2 Minute Step Test

Last Updated

August 01, 2021

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Purpose

The 2 Minute Step Test is used to assess an individual’s aerobic capacity and evaluate their level of functional fitness.

Acronym 2MST, TMST

Area of Assessment

Aerobic Capacity

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

Cardiovascular Disease

Healthy Adults

Renal Disease

Stroke

Pulmonary Diseases

Parkinson's Disease

Older Adults and Geriatric Care

Alzheimer's Disease and Progressive Dementia

Mixed Populations

Cancer

Back Pain

A clinician can administer the 2 Minute Step Test by measuring a point that is halfway between the midpoint of the patient’s patella and the top of their iliac crest and then measuring how many times the patient’s right knee reaches this point while marching in place for 2 minutes.
A person with reduced balance may use a table, wall, or chair as a touch-hold for stability.
Higher scores indicate greater levels of aerobic capacity.

Number of Items

Stopwatch
Tape measure
Tape

2 minutes

Required Training

No Training

Adult

60 - 64

years

Older Adults

65 +

years

Instrument Reviewers

Riley Caughlin, BS, MS, SPT

Bayler Andrews, BS, SPT

Mike Richardson, PT, DPT, DHSc, Board Certified Geriatric Clinical Specialist

Leslie Ayres, PT, DPT, Board Certified Cardiovascular and Pulmonary Clinical Specialist

Kenneth L Miller, PT, DPT, Board Certified Geriatric Clinical Specialist

Body Part

Lower Extremity

ICF Domain

Body Function
Body Structure
Activity

Measurement Domain

Activities of Daily Living
Motor

Considerations

The original study for the 2 Minute Step Test did not specify if the use of assistive devices (i.e. walkers or canes) were allowed; however, various subsequent studies have allowed for the use of assistive devices to maintain balance while conducting the test.

Standard Error of Measurement (SEM)

Older Adults: (Uher & Liba, 2017; N = 112; age range = 64-65 years; Slovakian sample)

SEM for persons living in a retirement facility: 2.72
SEM for persons living at home: 5.63

Cut-Off Scores

Older Adults: (Rikli & Jones, 2013; N = 2,140; age range = 60-94 years)

Cut-off scores for predicting physical independence:

Age (Years)	Step count (Male participants)	Step count (Female participants)
60-64	106	97
65-69	101	93
70-74	95	89
75-79	88	84
80-84	80	78
85-89	71	70
90-94	60	60

Normative Data

Older Adults: (Rikli & Jones, 1999b; N = 7,183; age range = 60-94 years)

Normative data for males (n = 2,135):

Age Range (years)	Participants (n)	Step Count (SD)
60-64	241	101 (21)
65-69	482	101 (23)
70-74	515	95 (23)
75-79	464	91 (27)
80-84	241	87 (24)
85-89	116	75 (24)
90-94	76	69 (26)

Normative data for females (n = 5,048):

Age Range (years)	Participants (n)	Step Count (SD)
60-64	620	91 (24)
65-69	1,084	90 (26)
70-74	1,298	84 (25)
75-79	987	84 (24)
80-84	543	75 (23)
85-89	354	70 (22)
90-94	158	58 (21)

Percentiles for males:

Age (Years)	10^th ^Percentile (steps)	25^{th Percentile}(steps)	50^{th Percentile}(steps)	75^{th Percentile}(steps)	90^{th Percentile} (steps)
60-64	74	87	101	115	128
65-69	72	86	101	116	130
70-74	66	80	95	110	125
75-79	56	73	91	109	125
80-84	56	71	87	103	118
85-89	44	59	75	91	106
90-94	36	52	69	86	102

Percentiles for females:

Age (Years)	10^th ^Percentile (steps)	25^{th Percentile}(steps)	50^{th Percentile}(steps)	75^{th Percentile}(steps)	90^{th Percentile}(steps)
60-64	60	75	91	107	122
65-69	57	73	90	107	123
70-74	53	68	84	101	116
75-79	52	68	84	100	115
80-84	46	60	75	91	104
85-89	42	55	70	85	98
90-94	31	44	58	72	85

Older Adults: (Rikli & Jones, 2013; N = 2,140; age range = 60-94 years)

Step counts for older adults defined as “moderate functioning” via the Composite Physical Function Scale:

Age (Years)	Participants (n)	Males: Step Count (SD)	Females: Step Count (SD)
60-64	144	92.6 (20.8)	85.9 (24.5)
65-69	369	89.3 (25.1)	85.1 (24.2)
70-74	538	92.5 (20.6)	83.5 (21.9)
75-79	515	90.1 (27.0)	83.1 (23.0)
80-84	306	81.2 (27.1)	78.5 (19.7)
85-89	180	75.5 (28.5)	74.2 (18.4)
90-94	88	60.0 (22.1)	60.4 (22.1)

Percent decline over 30 years for men: 35.2%
Percent decline over 30 years for women: 29.7%

Older Adults with Obesity: (Guede-Rojas et al., 2020; N = 75; mean age (SD) = 79.1 (5.6) years; Chilean sample)

Gender	Age (SD)	BMI (SD)	Steps (SD)
Males (n = 19)	72.5 (6.2)	32.7 (4.5)	64.79 (16.56)
Females (n = 56)	71.8 (5.4)	31.8 (5.2)	46.16 (18.81)

