Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Back Pain | Research

Construct validity and reliability of the 2-Minute Step Test (2MST) in individuals with low back pain

Authors: Sulamizia Filomena Costa de Jesus, Daniela Bassi-Dibai, André Pontes-Silva, Aliny da Silva de Araujo, Silvana de Freitas Faria Silva, Christiano Eduardo Veneroso, Cid André Fidelis de Paula Gomes, Almir Vieira Dibai-Filho

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Login to get access

Abstract

Background

Functional tests are important clinical tools, since they are non-invasive methods, with simple applicability, and low cost. However, there are few tests adapted for individuals with chronic low back pain. Thus, our objective was to evaluate the test-retest and inter-rater reliability of the 2-Minute Step Test in individuals with chronic low back pain and to correlate the test score with measures of pain and physical activity.

Methods

We included patients aged between 18 and 45 years, of both sexes, and with low back pain. The interval between the test and retest was 7 days. We analyzed the data via intra-class correlation coefficient (ICC), confidence interval at 95%, standard error of measurement, and minimum detectable change for reliability. We used the Spearman’s correlation coefficient to verify the correlation between 2-Minute Step Test and measures of pain and physical activity (Numerical Pain Scale, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Baecke Habitual Physical Activity Questionnaire).

Results

Sample is composed of 37 individuals, most of them female, with overweight and low back pain > 60 months. 2-Minute Step Test showed excellent test-retest (ICC = 0.903) and inter-rater (ICC = 0.925) reliability. Sport domain of the Baecke showed a significant correlation with the 2-Minute Step Test (rho = 0.444).

