RELIABILITY AND VALIDITY OF 2-MINUTE STEP TEST IN NORMAL, OVERWEIGHT AND OBESE CHILDREN
Description
Background: The Two-Minute Step Test (2MST) is a simple-field based assessment commonly utilized to evaluate cardiovascular fitness in children. The current increasing trend of obesity among children has made cardio-respiratory fitness a serious concern. Although there are multiple functional tests available, some have a limitation in terms of requiring maximum effort or huge space, which makes them difficult to apply in school and community situations. There has been little research carried out on the reliability and validity of the Two-Minute Step Test (2MST), especially in children belonging to various body mass index (BMI) groups. Objectives: To determine the reliability and validity of the Two-Minute Step Test (2MST) among 6 to 12year-old children belonging to various BMI groups (normal weight, overweight, obese). Methodology: A cross-sectional reliability study was done on 153 children with an age range of 6 to 12 years old. The subjects were stratified by BMI percentile into three equal groups with normal weight, overweight, and obesity status. The participants underwent the 2MST under controlled conditions, with data measured as number of steps. ICC and correlation with the Six-Minute Walk Test (6MWT) were used to assess reliability and validity, respectively. HR and SpO₂ were monitored both pre- and post-test. Analysis included descriptive statistics, Spearman correlation, and Kruskal–Wallis test. Result: The Two-Minute Step Test demonstrated good to excellent test–retest reliability as indicated by high Intraclass Correlation Coefficient (ICC) values, with low measurement error. Criterion validity was supported by a strong positive correlation between 2MST and 6MWT (Spearman’s rho = 0.648, p < 0.001). A significant decline in 2MST performance was observed across BMI categories, with highest performance in normal-weight children and lowest in obese children. Kruskal–Wallis’s test revealed a statistically significant difference among groups H =72.04, with post-hoc analysis confirming significant differences between all BMI categories. Additionally, heart rate increased significantly following the test across all groups, while SpO₂ showed a slight decrease, indicating appropriate physiological response. Conclusion: The Two-Minute Step Test is a useful, valid, and reliable way to measure how well children can do things. It is sensitive to differences between BMI groups and shows normal physiological responses, so it can be used in schools and communities. The test can be effectively employed in paediatric physiotherapy for evaluation, screening, and monitoring of functional fitness.
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Steps to reproduce
Step 1: Administrative Permission Permission was obtained from the school authorities prior to the initiation of data collection initiated Step 2: Recruitment Students aged 6–12 years were invited through school notification. Detailed information regarding the study will be provided. Assent forms were provided to the children. Parents/guardians were provided with informed consent forms Step 3: Baseline Assessment The following information was recorded: Age (years) Height (cm) Weight (kg) Medical history (cardiorespiratory or neurodevelopmental disorders) Medication history History of fall-related injuries BMI will be calculated using: BMI=(Weight(kg))/(Height(m)^2 ) Participants will be classified based on WHO BMI-for-age percentiles. Step 4: Administration of 2MST The 2MST is a field-based functional test used to assess aerobic endurance and functional capacity. Test Setup The required knee height was marked using tape. The target height was set at the midpoint between the following anatomical landmarks: Patella Anterior superior iliac spine (ASIS) Testing Environment The test was performed in a temperature-controlled room maintained at (~23°C) The room was quiet and well-ventilated setting. An emergency protocol was available Test Procedure The Participant stood upright near a wall. The examiner demonstrates the test procedure. On the command “Start,” the participant began stepping in place. The knees were required to reach the predetermined height. Only right knee elevations were counted. The total amount of correctly performed steps completed in 2 minutes was recorded Standardized verbal encouragement was provided. Participants were instructed to maintain a steady pace throughout the test . Physiological Monitoring Heart rate and SpO₂ were recorded at the following time points: Before the test Immediately after the test Test–Retest Procedure The test was repeated after 48 hours to assess test-retest reliability
Institutions
- Maharishi Markandeshwar University, MullanaHaryana, Ambāla