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Feasibility, Test-Retest Reliability and Convergent Validity of the Two-Minute Step Test in Older Adults With
M M A de Bondt1, T I M Hilgenkamp2,3, A Oppewal3,4
1Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Journal of Intellectual Disability Research : JIDR
|December 8, 2025
Summary
The Two-Minute Step Test (2MST) is a feasible, reliable, and valid measure of cardiorespiratory fitness in older adults with intellectual disabilities (ID). While feasibility varies by ID severity, its strong reliability and validity support its use in this population.
Area of Science:
- Gerontology
- Exercise Physiology
- Intellectual Disabilities Research
Background:
- Cardiorespiratory fitness is vital for health, yet challenging to assess in older adults with intellectual disabilities (ID).
- The Two-Minute Step Test (2MST) is a brief, accessible submaximal test, but its properties in older adults with ID were unestablished.
Purpose of the Study:
- To evaluate the feasibility, test-retest reliability, and convergent validity of the 2MST in older adults with ID.
- To determine if the 2MST is a suitable field test for assessing cardiorespiratory fitness in this demographic.
Main Methods:
- A cross-sectional study of 180 older adults (mean age 70.6 years) with ID within the HA-ID cohort.
- Feasibility assessed by protocol completion; reliability by intraclass correlation coefficient (ICC); convergent validity against balance, muscular endurance, and gait speed measures.
Main Results:
- The 2MST demonstrated moderate feasibility overall (48-49%), with good feasibility in borderline to moderate ID, but low feasibility in severe/profound ID.
- Excellent test-retest reliability was found (ICC = 0.88).
- The 2MST showed moderate to good convergent validity with static balance (r=0.46), gait speed (r=0.42-0.51), and muscular endurance (r=0.63).
Conclusions:
- The 2MST is a feasible, reliable, and valid field test for cardiorespiratory fitness in older adults with ID.
- Its suitability is particularly noted for individuals with borderline to moderate ID, while caution is advised for those with severe ID.
- The test's strong psychometric properties support its application in research and clinical settings for this population.