Conclusion

2-Minute Step Test is a reliable measure to measure the functional capacity of patients with chronic low back pain considering different times and examiners, as well as being positively correlated with sports practice.
Literature
1.
go back to reference Morais CA, DeMonte LC, Bartley EJ. Regulatory Emotional Self-Efficacy Buffers the Effect of Heart Rate Variability on Functional Capacity in Older Adults With Chronic Low Back Pain. Front pain Res (Lausanne, Switzerland). 2022;3:818408.CrossRef Morais CA, DeMonte LC, Bartley EJ. Regulatory Emotional Self-Efficacy Buffers the Effect of Heart Rate Variability on Functional Capacity in Older Adults With Chronic Low Back Pain. Front pain Res (Lausanne, Switzerland). 2022;3:818408.CrossRef
2.
go back to reference Kersten RFMR, Fikkers J, Wolterbeek N, Öner FC, van Gaalen SM. Are the Roland Morris Disability Questionnaire and Oswestry Disability Index interchangeable in patients after lumbar spinal fusion? J Back Musculoskelet Rehabil. 2021;34:605–11.CrossRef Kersten RFMR, Fikkers J, Wolterbeek N, Öner FC, van Gaalen SM. Are the Roland Morris Disability Questionnaire and Oswestry Disability Index interchangeable in patients after lumbar spinal fusion? J Back Musculoskelet Rehabil. 2021;34:605–11.CrossRef
3.
go back to reference Van Abbema R, Lakke SE, Reneman MF, van der Schans CP, van Haastert CJM, Geertzen JHB, et al. Factors associated with functional capacity test results in patients with non-specific chronic low back pain: a systematic review. J Occup Rehabil. 2011;21:455–73.CrossRef Van Abbema R, Lakke SE, Reneman MF, van der Schans CP, van Haastert CJM, Geertzen JHB, et al. Factors associated with functional capacity test results in patients with non-specific chronic low back pain: a systematic review. J Occup Rehabil. 2011;21:455–73.CrossRef
4.
go back to reference Yilmaz Yelvar GD, Çırak Y, Dalkılınç M, Parlak Demir Y, Guner Z, Boydak A. Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2017;26:538–45.CrossRef Yilmaz Yelvar GD, Çırak Y, Dalkılınç M, Parlak Demir Y, Guner Z, Boydak A. Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2017;26:538–45.CrossRef
5.
go back to reference Juneau P, Baddour N, Burger H, Bavec A, Lemaire ED. Amputee Fall Risk Classification Using Machine Learning and Smartphone Sensor Data from 2-Minute and 6-Minute Walk Tests. Sensors (Basel). 2022:22. Juneau P, Baddour N, Burger H, Bavec A, Lemaire ED. Amputee Fall Risk Classification Using Machine Learning and Smartphone Sensor Data from 2-Minute and 6-Minute Walk Tests. Sensors (Basel). 2022:22.
6.
go back to reference Carvalho AR, Ribeiro Bertor WR, Briani RV, Zanini GM, Silva LI, Andrade A, et al. Effect of Nonspecific Chronic Low Back Pain on Walking Economy: An Observational Study. J Mot Behav. 2016;48:218–26.CrossRef Carvalho AR, Ribeiro Bertor WR, Briani RV, Zanini GM, Silva LI, Andrade A, et al. Effect of Nonspecific Chronic Low Back Pain on Walking Economy: An Observational Study. J Mot Behav. 2016;48:218–26.CrossRef
7.
go back to reference De Morais Almeida TF, Dibai-Filho AV, de Freitas TF, Lima EAA, Cabido CET. Construct validity and reliability of the 2-minute step test in patients with knee osteoarthritis. BMC Musculoskelet Disord. 2022;23:159.CrossRef De Morais Almeida TF, Dibai-Filho AV, de Freitas TF, Lima EAA, Cabido CET. Construct validity and reliability of the 2-minute step test in patients with knee osteoarthritis. BMC Musculoskelet Disord. 2022;23:159.CrossRef
8.
go back to reference Nogueira MA, Almeida TDN, Andrade GS, Ribeiro AS, Rêgo AS, Dias R da S, et al. Reliability and Accuracy of 2-Minute Step Test in Active and Sedentary Lean Adults. J Manip Physiol Ther. 2021;44:120–7.CrossRef Nogueira MA, Almeida TDN, Andrade GS, Ribeiro AS, Rêgo AS, Dias R da S, et al. Reliability and Accuracy of 2-Minute Step Test in Active and Sedentary Lean Adults. J Manip Physiol Ther. 2021;44:120–7.CrossRef
9.
go back to reference Rikli RE, Jones CJ. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist. 2013;53:255–67.CrossRef Rikli RE, Jones CJ. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist. 2013;53:255–67.CrossRef
10.
