Validity and Reliability of Mixed Reality-Based Functional Mobility Tests in Type 2 Diabetes
Validity and Reliability of the Mixed Reality Adaptation of the 6-Minute Walk, Timed Up and Go, and Five-Repetition Sit-to-Stand Tests in Individuals With Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus (T2DM) is a multifaceted metabolic disease associated not only with impaired glycemic control but also with reductions in muscle strength, balance, functional mobility, and walking performance. Individuals with T2DM may experience impairments in lower extremity function, postural control, and overall functional performance, which can negatively affect activities of daily living and quality of life. Therefore, the assessment of functional performance using reliable and valid methods is important for clinical monitoring and rehabilitation planning.
The 6-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), and Five-Repetition Sit-to-Stand Test (5xSTS) are widely used clinical assessments for evaluating walking capacity, functional mobility, lower extremity function, and physical performance in individuals with T2DM. Previous studies have demonstrated that these tests provide reliable and clinically meaningful measurements in this population.
In recent years, virtual and mixed reality technologies have provided opportunities to conduct assessments in a more objective, standardized, and user-friendly manner. These technologies also offer important advantages, including real-time data collection, enhanced user interaction, and potential integration into future remote assessment applications. However, evidence regarding the measurement properties of mixed reality-based adaptations of commonly used functional performance tests in individuals with T2DM remains limited.
The aim of this study is to evaluate the validity and reliability of mixed reality-based adaptations of the 6-Minute Walk Test, Timed Up and Go Test, and Five-Repetition Sit-to-Stand Test developed using the Meta Quest 3 platform. In addition, convergent validity will be examined by investigating the relationships between outcomes obtained from the mixed reality-based assessments and measures of knee extensor muscle strength and handgrip strength.
The findings of this study are expected to contribute to the development of innovative, safe, standardized, and digital approaches for assessing functional performance in individuals with Type 2 Diabetes Mellitus. Furthermore, the results may provide a scientific foundation for future digital health applications and remote assessment strategies.
調査の概要
研究の種類
入学 (推定)
連絡先と場所
研究連絡先
- 名前:Mehmet K ALTUNOK, PHD(c) in PT
- 電話番号:+90 5558175133
- メール:mehmetkaan.altunok@selcuk.edu.tr
研究場所
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Selcuklu
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Konya、Selcuklu、トルコ(Türkiye)、42130
- 募集
- Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
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コンタクト:
- Mehmet K ALTUNOK, PHD(c) in PT
- 電話番号:+90 5558175133
- メール:mehmetkaan.altunok@selcuk.edu.tr
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Diagnosed with Type 2 Diabetes Mellitus by a physician,
- Aged between 18 and 65 years,
- Ability to ambulate independently without the use of an assistive device,
- No participation in a structured exercise program within the previous 6 months,
- Cognitive ability sufficient to understand and follow test instructions,
- Visual, auditory, and vestibular functions sufficient to tolerate mixed reality applications,
- Ability to read, understand, and follow instructions in Turkish,
- Willingness to participate voluntarily in the study and provision of written informed consent.
Exclusion Criteria:
- Presence of proliferative diabetic retinopathy or severe non-proliferative diabetic retinopathy,
- Advanced peripheral neuropathy, active foot ulcer, Charcot foot, or significant sensory loss that may compromise safe test performance,
- Presence of peripheral arterial disease,
- Advanced renal failure, requirement for dialysis, or nephropathy that may compromise exercise safety,
- Myocardial infarction within the previous 6 months,
- Unstable ischemic heart disease or uncontrolled angina,
- Resting blood pressure greater than 160/100 mmHg,
- Presence of severe musculoskeletal, neurological, or vestibular disorders that may interfere with safe test performance,
- High risk of balance loss or spatial disorientation in the mixed reality environment due to visual, auditory, or balance impairments,
- Cognitive, behavioral, or compliance-related problems that may prevent completion of the study procedures.
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
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Individuals with Type 2 Diabetes Mellitus
Adults aged 18-65 years diagnosed with Type 2 Diabetes Mellitus who will undergo conventional and mixed reality-based assessments of functional performance, including the 6-Minute Walk Test, Timed Up and Go Test, and Five-Repetition Sit-to-Stand Test.
Additional assessments of knee extensor muscle strength and handgrip strength will be performed to evaluate convergent validity.