Older Adults in community or nursing home settings: (Kazoglu & Yuruk, 2020; N = 118; Turkish sample)

Setting	Participants (n)	Age (SD)	Steps (SD)
Nursing Home	n = 59	70.2 (2.3)	80.3 (7.1)
Community	n = 59	70.3 (3.9)	66.5 (11.2)

Older Adults: (Uher & Liba, 2017; N = 112; age range = 64-65 years; Slovakian sample)

Living Environment	Participants (n)	Steps (SD)
Home	n = 55	68.71 (34.36)
Facility	n = 57	29 (20.54)

Older Adults: (Bhattacharya et al., 2017; N = 400; mean (SD) age for males = 69.80 (3.82) years; mean (SD) age for females = 67.25 (2.57) years; Indian sample)

Normative data for males (n = 284):

Age (years)	Participants (n)	Steps (SD)
65-69	147	67.4 (21.9)
70-74	117	56.1 (21.4)
75-79	12	53.4 (12.2)
> 80	8	47.2 (14)

Normative data for females (n = 116):

Age (years)	Participants (n)	Steps (SD)
65-69	100	62.7 (16.9)
70-74	14	51.7 (10.5)
75-79	2	37.0 (0)

Percentiles for males:

Age (Years)	10^th ^Percentile (steps)	25^{th Percentile} (steps)	50^{th Percentile} (steps)	75^th ^Percentile (steps)	90^th ^Percentile (steps)	99^th ^Percentile (steps)
65-69	39.0	51.0	67.0	82.0	99.0	120.0
70-74	30.8	41.0	54.0	70.0	87.0	116.6
75-79	35.0	48.0	53.5	60.0	75.2	80.0
> 80	20.0	39.0	50.0	60.0	60.0	60.0

Percentiles for females:

Age (years)	10^th ^Percentile (steps)	25^th ^Percentile (steps)	50^th ^Percentile (steps)	75^th ^Percentile (steps)	90^th ^Percentile (steps)	99^th ^Percentile (steps)
65-69	43.0	49.3	64.0	76.5	85.0	98.9
70-74	35.0	45.3	52.0	60.8	64.0	64.0
75-79	37.0	37.0	37.0	37.0	37.0	37.0

Older Adults: (Kim et al., 2020; N = 1009; Nepalese sample)

Normative data for males (n = 449):

Age (years)	Participants (n)	Steps (SD)
60-64	121	57.7 (18.96)
65-69	140	56.2 (19.18)
70-74	85	49.5 (18.48)
75-79	66	44.5 (18.60)
> 80	37	42.5 (19.33)

Normative data for females (n = 560):

Age (years)	Participants (n)	Steps (SD)
60-64	198	44.8 (16.39)
65-69	185	42.3 (15.74)
70-74	101	41.9 (11.85)
75-79	50	37.7 (13.90)
> 80	26	34.5 (13.73)

Older adults: (Hsiao et al., 2017; N = 442; Taiwanese sample)

Mean (SD) 2MST score for sample under 75 years of age (n = 278): 96.9 (19.0) steps
Mean (SD) 2MST score for sample over 75 years of age (n = 164): 92.8 (17.9) steps

Test/Retest Reliability

Older Adults: (Rikli & Jones, 2013)

88% of all participants either met or did not meet standards for physical independence on the 2MWT on both day 1 and day 2.
87% of men either met standards or did not meet standards on both days.
90% of women either met standards or did not meet standards on both days.
Adequate test-retest reliability for all participants (modified kappa = 0.76)
Adequate test-retest reliability for men (modified kappa = 0.74)
Adequate test-retest reliability for women (modified kappa = 0.80

Older Adults: (Rikli & Jones, 1999a; N = 82; Mean (SD) age = 71.8 (6.9) years)

Excellent reliability for full sample (ICC = 0.90)
Excellent reliability for men (ICC = 0.90)
Excellent reliability for women (ICC = 0.89)

Interrater/Intrarater Reliability

Older Adults: (Rikli & Jones, 2013)

91% of all participants either met standards for physical independence on both the 2MST and the Composite Physical Functioning scale or did not meet standards on both scales.
89% of males either met the standards on both scales or did not meet the standards on both scales.
92% of females either met the standards on both scales or did not meet the standards on both scales.
Excellent interrater reliability between the 2MST and Composite Physical Functioning scale when categorizing levels of functional independence for all participants (phi = .79)
Excellent interrater reliability between the 2MST and Composite Physical Functioning scale when categorizing levels of functional independence for males (phi = .76)
Excellent interrater reliability between the 2MST and Composite Physical Functioning scale when categorizing levels of functional independence for females (phi = .81)

Criterion Validity (Predictive/Concurrent)

Predictive Validity:

Taiwanese Older adults: (Hsiao et al., 2017)

Poor predictive validity of the maximum Forward Reach predicting 2MST (R²= 0.05)
Poor predictive validity of the velocity of halfway point of Forward Reach predicting 2MST (R² = 0.06)

Older Obese Adults: (Guede-Rojas et al., 2020)