go back to reference Vachalathiti R, Sakulsriprasert P, Kingcha P. Decreased Functional Capacity in Individuals with Chronic Non-Specific Low Back Pain: A Cross-Sectional Comparative Study. J Pain Res. 2020;13:1979–86.CrossRef Vachalathiti R, Sakulsriprasert P, Kingcha P. Decreased Functional Capacity in Individuals with Chronic Non-Specific Low Back Pain: A Cross-Sectional Comparative Study. J Pain Res. 2020;13:1979–86.CrossRef
11.
go back to reference Węgrzynowska-Teodorczyk K, Mozdzanowska D, Josiak K, Siennicka A, Nowakowska K, Banasiak W, et al. Could the two-minute step test be an alternative to the six-minute walk test for patients with systolic heart failure? Eur J Prev Cardiol. 2016;23:1307–13.CrossRef Węgrzynowska-Teodorczyk K, Mozdzanowska D, Josiak K, Siennicka A, Nowakowska K, Banasiak W, et al. Could the two-minute step test be an alternative to the six-minute walk test for patients with systolic heart failure? Eur J Prev Cardiol. 2016;23:1307–13.CrossRef
12.
go back to reference Guedes MBOG, Lopes JM, de S AA, TSR G, Ribeiro JM, de A CLC. Validation of the two minute step test for diagnosis of the functional capacity of hypertensive elderly persons. Rev Bras Geriatr e Gerontol. 2015;18:921–6.CrossRef Guedes MBOG, Lopes JM, de S AA, TSR G, Ribeiro JM, de A CLC. Validation of the two minute step test for diagnosis of the functional capacity of hypertensive elderly persons. Rev Bras Geriatr e Gerontol. 2015;18:921–6.CrossRef
13.
go back to reference Ricci PA, Cabiddu R, Jürgensen SP, André LD, Oliveira CR, Di Thommazo-Luporini L, et al. Validation of the two-minute step test in obese with comorbibities and morbidly obese patients. Brazilian J Med Biol Res = Rev Bras Pesqui medicas e Biol. 2019;52:e8402.CrossRef Ricci PA, Cabiddu R, Jürgensen SP, André LD, Oliveira CR, Di Thommazo-Luporini L, et al. Validation of the two-minute step test in obese with comorbibities and morbidly obese patients. Brazilian J Med Biol Res = Rev Bras Pesqui medicas e Biol. 2019;52:e8402.CrossRef
14.
go back to reference de CA, Andrade A, Peyré-Tartaruga LA. Possible changes in energy-minimizer mechanisms of locomotion due to chronic low back pain - a literature review. Rev Bras Reumatol English Ed. 2015;55:55–61. de CA, Andrade A, Peyré-Tartaruga LA. Possible changes in energy-minimizer mechanisms of locomotion due to chronic low back pain - a literature review. Rev Bras Reumatol English Ed. 2015;55:55–61.
15.
go back to reference Kottner J, Audigé L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol. 2011;64:96–106.CrossRef Kottner J, Audigé L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol. 2011;64:96–106.CrossRef
16.
go back to reference Dibai-Filho AV, Guirro ECO, Ferreira VTK, Brandino HE, Vaz MMOLL, Guirro RRJ. Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle. Brazilian. J Phys Ther. 2015;19:122–8. Dibai-Filho AV, Guirro ECO, Ferreira VTK, Brandino HE, Vaz MMOLL, Guirro RRJ. Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle. Brazilian. J Phys Ther. 2015;19:122–8.
17.
go back to reference Pontes-Silva A, Avila MA, de Araujo A d S, TFC P, Takahasi HY, Bassi-Dibai D, et al. Assessment of the Reliability of the Leg Lateral Reach Test to Measure Thoraco-Lumbo-Pelvic Rotation in Individuals With Chronic Low Back Pain. J Manip Physiol Ther. 2021;44:566–72.CrossRef Pontes-Silva A, Avila MA, de Araujo A d S, TFC P, Takahasi HY, Bassi-Dibai D, et al. Assessment of the Reliability of the Leg Lateral Reach Test to Measure Thoraco-Lumbo-Pelvic Rotation in Individuals With Chronic Low Back Pain. J Manip Physiol Ther. 2021;44:566–72.CrossRef
18.
go back to reference Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152:2399–404.CrossRef Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152:2399–404.CrossRef
19.
go back to reference Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris. Brazilian J Med Biol Res. 2001;34:203–10.CrossRef Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris. Brazilian J Med Biol Res. 2001;34:203–10.CrossRef
20.
go back to reference Siqueira FB, Teixeira-Salmela LF, Magalhães LDC. Analysis of the Psychometric Properties of the Brazilian Version of the Tampa Scale For Kinesiophobia. 2007;15:19–24. Siqueira FB, Teixeira-Salmela LF, Magalhães LDC. Analysis of the Psychometric Properties of the Brazilian Version of the Tampa Scale For Kinesiophobia. 2007;15:19–24.
