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2 Minute Step Test

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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

Key Descriptions

  • 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

1

Equipment Required

  • Stopwatch
  • Tape measure
  • Tape

Time to Administer

2 minutes

Required Training

No Training

Age Ranges

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.

Older Adults and Geriatric Care

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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)

10th

Percentile (steps)

25th Percentile (steps)

50th Percentile (steps)

75th Percentile (steps)

90th 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)

10th

Percentile

(steps)

25th Percentile (steps)

50th Percentile (steps)

75th Percentile (steps)

90th 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)

10th  

Percentile (steps)

25th Percentile (steps)

50th Percentile (steps)

75th

Percentile (steps)

90th

Percentile (steps)

99th 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)

10th

Percentile (steps)

25th

Percentile (steps)

50th

Percentile (steps)

75th

Percentile (steps)

90th

Percentile (steps)

99th

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)

Pulmonary Diseases

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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.

Cardiovascular Disease

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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)

Healthy Adults

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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)

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)

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

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)

  • 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

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)

  • 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

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

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:

 

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)

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

 

Concurrent validity:

 

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)

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

Cancer

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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)

Alzheimer's Disease and Progressive Dementia

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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:

 

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)

  • 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)

Parkinson's Disease

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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)

Renal Disease

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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

Back Pain

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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

Stroke

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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)

Mixed Populations

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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)

 

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)

  • 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:

 

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)

  • 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

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)

  • Partial eta squared = 0.09

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