Validity of the 2-Minute-Step Test Administered Virtually

ABSTRACT

PURPOSE/HYPOTHESIS: The 2-minute-step test (2MST) is a face-to-face (F2F) measure used to clinically evaluate aerobic capacity in adults. With the onset of the COVID-19 pandemic, the need to assess cardiovascular health in a virtual environment became evident. The 2MST is amenable to being performed in a virtual environment due to low space requirements, simple instructions, and the ability to visually count step performance through a remote visual setup. The purpose of this study is to determine if there is a difference in performance on the 2MST when administered virtually compared with F2F. NUMBER OF SUBJECTS: 28 healthy adults aged 18-35 were recruited. Subjects were screened to determine eligibility and scheduled for a practice session in both test environments. Exclusion criterion included balance impairments, cardiopulmonary conditions, and pain/recent surgeries that would adversely impact stepping performance. MATERIALS AND METHODS: Subjects performed the 2MST virtually via Zoom platform and F2F on two separate days within 1 week of each other in a counterbalanced order. The primary outcome measure was total number of steps with the right leg to the marked height in both testing sessions. Heart rate was measured prior to performance and immediately upon test completion on both days. Group differences were analyzed using twotailed paired t-tests. RESULT(S) 25 adults (mean age = 24.0 years, 9males, 16 females) completed both sessions. Three subjects were not able to complete both tests and were excluded from analysis. There is no significant difference in mean number of steps performed F2F (M=108.6, SD=11.5) and virtual (M=109.2, SD=15.1);t(24)= .359, p = .7227. The average of the difference in steps between F2F and the virtual environment was <1 step (0.6). Change in heart rate (bpm) was not significantly different in the second test (M=50.4, SD=24.8) compared with the first test (M=46.7, SD=23.6) suggesting similar exertion in both test environments;t(23)=1.0288, p= .3143. CONCLUSION(S) Our findings indicate 2MST performance in healthy adults aged 18-35 is not significantly different when administered via Zoom compared with F2F. This suggests the 2MST may be an effective tool, if a visual virtual option such as Zoom or Facetime, is available when assessing aerobic capacity remotely. Limitations of the study include generalizability to other age groups is currently unknown and the ability of subjects to independently set up the test remotely was not assessed. As in all virtual assessments, clinical reasoning guides which patients are appropriate to perform outcome measures safely, if skilled assistance in not available. CLINICAL RELEVANCE A valid tool to assess aerobic capacity in a virtual environment can improve patient care, improve access to physical activity interventions and improve health outcomes. Vulnerable populations, such as cancer survivors, who need virtual options for ongoing care will benefit from assessment tools that are adaptable and valid in virtual settings.