21.
go back to reference Sardá-Junior J, Nicholas MK, Pereira IA, de M PC, Asghari A, RMC C. Validation of the Pain-Related Catastrophizing Thoughts Scale. Bangladesh. J Med Sci. 2008;34:1–17. Sardá-Junior J, Nicholas MK, Pereira IA, de M PC, Asghari A, RMC C. Validation of the Pain-Related Catastrophizing Thoughts Scale. Bangladesh. J Med Sci. 2008;34:1–17.
22.
go back to reference Florindo AA, Latorre M, do RD de O. Validação e reprodutibilidade do questionário de Baecke de avaliação da atividade física habitual em homens adultos. Rev Bras Med Esporte. 2003;9:129–35.CrossRef Florindo AA, Latorre M, do RD de O. Validação e reprodutibilidade do questionário de Baecke de avaliação da atividade física habitual em homens adultos. Rev Bras Med Esporte. 2003;9:129–35.CrossRef
23.
go back to reference Fleiss JL. The Design and Analysis of Clinical Experiments. New York: Wiley; 1986. Fleiss JL. The Design and Analysis of Clinical Experiments. New York: Wiley; 1986.
24.
go back to reference Pontes-Silva A, Avila MA, Fidelis-de-Paula-Gomes CA, Dibai-Filho AV. The Short-Form Neck Disability index has adequate measurement properties in chronic neck pain patients. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2021;30:3593–9.CrossRef Pontes-Silva A, Avila MA, Fidelis-de-Paula-Gomes CA, Dibai-Filho AV. The Short-Form Neck Disability index has adequate measurement properties in chronic neck pain patients. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2021;30:3593–9.CrossRef
25.
go back to reference Zou KH, Tuncali K, Silverman SG. Correlation and simple linear regression. Radiology. 2003;227:617–22.CrossRef Zou KH, Tuncali K, Silverman SG. Correlation and simple linear regression. Radiology. 2003;227:617–22.CrossRef
26.
go back to reference Rikli R, Jones J. Development and validation of functional fitness test for community – residing older adults. J Aging Phys Act. 1999;7:129–61.CrossRef Rikli R, Jones J. Development and validation of functional fitness test for community – residing older adults. J Aging Phys Act. 1999;7:129–61.CrossRef
27.
go back to reference Braghieri HA, Kanegusuku H, Corso SD, Cucato GG, Monteiro F, Wolosker N, et al. Validity and reliability of 2-min step test in patients with symptomatic peripheral artery disease. J Vasc Nurs Off Publ Soc Peripher Vasc Nurs. 2021;39:33–8. Braghieri HA, Kanegusuku H, Corso SD, Cucato GG, Monteiro F, Wolosker N, et al. Validity and reliability of 2-min step test in patients with symptomatic peripheral artery disease. J Vasc Nurs Off Publ Soc Peripher Vasc Nurs. 2021;39:33–8.
28.
go back to reference Bento TPF, Cornelio GP, Perrucini PO, SFAP S, MHS d C, de Vitta A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr. 2020;96:717–24.CrossRef Bento TPF, Cornelio GP, Perrucini PO, SFAP S, MHS d C, de Vitta A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr. 2020;96:717–24.CrossRef
29.
go back to reference Christofaro DGD, Andersen LB, SM de A, MVG de B, Saraiva BTC, Fernandes RA, et al. Adolescents’ physical activity is associated with previous and current physical activity practice by their parents. J Pediatr. 2018;94:48–55.CrossRef Christofaro DGD, Andersen LB, SM de A, MVG de B, Saraiva BTC, Fernandes RA, et al. Adolescents’ physical activity is associated with previous and current physical activity practice by their parents. J Pediatr. 2018;94:48–55.CrossRef
30.
go back to reference Werneck AO, Silva DR, Collings PJ, Fernandes RA, Ronque ERV, Coelho-E-Silva MJ, et al. Biocultural approach of the association between maturity and physical activity in youth. J Pediatr. 2018;94:658–65.CrossRef Werneck AO, Silva DR, Collings PJ, Fernandes RA, Ronque ERV, Coelho-E-Silva MJ, et al. Biocultural approach of the association between maturity and physical activity in youth. J Pediatr. 2018;94:658–65.CrossRef
31.