Poor predictive validity of BMI predicting 2MST outcomes (R²= 0.05, beta = -1.01)
Poor predictive validity of waist-to-hip ratio predicting 2MST outcomes (R²= 0.08, beta = -7.24)
Adequate predictive validity of fat mass predicting 2MST outcomes (R²= 0.22, beta = -1.54)

Concurrent Validity:

Older Adults: (Dugas, 1996; N = 24; mean (SD) age = 69.6 (6.5) years)

Excellent Pearson correlation between 2MST and 1 mile walk time (r =.73)

Older Adults: (Johnston, 1998; N = 25; mean (SD) age = 72.1 (6.2) years)

Excellent Pearson correlation between 2MST and time on treadmill to 85% heart rate (r =.74)

Older Obese Adults: (Guede-Rojas et al., 2020)

Poor Pearson correlation between 2MST and BMI (r = -0.26)
Adequate Pearson correlation between 2MST and waist-to-hip ratio (r = -0.31)
Adequate Pearson correlation between 2MST and fat mass (r = -0.48)

Older Adults: (de Oliviera Brito et al., 2014; N = 37; mean (SD) age = 70 (7) years)

Adequate correlation between the 2MST and the Veterans Specific Activity Questionnaire (r = 0.567)

Responsiveness

Older Adults: (Rikli & Jones, 1999b)

Moderate effect size of step counts between men and women (0.37)

Construct Validity

Convergent validity:

Mild to Moderate Chronic Obstructive Pulmonary Disease: (Priya et al., 2019; N = 30; age range 20-75 years)

Excellent correlation among distance walked in the Six-Minute Walk Test and number of steps taken in 2MST (r = 0.69)
Excellent correlation among the mean values of Heart rate (r = 0.75), Respiratory rate (r = 0.75), Dyspnea (r = 0.70) and Fatigue (r = 0.73) between Six-Minute Walk Test and 2MST.
Adequate correlation among the mean values of oxygen saturation (r = 0.48), systolic blood pressure (r = 0.47) and diastolic blood pressure (r = 0.56) between Six-Minute Walk Test and 2MST.

Cut-Off Scores

Hypertensive Older Adults: (Guedes et al., 2015; N = 101; mean (SD) age = 69.80 (7.55) years; 59% Normotensive (BP < 139/89), 41% Hypertensive (BP > 140/90); Brazilian sample)

Cutoff point of hypertensive elderly for normal functional capacity was 69 steps (sensitivity of 80% and specificity of 54%).
Cutoff point of hypertensive elderly with associated conditions for normal functional capacity was 65 steps (sensitivity of 83% and specificity of 67%).

Normative Data

Hypertensive Older Adults: (Chhajed, 2014; N = 30; mean (SD) age = 71.13 (7.17) years; mean (SD) systolic blood pressure = 134.77 (9.72); mean (SD) diastolic blood pressure = 79.27 (9.13))

Mean (SD) 2MST score: 68.5 (16.03)
Range: 38 to 94

Heart Failure: (Wegrzynowska-Tedorczyk et al., 2016; N = 168; mean (SD) age: 59 (12) years; New York Heart Association Classification: Class I n = 28, Class II n = 85, Class III n = 49, Class IV n = 6; mean (SD) Left Ventricular Ejection Fraction = 32% (8%); Polish sample)

New York Heart Association Classification Scale	Steps (SD)
NYHA Class I-II (n = 113)	92.3 (21.2)
NYHA Class III-IV (n = 55)	79.4 (19.7)
NYHA Class I-IV (n = 168)	88.0 (22.1)

Heart Failure: (Alosco et al., 2012; N = 145; mean (SD) age = 68.97 (9.31) years; New York Heart Association Classification Class II-III at time of study)

Gender	Steps (SD)
Males (n = 89)	60.85 (23.13)
Females (n = 56)	55.79 (21.91)
Group (n = 145)	58.90 (22.73)

Heart Failure: (Alosco et al., 2013; N = 69; mean (SD) age = 68.07 (8.02) years; mean (SD) Left Ventricular Ejection Fraction = 42.32% (14.11%))

Gender	Steps (SD)
Males (n = 40)	70.30 (22.17)
Females (n = 29)	57.34 (18.37)
Group (n = 69)	64.86 (21.50)

Hypertensive Older Adults: (Guedes et al., 2015; N = 101; mean (SD) age = 69.80 (7.55) years; 59% Normotensive (BP < 139/89), 41% Hypertensive (BP > 140/90); Brazilian sample)

Mean (SD) 2MST score for Hypertensive sample: 78.41 (25.78) steps
Mean (SD) 2MST score for Normotensive sample: 88.68 (24.63) steps

Hypertensive Older Women: (Pedrosa & Holanda, 2009; N = 32; mean (SD) age = 65.4 (5.4) years; mean (SD) time since diagnosis = 17.7 (9.2) years)

Mean (SD) 2MST score: 62.7 (20.2)

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Hypertensive Older Adults: (Guedes et al., 2015; N = 101; mean (SD) age = 69.80 (7.55) years; 59% Normotensive (BP < 139/89), 41% Hypertensive (BP > 140/90); Brazilian sample)

Poor predictive validity of the 2MST at predicting functional capacity among Normotensive population (AUC = 0.61; CI95: 0.42 to 0.75)
Adequate predictive validity of the 2MST at predicting functional capacity among Hypertensive population (AUC = 0.70; CI95: 0.50-0.87)