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Participants will perform mixed reality-based adaptations of the 6-Minute Walk Test (6MW-MR), Timed Up and Go Test (TUG-MR), and Five-Repetition Sit-to-Stand Test (5xSTS-MR) developed for the Meta Quest 3 platform.
The mixed reality environment digitally replicates the conventional test setups and provides standardized visual guidance while allowing participants to interact safely with the real environment.
Test outcomes will be automatically recorded by the system and compared with conventional clinical assessments to evaluate validity.
The mixed reality-based tests will be repeated one week later to assess test-retest reliability.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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6-Minute Walk Test - Mixed Reality (6MW-MR)
時間枠:Baseline and 1-week follow-up
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Functional exercise capacity and walking endurance will be assessed using a mixed reality-based adaptation of the 6-Minute Walk Test.
Walking distance will be recorded in meters, with greater distances indicating better performance.
Validity will be evaluated by comparison with the conventional 6-Minute Walk Test, and reliability will be assessed using repeated measurements performed one week apart.
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Baseline and 1-week follow-up
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Timed Up and Go Test - Mixed Reality (TUG-MR)
時間枠:Baseline and 1-week follow-up
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Functional mobility will be assessed using a mixed reality-based adaptation of the Timed Up and Go Test.
Test completion time will be recorded in seconds, with shorter times indicating better functional mobility.
Validity and reliability will be evaluated through comparison with the conventional Timed Up and Go Test and repeated measurements.
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Baseline and 1-week follow-up
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Five-Repetition Sit-to-Stand Test - Mixed Reality (5xSTS-MR)
時間枠:Baseline and 1-week follow-up
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Lower extremity functional performance will be assessed using a mixed reality-based adaptation of the Five-Repetition Sit-to-Stand Test.
Test duration will be recorded in seconds, with shorter times indicating better performance.
Validity and reliability will be evaluated through comparison with the conventional Five-Repetition Sit-to-Stand Test and repeated measurements.
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Baseline and 1-week follow-up
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Participant Satisfaction
時間枠:Baseline
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Participant satisfaction with conventional and mixed reality-based assessments will be evaluated using a 10-point visual analog scale ranging from 1 to 10, with higher scores indicating greater satisfaction.
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Baseline
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6-Minute Walk Test - Conventional
時間枠:Baseline
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Walking distance measured during the conventional 6-Minute Walk Test will be used as a reference measure for concurrent validity analyses.
Greater distances indicate better functional exercise capacity.
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Baseline
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Timed Up and Go Test - Conventional
時間枠:Baseline
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The conventional Timed Up and Go Test will be administered to assess functional mobility and will serve as a reference measure for validity analyses.
Test completion time will be recorded in seconds, with shorter times indicating better functional mobility.
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Baseline
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Five-Repetition Sit-to-Stand Test - Conventional
時間枠:Baseline
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The conventional Five-Repetition Sit-to-Stand Test will be used as a reference measure for validity analyses.
Test completion time will be recorded in seconds, with shorter times indicating better lower extremity functional performance.
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Baseline
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Knee Extensor Muscle Strength
時間枠:Baseline
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Knee extensor muscle strength will be measured using a handheld digital dynamometer.
Maximum voluntary contraction values will be recorded, with higher values indicating greater muscle strength.
Outcomes will be analyzed for convergent validity with mixed reality-based test results.
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Baseline
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Handgrip Strength
時間枠:Baseline
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Handgrip strength will be assessed using a hand dynamometer.
The highest value obtained from repeated trials will be recorded, with higher values indicating greater muscle strength.
Outcomes will be analyzed for convergent validity with mixed reality-based test results.
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Baseline
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協力者と研究者
スポンサー
捜査官
- スタディチェア:Gülşah ÖZSOY, Assist. Prof. Dr.、Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
- スタディチェア:Zehra KORKUT, Assist. Prof. Dr.、Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
- スタディチェア:İsmail ÖZSOY, Assoc. Prof. Dr.、Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
- スタディチェア:Mehmet A GÜLER, PhD、Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
- スタディチェア:İhsan KODAK, Assist. Prof. Dr.、Kırşehir Ahi Evran University, School of Physical Therapy and Rehabilitation, Kırşehir, Türkiye
- スタディチェア:Yasemin GEDİKLİ ERTÜRK, PhD (c) in PT、Selcuk University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Konya, Türkiye
- スタディチェア:Selma Ö ÇELİKDELEN, Assist. Prof. Dr.、Konya City Hospital
出版物と役立つリンク
一般刊行物
- Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991 Feb;39(2):142-8. doi: 10.1111/j.1532-5415.1991.tb01616.x.
- Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review. BMC Geriatr. 2017 Oct 16;17(1):238. doi: 10.1186/s12877-017-0625-y.
- Cesari M, Kritchevsky SB, Newman AB, Simonsick EM, Harris TB, Penninx BW, Brach JS, Tylavsky FA, Satterfield S, Bauer DC, Rubin SM, Visser M, Pahor M; Health, Aging and Body Composition Study. Added value of physical performance measures in predicting adverse health-related events: results from the Health, Aging And Body Composition Study. J Am Geriatr Soc. 2009 Feb;57(2):251-9. doi: 10.1111/j.1532-5415.2008.02126.x.
- Munoz-Bermejo L, Adsuar JC, Mendoza-Munoz M, Barrios-Fernandez S, Garcia-Gordillo MA, Perez-Gomez J, Carlos-Vivas J. Test-Retest Reliability of Five Times Sit to Stand Test (FTSST) in Adults: A Systematic Review and Meta-Analysis. Biology (Basel). 2021 Jun 9;10(6):510. doi: 10.3390/biology10060510.
- Lee MC. Validity of the 6-minute walk test and step test for evaluation of cardio respiratory fitness in patients with type 2 diabetes mellitus. J Exerc Nutrition Biochem. 2018 Mar 30;22(1):49-55. doi: 10.20463/jenb.2018.0008.
- Greco F, Tarsitano MG, Cosco LF, Quinzi F, Folino K, Spadafora M, Afzal M, Segura-Garcia C, Maurotti S, Pujia R, Pujia A, Buono P, Emerenziani GP. The Effects of Online Home-Based Pilates Combined with Diet on Body Composition in Women Affected by Obesity: A Preliminary Study. Nutrients. 2024 Mar 21;16(6):902. doi: 10.3390/nu16060902.
- Goldberg A, Chavis M, Watkins J, Wilson T. The five-times-sit-to-stand test: validity, reliability and detectable change in older females. Aging Clin Exp Res. 2012 Aug;24(4):339-44. doi: 10.1007/BF03325265.
- ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102. No abstract available.
- Maden C, Gozacan Karabulut D, Bagci B. Validity and reliability of an immersive virtual reality adaptation of the 6-minute pegboard and ring test. Hand Surg Rehabil. 2025 Feb;44(1):101981. doi: 10.1016/j.hansur.2024.101981. Epub 2024 Oct 30.
- Bayram GA, Sahin GE, Yilmaz G, Tayboga UI, Celik AG, Yildirim Y, Saribas PK, Tarakci D. Integration of the wingate anaerobic test into a virtual reality- based evaluation system. BMC Sports Sci Med Rehabil. 2025 Jul 2;17(1):163. doi: 10.1186/s13102-025-01220-4.
- Vaz MM, Costa GC, Reis JG, Junior WM, Albuquerque de Paula FJ, Abreu DC. Postural control and functional strength in patients with type 2 diabetes mellitus with and without peripheral neuropathy. Arch Phys Med Rehabil. 2013 Dec;94(12):2465-2470. doi: 10.1016/j.apmr.2013.06.007. Epub 2013 Jun 24.
- Kowall B. Lower body muscle strength, dynapenic obesity and risk of type 2 diabetes -longitudinal results on the chair-stand test from the Survey of Health, Ageing and Retirement in Europe (SHARE). BMC Geriatr. 2022 Dec 1;22(1):924. doi: 10.1186/s12877-022-03647-7.
- Dominguez-Munoz FJ, Adsuar JC, Villafaina S, Garcia-Gordillo MA, Hernandez-Mocholi MA, Collado-Mateo D, Gusi N. Test-Retest Reliability of Vibration Perception Threshold Test in People with Type 2 Diabetes Mellitus. Int J Environ Res Public Health. 2020 Mar 9;17(5):1773. doi: 10.3390/ijerph17051773.
- Alfonso-Rosa RM, Del Pozo-Cruz B, Del Pozo-Cruz J, Sanudo B, Rogers ME. Test-retest reliability and minimal detectable change scores for fitness assessment in older adults with type 2 diabetes. Rehabil Nurs. 2014 Sep-Oct;39(5):260-8. doi: 10.1002/rnj.111. Epub 2013 Jun 18.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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