Validity and reliability of the 2-minute walk test in individuals with spinal cord injury

Romina Willi, Mario Widmer, Nora Merz, Caroline H G Bastiaenen, Björn Zörner, Marc Bolliger, Romina Willi, Mario Widmer, Nora Merz, Caroline H G Bastiaenen, Björn Zörner, Marc Bolliger

Abstract

Study design: Multicentre-observational study.

Objectives: The 6-minute walk test (6mWT) is an established assessment of walking function in individuals with spinal cord injury (SCI). However, walking 6 min can be demanding for severely impaired individuals. The 2-minute walk test (2mWT) could be an appropriate alternative that has already been validated in other neurological disorders. The aim of this study was to assess construct validity and test-rest reliability of the 2mWT in individuals with SCI. In addition, the influence of walking performance on sensitivity to change of the 2mWT was assessed.

Setting: Swiss Paraplegic Center Nottwil, Switzerland; Balgrist University Hospital, Zürich, Switzerland.

Methods: Fifty individuals (aged 18-79) with SCI (neurological level of injury: C1-L3, AIS: A-D) were assessed on two test days separated by 1 to 7 days. The first assessment consisted of a 2mWT familiarization, followed by a 2mWT and 10-meter walk test (10MWT) (including the Walking Index for Spinal Cord Injury (WISCI II)) in randomized order. The second assessment consisted of 2mWT and 6mWT in randomized order. Tests were separated by at least 30 min of rest.

Results: The interclass correlation coefficient between the 2mWT assessed on the first and second test day was excellent (r = 0.980, p < 0.001). The 2mWT correlated very strongly with the 6mWT (r = 0.992, p < 0.001) and the 10MWT (r = 0.964, p < 0.001), and moderately with the WISCI II (r = 0.571, p < 0.001). Sensitivity to change was slightly affected by walking performance.

Conclusion: The 2mWT is a valid and reliable alternative to the 6mWT to measure walking function in individuals with SCI.

Trial registration: NCT04555759.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1. Correlation between 2-minute walk (2mWT)…
Fig. 1. Correlation between 2-minute walk (2mWT) test and 6-minute walk test (6mWT).
Distances walked in 2mWT and 6mWT. Individuals grouped into fast walkers (circles) and slow walkers (triangles).
Fig. 2. Bland Altman plot to assess…
Fig. 2. Bland Altman plot to assess test retest reliability.
The averages of the two measurements were plotted against the differences. The closer the points are located to the horizontal solid line the better the reliability. The dashed lines represent the 95% limits of agreement.
Fig. 3. Minute intervals of 2mWT and…
Fig. 3. Minute intervals of 2mWT and 6mWT.
Walked distances during minute intervals from the 2-minute walk test (2mWT) and the 6-minute walk test (6mWT) overall (A) and when separated in slow (B) and fast walkers (C).

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