Concurrent validity:

Heart Failure: (Alosco et al., 2012; N = 145; mean (SD) age = 68.97 (9.31) years; New York Heart Association Classification Class II-III at time of study)

Poor correlation between 2MST and Beck Depression Inventory scores (r = 0.18)
Poor partial correlation between 2MST and Modified Mini Mental State Examination when controlling for age, sex, and depression symptoms (r = 0.28)

Heart Failure: (Garcia et al., 2013; N = 41; mean (SD) age 68.34 (8.41) years; mean (SD) Left Ventricular Ejection Fraction = 39.00% (10.79%)

Adequate partial correlation between 2MST and metabolic equivalents while controlling for medical and demographic characteristics (r = 0.41)

Construct Validity

Convergent validity:

Heart Failure: (Wegrzynowska-Tedorczyk et al., 2016; N = 168; mean (SD) age: 59 (12) years; New York Heart Association Classification: Class I n = 28, Class II n = 85, Class III n = 49, Class IV n = 6; Left Ventricular Ejection Fraction (SD) = 32% (8%); Polish sample)

Adequate correlation between 2MST and Six-Minute Walk Test (r = 0.44)
Adequate correlation between 2MST and the Modified Bruce Protocol (r = 0.34)
Excellent correlation between 2MST and quadriceps strength (r = 0.61)

Hypertensive Older Adults: (Chhajed, 2014; N = 30; mean (SD) age = 71.13 (7.17) years; mean (SD) systolic blood pressure = 134.77 (9.72); mean (SD) diastolic blood pressure = 79.27 (9.13))

Excellent correlation among systolic blood pressures between the 2MST and Six-Minute Walk Test (r = 0.88)
Excellent correlation among diastolic blood pressures between the 2MST and Six-Minute Walk Test (r = 0.62)
Excellent correlation among heart rates between the 2MST and 6-Minute Walk Test (r = 0.84)
Excellent correlation among heart rates between the 2MST and Timed Up-And-Go (r = 0.60)
Adequate correlation among systolic blood pressures between the 2MST and Timed Up-And-Go (r = 0.50)
Poor correlation among diastolic blood pressures between the 2MST and Timed Up-And-Go (r = 0.21)

Hypertensive Older Women: (Pedrosa & Holanda, 2009)

Excellent correlation between the 2MST and the Timed Up-And-Go (r = -0.66)
Adequate correlation between the 2MST and the Six-Minute Walk Test (r = 0.36)

Standard Error of Measurement (SEM)

Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)


Activity Level	Average (SD) age (years)	SEM (steps) for interrater reliability	SEM (steps) for intrarater reliability
Sedentary (age 18-24)	21.69 (1.53)	3.47	3.98
Active (age 18-24)	21.92 (1.45)	6.87	8.70
Sedentary (age 25-44)	29.44 (5.17)	4.41	7.17
Active (age 25-44)	30.80 (5.72)	5.08	6.85

Minimal Detectable Change (MDC)

Activity Level	Average (SD) age (years)	MDC95 (steps)
Sedentary (age 18-24)	21.69 (1.53)	9.61-11.05
Active (age 18-24)	21.92 (1.45)	19.05-24.10
Sedentary (age 25-44)	29.44 (5.17)	12.21-19.80
Active (age 25-44)	30.80 (5.72)	14.09-18.99

Cut-Off Scores

97.5 steps is the cut-off between active and sedentary classification when the 2MST was correlated to the Baecke Questionnaire, with a sensitivity of 61% and a specificity of 67%.

Normative Data

Mean (SD) step count for sedentary group aged 18-24: 101.20 (10.69) steps
Mean (SD) step count for active group aged 18-24: 117.22 (25.63) steps
Mean (SD) step count for sedentary group aged 25-44: 95.00 (20.50) steps
Mean (SD) step count for active group aged 25-44: 103.14 (22.26) steps

Young Adults: (Freitas et al., 2020; N = 60; 33.33% eutrophic, 33.33% overweight, 33.33% obese type I; mean (SD) age of eutrophic population = 21.95 (1.82) years; mean (SD) age of overweight population = 25.05 (8.10) years; mean (SD) age of obese type I population = 26.50 (9.76) years; Brazilian sample)

Body Type	Average (SD) age (years)	BMI (SD)	Steps (SD)
Eutrophic	21.95 (1.82)	21.59 (1.75)	78.70 (16.37)
Overweight	25.05 (8.10)	26.51 (1.06)	83.65 (10.77)
Obese	26.50 (9.76)	31.34 (1.39)	79.15 (13.92)

Interrater/Intrarater Reliability

Activity Level	Interrater Reliability (ICC)	Intrarater Reliability (ICC)
Sedentary (age 18-24)	Excellent (0.90)	Excellent (0.87)
Active (age 18-24)	Excellent (0.92)	Excellent (0.90)
Sedentary (age 25-44)	Excellent (0.92)	Excellent (0.83)
Active (age 25-44)	Excellent (0.96)	Excellent (0.91)

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Poor predictive validity of the 2MST at predicting levels of activity according to the Baecke Questionnaire (AUC = 0.67)

