Articles
Reliability of the two-minute walk test in individuals with transtibial amputation,☆☆

Preliminary results presented at the Ontario Association of Amputee Care Conference, May 2001, Kingston, Ont, Canada.
https://doi.org/10.1053/apmr.2002.34600Get rights and content

Abstract

Brooks D, Hunter JP, Parsons J, Livsey E, Quirt J, Devlin M. Reliability of the two-minute walk test in individuals with transtibial amputation. Arch Phys Med Rehabil 2002;83:1562-5. Objective: To determine inter- and intrarater reliability of the two-minute walk test (2MWT) in individuals with transtibial amputation. Design: Prospective; test-retest method by a pair of trained physical therapists. Setting: Two regional amputee rehabilitation centers in Canada. Participants: Thirty-three subjects (23 men, 10 women; mean age ± standard error, 63.6±2.0y) with transtibial amputation; 6 in outpatient rehabilitation, 27 in inpatient rehabilitation. The most common primary diagnoses were peripheral vascular disease (n=15) and diabetes (n=11). Interventions: Each subject performed a total of four 2MWTs, 1 test for each rater, on 2 consecutive days at approximately the same time of day. Subjects were given at least a 20-minute rest between tests. The order of raters was randomized on the first day and reversed for the next day. The walk tests were performed in the same enclosed corridors with the same starting point for all tests. The subjects were familiar with the test or were given 1 or more practice tests at least 1 day before testing. Subjects were allowed to walk with a mobility aid of their choice. Raters used a digital stopwatch to time the tests and a calibrated wheel with a counter to measure the distance walked in meters. The raters were blinded to each other's scores. Main Outcome Measure: Distance walked in 2 minutes (in meters). Results: Within-rater reliability was high (intraclass correlation coefficient [ICC],.90–.96). Between rater reliability was also high (ICC.98–.99). Analysis of variance (ANOVA) showed a significant effect for day of test (P<.001) in the inpatient group but no effect for therapist (P=.098) or for interaction of day and therapist (P=.710). Similarly, in the outpatient group, ANOVA showed a significant effect for day (P=.013) but no effect for therapist (P=.259) or interaction of day and therapist (P=.923). Conclusion: Although the 2MWT showed evidence of inter- and intrarater reliability in individuals with unilateral below-knee amputation, the distance walked in 2 minutes continued to improve over time. This improvement was not solely the result of a training and learning effect. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Methods

The methods for the present study were based on the study by Connelly7 who examined the reliability of the 2MWT in the frail elderly. Our participants were physical therapists and clients from 2 regional amputee rehabilitation programs in the province of Ontario. Ethics approval was obtained from the research ethics boards of the University of Toronto and the 2 centers involved. At each site, reliability was evaluated by using the test-retest method with 2 physical therapists. Each subject

Results

The characteristics of the subjects in the total sample and in the inpatient and outpatient subgroups are in table 1.

. Subjects' characteristics, outpatients, inpatients, and total sample

Empty CellOutpatientsInpatientsAll
N62733
Age (y)55.3±4.4 (44–69)65.4±2.1 (42–80)63.6±2.0 (42–80)
No. of prior walk tests7.0±1.5 (1–10)1.5±0.2 (1–6)2.6±0.5 (1–10)
Days since prosthesis fitted105.2±53.0 (28–365)30.7±9.4 (7–270)44.2±12.8 (7–365)
Days of rehabilitation134.0±46.7 (56–365)31.5±3.5 (8–90)50.2±10.9 (8–365)
Days since

Discussion

The 2MWT exhibits good within- and between-rater reliability in individuals with transtibial amputation. However, the distance walked in 2 minutes was not constant over time, but increased over the 2 days in individuals undergoing either out- or inpatient rehabilitation.

Reliability is a fundamental measurement property that is relatively easy to determine. It is quantified in terms of degree of consistency and repeatability when properly administered under similar circumstances. Clinically,

Conclusion

The 2MWT is practical, simple, quick, and easy to administer. In the present prospective study, we found evidence of good inter- and intrarater reliability of the 2MWT in for the population of persons with unilateral below-knee amputation. However, the distance walked in 2 minutes was not constant, and it improved over time. The improvement was not solely the result of a training and learning effect and does not appear to plateau with repetition. The explanation for the improved performance

Acknowledgements

We thank Janet Campbell, Debbie Albuquerque, Ian Lowe, Maria Laskowski, and Rosalie Chan for their assistance with data collection.

References (15)

There are more references available in the full text version of this article.

Cited by (119)

View all citing articles on Scopus

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

☆☆

Reprint requests to Dina Brooks, PhD, Clinical Evaluation and Research Unit, West Park Healthcare Centre, 82 Buttonwood Ave, Toronto, Ont M6M 2J5, Canada, e-mail: [email protected].

View full text