Validity and Reliability of 6-minute Pegboard and Ring Test

Validity and Reliability of 6-minute Pegboard and Ring Test in Individuals With Spinal Cord Injury

Spinal Cord Injury (SCI) is a severe neurological condition that occurs as a result of traumatic or non-traumatic causes and results in motor, sensory, and/or autonomic dysfunction. The daily life of individuals with SCI often consists of low activity levels, which can cause loss of physical condition. Therefore, the participation of individuals with SCI in exercise is necessary to improve cardiovascular health and function, as well as to increase life expectancy and quality. Determining the strength, endurance, and exercise capacity of the upper extremities in individuals with SCI is an important issue in the management of SCI. One of the tests that serves this purpose is the six-minute pegboard and ring test (6PBRT). Since 6PBRT is used in clinical and research applications in individuals with SCI, it is important to know its validity and reliability. This study aims to investigate the validity and reliability of 6PBRT in individuals with SCI.

Study Overview

• Status: Completed
• Conditions: Spinal Cord Injury
• Intervention / Treatment: Other: There will be no intervention on the participants within the scope of this study.

Detailed Description

Spinal Cord Injury (SCI) is a severe neurological condition that occurs as a result of traumatic or non-traumatic causes and results in motor, sensory, and/or autonomic dysfunction. Serious and long-term social, physical, and psychological problems that occur following the injury, a rapid decrease in the quality of life of patients, and economic problems such as loss of employment make SCI an important problem with both individual and societal dimensions. The annual SCI incidence is 12.7/million in our country, and the average age of injury is 35.5.

Secondary complications that occur in the short and long term following SCI play an important role in the continuity of care of individuals with SCI. According to the data of the National SCI Statistics Center (NSCISC), complications such as pneumonia, atelectasis, deep vein thrombosis, pulmonary embolism, pressure ulcers, autonomic dysreflexia, renal problems, and fractures are very common after SCI. It is thought that these complications resulting from SCI are a direct result of immobility. In addition, physical inactivity causes loss of functional independence, decreases quality of life, and significantly affects social participation. The daily life of individuals with SCI often consists of low activity levels and leads loss of physical condition. Therefore, the participation of individuals with SCI in exercise and improvement of cardiovascular health and function is necessary to increase life expectancy and quality. Various upper extremity exercises have been shown to improve the general condition of individuals with SCI. Determination of upper extremity strength, endurance, and exercise capacity in individuals with SCI is an important issue in the management of SCI. One of the tests that serves this purpose is the six-minute pegboard and ring test (6PBRT), which is valid and reliable in individuals with chronic obstructive pulmonary disease. Since 6PBRT is used in clinical and research applications in individuals with SCI, it is important to know its validity and reliability. This study aims to investigate the validity and reliability of 6PBRT in individuals with SCI.

• Study Type: Observational
• Enrollment (Actual): 34

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Zeytinburnu
    • Istanbul, Zeytinburnu, Turkey (Türkiye), 34010
      • Yunus Emre TÜTÜNEKEN

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Individuals With Spinal Cord Injury

Description

Inclusion Criteria:

• At least one year since the spinal cord injury
• Being an adult (≥18 years old)
• Injury level between T1 and L5
• Being a full-time wheelchair (WD) user for mobility

Exclusion Criteria:

- Have additional medical conditions (upper extremity and shoulder injuries, etc.) that may affect their ability to perform the tests

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Study group	Other: There will be no intervention on the participants within the scope of this study.; There will be no intervention on the participants within the scope of this study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
6-minute pegboard and ring test	The 6PBRT is an upper extremity exercise test that evaluates upper extremity functional capacity through unsupported arm activities. The 6PBRT apparatus consists of four bars placed horizontally on the wall, two at shoulder height and the other two 20 centimeters (cm) above shoulder height. Initially, 10 rings are placed on the lower two bars. Participants sit in a chair in front of the apparatus with back support and feet in full contact with the floor. Participants are instructed to move two rings at a time from the lower bar to the upper bar with both hands (one on each side). When 20 rings are placed from the lower bars to the upper levels, participants are asked to return the rings to the lower level. This sequence of movements is repeated for six minutes. The number of rings moved during the test is used as the final score representing performance. Participants are verbally encouraged every minute during the test, and the verbal command is standardized.	1 week
Shoulder flexor muscle strength	Muscle strength will be measured using a digital dynamometer with the patient in a sitting position. Muscle tests will be repeated three times for each side, and the highest value will be recorded in kg.	1 week
Shoulder abductor muscle strength	Muscle strength will be measured using a digital dynamometer with the patient in a sitting position. Muscle tests will be repeated three times for each side, and the highest value will be recorded in kg.	1 week
Elbow extensor muscle strength	Muscle strength will be measured using a digital dynamometer with the patient in a sitting position. Muscle tests will be repeated three times for each side, and the highest value will be recorded in kg.	1 week
Elbow flexor muscle strength	Muscle strength will be measured using a digital dynamometer with the patient in a sitting position. Muscle tests will be repeated three times for each side, and the highest value will be recorded in kg.	1 week
Handgrip strength	The participant will be measured using a hand dynamometer in a sitting position. Muscle tests will be repeated three times for each side, and the highest value will be recorded in kg.	1 week
The 20-m propulsion test (MWPT 20m )	It will be used to evaluate the participants' ability to use a manual wheelchair. A 20-meter track was set up by drawing a line at the beginning and end. Patients were asked to drive their wheelchairs as fast as they could on this 20-meter track. During this time, the evaluator determined how many seconds it took to complete the 20-meter track with a stopwatch, and the results were recorded in seconds.	1 week
Modified Functional Reach Test (mFUT)	This test is a quick and easy-to-use test that can be used to measure sitting balance in individuals with SCI. The test is performed while the patient is sitting in a wheelchair with their hips, knees, and ankles flexed at 90 degrees. Individuals place their upper extremities at 90 degrees of flexion in the starting position. After measuring with an inflexible tape measure in this position, patients extend as far as they can and measure again. The distance between them is measured and recorded in centimeters. Participants performed flexion and abduction extensions for the right and left upper extremities separately, and the results will be recorded in centimeters (cm).	1 week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Barthel Index (BI)	BI is a scale that evaluates all steps of daily living activities. It is used to determine the level of independence of individuals in their activities. The scores of the Barthel index vary between 0-100, 0-20 points; completely dependent, 21-61 points; advanced dependent, 62-90 points; moderate dependent, 91-99 points; mild dependent, 100 points; independence.	1 week

Collaborators and Investigators

• Sponsor: Istinye University

Study record dates

Study Major Dates

• Study Start (Actual): April 28, 2025
• Primary Completion (Actual): June 15, 2025
• Study Completion (Actual): August 15, 2025

Study Registration Dates

• First Submitted: April 17, 2025
• First Submitted That Met QC Criteria: April 17, 2025
• First Posted (Actual): April 24, 2025

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 9, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Validity; Reliability; Spinal cord injury; 6PBRT
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Trauma, Nervous System; Spinal Cord Diseases; Spinal Cord Injuries
• Other Study ID Numbers: 1111 (Prima Psychiatry internal research fund)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No