Concurrent validity:

Adequate correlation between the 2MST and the Baecke Questionnaire (r = 0.34)

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Cancer Patients: (Quinn et al., 2020; N = 103; mean (SD) age = 64.7 (11.6) years)

Adequate Spearman correlation between the 2MST and the Eastern Cooperative Oncology Group Performance Status Scale (ECOG; r = -0.54)

Normative Data

Alzheimer’s Dementia: (Plácido et al., 2019; N = 93; age > 60 years; 39% healthy adults, 19% mild cognitive impairment, 27% mild Alzheimer’s Dementia, 15% moderate Alzheimer’s Dementia; Brazilian sample)

Population	Mean (SD) age (years)	Steps Count (SD)
Healthy Adults	74.2 (9.2)	87.6 (20.8)
Mild Cognitive Impairment	78.0 (5.5)	75.7 (21.0)
Mild Alzheimer’s Dementia	78.5 (7.4)	63.8 (27.2)
Moderate Alzheimer’s Dementia	78.9 (8.3)	54.6 (26.5)

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Adequate relationship between the 2MST and global cognition, as measured by the Mini Mental State Exam, after controlling for confounding variables (R^2 = 0.35)

Normative Data

Parkinson’s Disease: (Youm et al., 2020; N = 17; Korean sample)

Group Sample	Mean (SD) age (years)	Mean (SD) Hoehn & Yahr stage	Mean (SD) Unified Parkinson’s Disease Rating Scale score	Baseline 2MST Steps (SD)
Exercise (n = 10)	68.0 (6.8)	2.40 (.32)	64.55 (18.33)	93.9 (18.5)
Control (n = 7)	72.1 (6.0)	2.29 (0.39)	66.00 (10.17)	83.9 (15.2)

Responsiveness

Parkinson’s Disease: (Youm et al., 2020; N = 17; Korean sample)

Moderate change after exercise program (effect size = 0.34)

Normative Data

Chronic Kidney Disease (Stage 4-5): (Chen et al., 2018; N = 156; Taiwanese sample)

Mean (SD) 2MST score for Chronic Kidney Disease (CKD) group: 102.0 (18.5) steps
Mean (SD) 2MST score for CKD identified as disabled by the TIADL: 95.0 (24.4) steps
Mean (SD) 2MST score for CKD identified as non-disabled by the TIADL: 104.2 (15.8) steps

Chronic Kidney Disease (Stage 3-4): (Aoike et al., 2014; N = 29; mean (SD) age = 55.1 (11.6) years; mean (SD) BMI for CKD exercise group = 31.7 (4.5); mean (SD) BMI for CKD control group = 30.7 (4.1); Brazilian sample)

Mean (SD) 2MST score for exercise group: 180.0 (36.5) steps
Mean (SD) 2MST score for control group: 189.5 (33.8) steps

Normative Data

Chronic Non-Specific Low Back Pain: (Vachalathiti et al., 2020; N = 60; 50% Chronic Non-Specific Low Back Pain (CNSLBP), 50% non-CNSLBP; Taiwanese sample)

Category	Number of participants	Mean (SD) age (years)	Mean (SD) 2MST score
CNSLBP	30	43.5 (8.53)	82.37 (23.52)
Non-CNSLBP	30	40.46 (8.66)	95.50 (16.41)

Chronic Non-Specific Low Back Pain: (Sakulsriprasert et al., 2019; N = 20; 35% male, 65% female; mean (SD) age = 43.15 (2.03); Chinese sample)

Mean (SD) 2MST score: 77.4 (34.0) steps

Responsiveness

Chronic Non-Specific Low Back Pain: (Sakulsriprasert et al., 2019)

2MST change score (difference between baseline and posttest data): 14.5
Moderate change (effect size = 0.42)
Standardized response mean: 0.58

Normative Data

Stroke: (Taylor-Piliae et al., 2012; N = 100; age (SD) = 70 (10) years; post stroke time (SD) = 39 (49) months)

Mean (SD) 2MST score: 39.7 (20.4; the paretic leg was not required to attain the full match position of midway between the patella and iliac crest)

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Stroke: (Taylor-Piliae et al., 2012; N = 100; age (SD) = 70 (10) years; post stroke time (SD) = 39 (49) months)

Adequate predictive validity of the 2MST in predicting gait velocity (sr² = 0.099, beta = 0.365, F = 3.41)

Concurrent validity:

Stroke: (Taylor-Piliae et al., 2012; N = 100; age (SD) = 70 (10) years; post stroke time (SD) = 39 (49) months)

Adequate Spearman correlation between 2MST and gait velocity: (r = 0.51)

Cut-Off Scores

Frailty: (Furtado et al., 2019; n = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)

Cut-off score for physical frailty including pre-frail group: 40 steps; sensitivity = 82-89%, specificity = 53-61%
Cut-off score for physical frailty excluding pre-frail group: 42 steps; sensitivity = 93-96%, specificity = 74-77%

Normative Data

Fallers and Non-Fallers: (Zhao & Chung, 2016; N = 78; 62% at risk of falling; mean (SD) age of participants at risk of falling = 69.70 (3.64) years; mean (SD) age of participants not at risk of falling = 70.10 (3.75) years; Chinese sample)

