical consultation for the estimation of CRF and physical function in adults. Methods: A systematic review of the scientific literature was undertaken to find all studies reporting the reliability and/or validity of submaximal tests of CRF and physical function. Studies published up to 12 January 2023 were included in the search of the Medline, Embase, Cinahl, SPORTdiscus, Cochrane library, Informit Health and Web of Science databases. Risk of bias was assessed using the JBI critical appraisal checklist for analytical cross-sectional studies. Data including reliability of the submaximal protocols as measured by test-retest Pearson’s r (r) or Intraclass co-efficient (ICC); and validity as measured by the correlation between the submaximal protocol results and the graded exercise test results (r) was extracted. Meta-analyses were performed to determine the overall mean r of the correlation coefficients. Results: In total 1754 studies were identified. Following screening, 143 studies including 15,760 participants were included. All clinical tests included in meta-analysis demonstrated strong reliability. The Siconolfi step test (r=0.81), Incremental shuttle walk test (r=0.768) and 1-minute sit-to-stand test (r=0.65) demonstrated strongest validity following meta-analysis. Conclusion: Based on the validity of the tests outlined, these can be used as an acceptable method of estimating VO2peak in a broad population, without the cost and access issues of formal GXT.

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Reliability and validity of six-minute step test in patients with heart failure

Cited by 8 publications

References 33 publications

Normative values and reference equation for the six-minute step test to evaluate functional exercise capacity: a multicenter study

Normative values and reference equation for the six-minute step test to evaluate functional exercise capacity: a multicenter study

Procedures and measurement properties of the 6-min step test: A systematic review with clinical recommendations

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

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