go back to reference Borges-Machado F, Barros D, Teixeira L, Ribeiro Ó, Carvalho J. Health-related physical indicators and self-rated quality of life in older adults with neurocognitive disorder. Qual life Res an Int J Qual life Asp Treat care Rehabil. 2021;30:2255–64.CrossRef Borges-Machado F, Barros D, Teixeira L, Ribeiro Ó, Carvalho J. Health-related physical indicators and self-rated quality of life in older adults with neurocognitive disorder. Qual life Res an Int J Qual life Asp Treat care Rehabil. 2021;30:2255–64.CrossRef
32.
go back to reference Rocha DS, Dibai-Filho AV, Pinheiro JS, de ALFS, Falcai A, de J TRR, et al. The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults. Rev Assoc Med Bras. 2022;68:912–6. Rocha DS, Dibai-Filho AV, Pinheiro JS, de ALFS, Falcai A, de J TRR, et al. The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults. Rev Assoc Med Bras. 2022;68:912–6.
33.
go back to reference Verbrugghe J, Agten A, Stevens S, Eijnde BO, Vandenabeele F, Roussel N, et al. Disability, kinesiophobia, perceived stress, and pain are not associated with trunk muscle strength or aerobic capacity in chronic nonspecific low back pain. Phys Ther Sport Off J Assoc Chart Physiother Sport Med. 2020;43:77–83. Verbrugghe J, Agten A, Stevens S, Eijnde BO, Vandenabeele F, Roussel N, et al. Disability, kinesiophobia, perceived stress, and pain are not associated with trunk muscle strength or aerobic capacity in chronic nonspecific low back pain. Phys Ther Sport Off J Assoc Chart Physiother Sport Med. 2020;43:77–83.
34.
go back to reference Vermue DJ, Dol MV, Ansuategui Echeita J, Dekker R, Schiphorst Preuper HR, Reneman MF. Maximal aerobic capacity is associated with lifting capacity, but not with self-reported functioning measures in patients with primary chronic low back pain: a cross-sectional study. BMJ Open Sport Exerc Med. 2022;8:e001253.CrossRef Vermue DJ, Dol MV, Ansuategui Echeita J, Dekker R, Schiphorst Preuper HR, Reneman MF. Maximal aerobic capacity is associated with lifting capacity, but not with self-reported functioning measures in patients with primary chronic low back pain: a cross-sectional study. BMJ Open Sport Exerc Med. 2022;8:e001253.CrossRef
35.
go back to reference Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, O Eijnde B, et al. Exercise Intensity Matters in Chronic Nonspecific Low Back Pain Rehabilitation. Med Sci Sports Exerc. 2019;51:2434–42.CrossRef Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, O Eijnde B, et al. Exercise Intensity Matters in Chronic Nonspecific Low Back Pain Rehabilitation. Med Sci Sports Exerc. 2019;51:2434–42.CrossRef
36.
go back to reference Ostelo RWJG, de Vet HCW, Knol DL, van den Brandt PA. 24-item Roland-Morris Disability Questionnaire was preferred out of six functional status questionnaires for post-lumbar disc surgery. J Clin Epidemiol. 2004;57:268–76.CrossRef Ostelo RWJG, de Vet HCW, Knol DL, van den Brandt PA. 24-item Roland-Morris Disability Questionnaire was preferred out of six functional status questionnaires for post-lumbar disc surgery. J Clin Epidemiol. 2004;57:268–76.CrossRef
37.
go back to reference Kovacs FM, Abraira V, Royuela A, Corcoll J, Alegre L, Tomás M, et al. Minimum detectable and minimal clinically important changes for pain in patients with nonspecific neck pain. BMC Musculoskelet Disord. 2008;9:43.CrossRef Kovacs FM, Abraira V, Royuela A, Corcoll J, Alegre L, Tomás M, et al. Minimum detectable and minimal clinically important changes for pain in patients with nonspecific neck pain. BMC Musculoskelet Disord. 2008;9:43.CrossRef
38.
go back to reference Bohannon RW, Crouch RH. Two-Minute Step Test of Exercise Capacity: Systematic Review of Procedures, Performance, and Clinimetric Properties. J Geriatr Phys Ther. 2019;42:105–12.CrossRef Bohannon RW, Crouch RH. Two-Minute Step Test of Exercise Capacity: Systematic Review of Procedures, Performance, and Clinimetric Properties. J Geriatr Phys Ther. 2019;42:105–12.CrossRef
Metadata
Title
Construct validity and reliability of the 2-Minute Step Test (2MST) in individuals with low back pain
Authors
Sulamizia Filomena Costa de Jesus
Daniela Bassi-Dibai
André Pontes-Silva
Aliny da Silva de Araujo
Silvana de Freitas Faria Silva
Christiano Eduardo Veneroso
Cid André Fidelis de Paula Gomes
Almir Vieira Dibai-Filho
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-06050-w

Other articles of this Issue 1/2022

BMC Musculoskeletal Disorders 1/2022 Go to the issue