Mean (SD) 2MST for participant at risk of falling: 82.70 (16.50) steps
Mean (SD) 2MST for participants not at risk of falling: 92.33 (11.93) steps

Fallers and Non-Fallers: (Toraman & Yıldırım, 2010; N = 60; mean (SD) age = 73.3 (6.6) years; Turkish sample)

Median 2MST score: 51 steps

Fallers and Non-Fallers: (Zak et al., 2017; N = 102, mean (SD) age = 70 (4.33) years; 49% between ages 65-69, 30% between ages 70-74, 21% between ages 75-79; female post-menopausal Breast Cancer survivors; Polish sample)

Mean (SD) 2MST score for age 65-69: 68.14 (16.38) steps
Mean (SD) 2MST score for age 70-74: 59.00 (15.55) steps
Mean (SD) 2MST score for age 75-79: 52.10 (19.28) steps

Sarcopenia: (Björkman et al., 2019; N = 262; 74% female; mean (SD) age of males = 83.4 (4.5) years; mean (SD) age of females = 82.4 (4.4) years; Finnish sample)

Mean (SD) 2MST score for males: 82.7 (23.4) steps
Mean (SD) 2MST score for females: 80.2 (22.5) steps

Frailty: (Furtado et al., 2019; n = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)

Mean 2MST score for whole sample: 37 steps
Mean 2MST score for non-frail participants: 50 steps
Mean 2MST score for pre-frail participants: 40 steps
Mean 2MST score for frail participants: 27.5 steps

Cognitively Impaired Older Adults: (Yang et al., 2018; N = 2096; 32% cognitively impaired, 68% non-cognitively impaired; mean (SD) age of participants with cognitive impairment = 74.40 (5.73) years; mean (SD) age of participants without cognitive impairment = 71.79 (4.63) years)

Cognitively Impaired: mean (SD) steps = 64.03 (37.10)
Non-Cognitively Impaired: mean (SD) steps = 82.37 (37.53)

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Frailty: (Furtado et al., 2019; N = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)

Adequate predictive validity of the 2MST to predict frailty at a cut-off score of 42 steps (AUC = 0.89)

Fallers and Non-Fallers: (Toraman & Yıldırım, 2010; N = 60; mean (SD) age = 73.3 (6.6) years; Turkish sample)

Less than 50 steps on the 2MST had an odds ratio of 11.59 (95% CI=2.56-52.38) for scoring less than 8.12 seconds on the single leg stance eyes open component of the Berg Balance Test.

Sarcopenia: (Björkman et al., 2019; N = 262; 74% female; mean (SD) age of males = 83.4 (4.5) years; mean (SD) age of females = 82.4 (4.4) years; Finnish sample)

2MST score had an odds ratio of 0.98 (95% CI = 0.97-0.99) for predicting the use of home care services.

Concurrent validity:

Fallers and Non-Fallers: (Toraman & Yıldırım, 2010; N = 60; mean (SD) age = 73.3 (6.6) years; Turkish sample)

Adequate Spearman correlation between 2MST and Berg Balance Test (r = 0.57)
Poor Spearman correlation between 2MST and Mini Mental State Exam (r = -0.02)
Adequate Spearman correlation between 2MST and Right Leg Single Stance with Eyes Open (r = 0.56)

Adequate correlation between the 2MST and the Tinetti POMA (r = 0.49)

Frailty: (Furtado et al., 2019; N = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)

Adequate Spearman correlation between the 2MST and physical frailty when controlling for educational level (rs = -0.55)

Construct Validity

Discriminant validity:

Excellent discriminant validity (small correlation) between Physical Activity Scale for the Elderly (PASE) and 2MST for cognitively impaired participants (r = 0.13)
Excellent discriminant validity (small correlation) between PASE and 2MST for non-cognitively impaired participants (r = 0.11)
Excellent discriminant validity (small correlation) between PASE and 2MST for all participants (r = 0.15)

Responsiveness

Partial eta squared = 0.09

Bibliography

Alosco, M. L., Brickman, A. M., Spitznagel, M. B., Griffith, E. Y., Narkhede, A., Raz, N., Cohen, R., Sweet, L. H., Colbert, L. H., Josephson, R., Hughes, J., Rosneck, J., & Gunstad, J. (2013). Poorer physical fitness is associated with reduced structural brain integrity in heart failure. Journal of the Neurological Sciences, 328(1-2), 51–57. https://doi.org/10.1016/j.jns.2013.02.015

Alosco, M. L., Spitznagel, M. B., Raz, N., Cohen, R., Sweet, L. H., Colbert, L. H., Josephson, R., Waechter, D., Hughes, J., Rosneck, J., & Gunstad, J. (2012). The 2-minute step test is independently associated with cognitive function in older adults with heart failure. Aging Clinical and Experimental Research, 24(5), 468–474. https://doi.org/10.3275/8186

Aoike, D. T., Baria, F., Kamimura, M. A., Ammirati, A., de Mello, M. T., & Cuppari, L. (2014). Impact of home-based aerobic exercise on the physical capacity of overweight patients with chronic kidney disease. International Urology and Nephrology, 47(2), 359–367. https://doi.org/10.1007/s11255-014-0894-8

