Feasibility of a Child-Friendly 2-Minute Walk Test: A Crossover Randomized Controlled Trial

Area of Science:

• Pediatric physical therapy
• Motor development assessment
• Clinical trial methodology

Background:

• Standardized protocols for the NIH Toolbox 2-Minute Walk Test (2MWT) are often modified for young children, impacting outcome generalizability.
• A need exists for a standardized, yet child-friendly, 2MWT protocol for children aged 3-6 years.

Purpose of the Study:

• To compare the performance of children aged 3-6 years on the standard NIH Toolbox 2MWT protocol versus a modified protocol (MAP).
• To evaluate test completion, distance walked, and accuracy between the two protocols.

Main Methods:

• A crossover randomized controlled trial involving 15 typically developing children aged 3-6 years.
• Children were randomly assigned to perform either the standard NIH Toolbox 2MWT or the Modified Accessibility Path (MAP) 2MWT first.
• Outcome measures included test completion, distance, and accuracy, analyzed using McNemar test, Wilcoxon signed-rank test, and generalized estimating equations.

Main Results:

• All children completed the 2MWT using the MAP protocol, whereas only 40% completed the standard NIH Toolbox protocol.
• Children exhibited significantly fewer errors per lap with the MAP protocol (p < 0.0001).
• Children walked a significantly greater distance with the MAP protocol (p = 0.006).

Conclusions:

• The Modified Accessibility Path (MAP) protocol demonstrates preliminary support for standardized 2MWT application in young children.
• A child-friendly protocol enhances completion rates, accuracy, and distance walked in the 2MWT for this age group.