Bhattacharya, P. K., Deka, K., Roy, A., & Saikia, H. (2017). Normative values of physical fitness test in the elderly: A community based study in an urban population in Northeast India. Journal of Clinical and Diagnostic Research. https://doi.org/10.7860/jcdr/2017/28079.10709

Björkman, M., Jyväkorpi, S. K., Strandberg, T. E., Pitkälä, K. H., & Tilvis, R. S. (2019). Sarcopenia indicators as predictors of functional decline and need for care among older people. The Journal of Nutrition, Health & Aging, 23(10), 916–922. https://doi.org/10.1007/s12603-019-1280-0

Chen, H.-M., Hsiao, S.-M., Kuo, M.-C., Lo, Y.-C., Huang, M.-F., Yeh, Y.-C., Yen, C.-F., & Chen, C.-S. (2018). Identifying early decline of daily function and its association with physical function in chronic kidney disease: Performance-based and self-reported measures. PeerJ, 6. https://doi.org/10.7717/peerj.5286

Chhajed, B. S. (2014). Correlation between 6MWT, 2MST and TUG among hypertensive older individuals. Indian Journal of Physiotherapy and Occupational Therapy - An International Journal, 8(1), 139. https://doi.org/10.5958/j.0973-5674.8.1.027

de Oliveira Brito, L. V., Maranhao Neto, G. A., Moraes, H., Emerick, R. F., & Deslandes, A. C. (2014). Relationship between level of independence in activities of daily living and estimated cardiovascular capacity in elderly women. Archives of Gerontology and Geriatrics, 59(2), 367–371. https://doi.org/10.1016/j.archger.2014.05.010

Dugas, E. W. (1996). The development and validation of a 2-minute step test to estimate aerobic endurance in older adults. Unpublished master’s thesis, California State University, Fullerton, Fullerton, CA.

Freitas, D. W. N., Frazão, M. B., Pereira, J. S., Almeida, M. Q. G., Rêgo, A. S., Pires, F. O., Dias, R., da Silva, I. M. A. F., Dibai-Filho, A. V., & Bassi-Dibai, D. (2020). Relationship between 2-Minute Step Test, anthropometric measures and habitual physical activity in sedentary individuals. Revista Andaluza de Medicina Del Deporte, 13(1), 21–24.

Furtado, G. E., Patrício, M., Loureiro, M., Hogervorst, E., Theou, O., Ferreira, J. P., & Teixeira, A. M. (2019). Physical frailty and health outcomes of fitness, hormones, psychological and disability in institutionalized older women: An exploratory association study. Women & Health, 60(2), 140–155. https://doi.org/10.1080/03630242.2019.1621978

Garcia, S., Alosco, M. L., Spitznagel, M. B., Cohen, R., Raz, N., Sweet, L., Josephson, R., Hughes, J., Rosneck, J., Oberle, M. L., & Gunstad, J. (2013). Cardiovascular fitness associated with cognitive performance in heart failure patients enrolled in cardiac rehabilitation. BMC Cardiovascular Disorders, 13, 29. https://doi.org/10.1186/1471-2261-13-29

Guede-Rojas, F., Jerez-Mayorga, D., Ulloa-Díaz, D., Soto-Martínez, A., Ramírez-Campillo, R., Barboza-González, P., & Angarita-Dávila, L. (2020). Relationship between anthropometric nutritional status and functional capacity in older adults living in the community. Revista Medica de Chile, 148(1), 69–77.

Guedes, M. B., Lopes, J. M., Andrade, A. de, Guedes, T. S., Ribeiro, J. M., & Cortez, L. C. (2015). Validation of the Two Minute Step Test for diagnosis of the functional capacity of hypertensive elderly persons. Revista Brasileira De Geriatria e Gerontologia, 18(4), 921–926. https://doi.org/10.1590/1809-9823.2015.14163

Hsiao, M.-Y., Li, C.-M., Lu, I.-S., Lin, Y.-H., Wang, T.-G., & Han, D.-S. (2017). An investigation of the use of the Kinect system as a measure of dynamic balance and forward reach in the elderly. Clinical Rehabilitation, 32(4), 473–482. https://doi.org/10.1177/0269215517730117

Johnston, J. (1998). Validation of a 2-minute step-in-place test relative to treadmill performance in older adults. Unpublished master’s thesis, California State University, Fullerton, Fullerton, CA.

Kazoglu, M., & Yuruk, Z. O. (2020). Comparison of the physical fitness levels in nursing home residents and community-dwelling older adults. Archives of Gerontology and Geriatrics, 89, 104106. https://doi.org/10.1016/j.archger.2020.104106

Kim, J. K., Son, W. I., Sim, Y. J., Lee, J. S., & Oli Saud, K. (2020). The study of health-related fitness normative scores for Nepalese older adults. International Journal of Environmental Research and Public Health, 17(8), 2723. https://doi.org/10.3390/ijerph17082723

Nogueira, M. A., Almeida, T., Andrade, G. S., Ribeiro, A. S., Rêgo, A. S., Dias, R., Ferreira, P. R., Penha, L., Pires, F. O., Dibai-Filho, A. V., & Bassi-Dibai, D. (2021). Reliability and accuracy of 2-Minute Step Test in active and sedentary lean adults. Journal of Manipulative and Physiological Therapeutics, 44(2), 120–127. https://doi.org/10.1016/j.jmpt.2020.07.013

Pedrosa, R., & Holanda, G. (2009). Correlação entre os testes da caminhada, marcha estacionária e TUG em hipertensas idosas. Brazilian Journal of Physical Therapy, 13(3), 252–256. https://doi.org/10.1590/s1413-35552009005000030

Plácido, J., Ferreira, J. V., de Oliveira, F., Sant'Anna, P., Monteiro-Junior, R. S., Laks, J., & Deslandes, A. C. (2019). Association among 2-min Step Test, functional level and diagnosis of dementia. Dementia & Neuropsychologia, 13(1), 97–103. https://doi.org/10.1590/1980-57642018dn13-010011

Priya, P. S., Nazar, A. K., Azarudheen, S., Saranya, N., Thenmozhi, A., & Vaishnavi, V. (2019). Comparison of the Two Minute Step Test with Six Minute Walk Test in chronic obstructive pulmonary disease patients. Indian Journal of Physiotherapy and Occupational Therapy - An International Journal, 13(2), 215. https://doi.org/10.5958/0973-5674.2019.00076.5

Quinn, S. E., Crandell, C. E., Blake, M. E., Bontrager, A. M., Dempsey, A. G., Lewis, D. J., Hamm, J. T., Flynn, J. M., Smith, G. S., & Wingard, C. J. (2020). The correlative strength of objective physical assessment against the ECOG performance status assessment in individuals diagnosed with cancer. Physical Therapy, 100(3), 416–428. https://doi.org/10.1093/ptj/pzz192

Rikli, R. E., & Jones, C. J. (1999a). Development and validation of a functional fitness test for community-residing older adults. Journal of Aging & Physical Activity, 7(2), 129.

Rikli, R.E., Jones, C. J. (1999b). Functional fitness normative scores for community-residing older adults, ages 60-94. Journal of Aging & Physical Activity. 7(2), 162-181.

Rikli, R. E., & Jones, C. J. (2002). Measuring functional fitness of older adults. The Journal on Active Aging. 24-30.

Rikli, R. E., & Jones, C. J. (2013). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. The Gerontologist, 53(2), 255–267. https://doi.org/10.1093/geront/gns071

Sakulsriprasert, P., Vachalathiti, R., & Kingcha, P. (2019). Responsiveness of pain, functional capacity tests, and disability level in individuals with chronic nonspecific low back pain. Hong Kong Physiotherapy Journal, 40(01), 11–17. https://doi.org/10.1142/s101370252050002x

Taylor-Piliae, R. E., Latt, L. D., Hepworth, J. T., & Coull, B. M. (2012). Predictors of gait velocity among community-dwelling stroke survivors. Gait & Posture, 35(3), 395–399. https://doi.org/10.1016/j.gaitpost.2011.10.358

Toraman, A., & Yıldırım, N. Ü. (2010). The falling risk and physical fitness in older people. Archives of Gerontology and Geriatrics, 51(2), 222–226. https://doi.org/10.1016/j.archger.2009.10.012

Uher, I., & Liba, J. (2017). Correlation between functional fitness of older people and environmental and accommodation conditions. Journal of Physical Education & Sport, 17(4), 2365–2371.

Vachalathiti, R., Sakrulsriprasert, P., & Kingcha, P. (2020). Decreased functional capacity in individuals with chronic non-specific low back pain: A cross-sectional comparative study. Journal of Pain Research, Volume 13, 1979–1986. https://doi.org/10.2147/jpr.s260875

Węgrzynowska-Teodorczyk, K., Mozdzanowska, D., Josiak, K., Siennicka, A., Nowakowska, K., Banasiak, W., Jankowska, E. A., Ponikowski, P., & Wozniewski, M. (2016). Could the Two-Minute Step Test be an Alternative to the Six-Minute Walk Test for Patients with Systolic Heart Failure? Eur J Prev Cardiol. 2016;23(12):1307-1313. doi:10.1177/2047487315625235

Yang, M., Guo, Y., Gong, J., Deng, M., Yang, N., & Yan, Y. (2018). Relationships between functional fitness and cognitive impairment in Chinese community-dwelling older adults: A cross-sectional study. BMJ Open, 8(5). https://doi.org/10.1136/bmjopen-2017-020695

Youm, C., Kim, Y., Noh, B., Lee, M., Kim, J., & Cheon, S. M. (2020). Impact of trunk resistance and stretching exercise on fall-related factors in patients with Parkinson's disease: A randomized controlled pilot study. Sensors (Basel, Switzerland), 20(15), 4106. https://doi.org/10.3390/s20154106

Zak, M., Biskup, M., Macek, P., Krol, H., Krupnik, S., & Opuchlik, A. (2017). Identifying predictive motor factors for falls in post-menopausal breast cancer survivors. PLoS One, 12(3). https://doi.org/10.1371/journal.pone.0173970

Zhao, Y., & Chung, P.-K. (2016). Differences in functional fitness among older adults with and without risk of falling. Asian Nursing Research, 10(1), 51–55. https://doi.org/10.1016/j.anr.2015.10.007

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Bibliography

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