The 6-min push test is reliable and predicts low fitness in spinal cord injury

Rachel E Cowan, Morgan K. Callahan, Mark S Nash

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

PURPOSE: The objective of this study is to assess 6-min push test (6MPT) reliability, determine whether the 6MPT is sensitive to fitness differences, and assess if 6MPT distance predicts fitness level in persons with spinal cord injury (SCI) or disease. METHODS: Forty individuals with SCI who could self-propel a manual wheelchair completed an incremental arm crank peak oxygen consumption assessment and two 6MPTs across 3 d (37% tetraplegia (TP), 63% paraplegia (PP), 85% men, 70% white, 63% Hispanic, mean age = 34 ± 10 yr, mean duration of injury = 13 ± 10 yr, and mean body mass index = 24 ± 5 kg•m). Intraclass correlation and Bland-Altman plots assessed 6MPT distance (m) reliability. Mann-Whitney U test compared 6MPT distance (m) of high and low fitness groups for TP and PP. The fitness status prediction was developed using N = 30 and validated in N = 10 (validation group (VG)). A nonstatistical prediction approach, below or above a threshold distance (TP = 445 m and PP = 604 m), was validated statistically by binomial logistic regression. Accuracy, sensitivity, and specificity were computed to evaluate the threshold approach. RESULTS: Intraclass correlation coefficients exceeded 0.90 for the whole sample and the TP/PP subsets. High fitness persons propelled farther than low fitness persons for both TP/PP (both P < 0.05). Binomial logistic regression (P < 0.008) predicted the same fitness levels in the VG as the threshold approach. In the VG, overall accuracy was 70%. Eighty-six percent of low fitness persons were correctly identified (sensitivity), and 33% of high fitness persons were correctly identified (specificity). CONCLUSION: The 6MPT may be a useful tool for SCI clinicians and researchers. 6MPT distance demonstrates excellent reliability and is sensitive to differences in fitness level. 6MPT distances less than a threshold distance may be an effective approach to identify low fitness in person with SCI.

Original languageEnglish
Pages (from-to)1993-2000
Number of pages8
JournalMedicine and Science in Sports and Exercise
Volume44
Issue number10
DOIs
StatePublished - Oct 1 2012

Fingerprint

Quadriplegia
Spinal Cord Injuries
Paraplegia
Logistic Models
Wheelchairs
Spinal Cord Diseases
Nonparametric Statistics
Hispanic Americans
Oxygen Consumption
Body Mass Index
Research Personnel
Sensitivity and Specificity
Wounds and Injuries

Keywords

  • cardiovascular fitness
  • field test
  • spinal cord injury
  • Wheelchair

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

The 6-min push test is reliable and predicts low fitness in spinal cord injury. / Cowan, Rachel E; Callahan, Morgan K.; Nash, Mark S.

In: Medicine and Science in Sports and Exercise, Vol. 44, No. 10, 01.10.2012, p. 1993-2000.

Research output: Contribution to journalArticle

@article{b3f0d4c182a64dc8b2fbf346e542cb35,
title = "The 6-min push test is reliable and predicts low fitness in spinal cord injury",
abstract = "PURPOSE: The objective of this study is to assess 6-min push test (6MPT) reliability, determine whether the 6MPT is sensitive to fitness differences, and assess if 6MPT distance predicts fitness level in persons with spinal cord injury (SCI) or disease. METHODS: Forty individuals with SCI who could self-propel a manual wheelchair completed an incremental arm crank peak oxygen consumption assessment and two 6MPTs across 3 d (37{\%} tetraplegia (TP), 63{\%} paraplegia (PP), 85{\%} men, 70{\%} white, 63{\%} Hispanic, mean age = 34 ± 10 yr, mean duration of injury = 13 ± 10 yr, and mean body mass index = 24 ± 5 kg•m). Intraclass correlation and Bland-Altman plots assessed 6MPT distance (m) reliability. Mann-Whitney U test compared 6MPT distance (m) of high and low fitness groups for TP and PP. The fitness status prediction was developed using N = 30 and validated in N = 10 (validation group (VG)). A nonstatistical prediction approach, below or above a threshold distance (TP = 445 m and PP = 604 m), was validated statistically by binomial logistic regression. Accuracy, sensitivity, and specificity were computed to evaluate the threshold approach. RESULTS: Intraclass correlation coefficients exceeded 0.90 for the whole sample and the TP/PP subsets. High fitness persons propelled farther than low fitness persons for both TP/PP (both P < 0.05). Binomial logistic regression (P < 0.008) predicted the same fitness levels in the VG as the threshold approach. In the VG, overall accuracy was 70{\%}. Eighty-six percent of low fitness persons were correctly identified (sensitivity), and 33{\%} of high fitness persons were correctly identified (specificity). CONCLUSION: The 6MPT may be a useful tool for SCI clinicians and researchers. 6MPT distance demonstrates excellent reliability and is sensitive to differences in fitness level. 6MPT distances less than a threshold distance may be an effective approach to identify low fitness in person with SCI.",
keywords = "cardiovascular fitness, field test, spinal cord injury, Wheelchair",
author = "Cowan, {Rachel E} and Callahan, {Morgan K.} and Nash, {Mark S}",
year = "2012",
month = "10",
day = "1",
doi = "10.1249/MSS.0b013e31825cb3b6",
language = "English",
volume = "44",
pages = "1993--2000",
journal = "Medicine and Science in Sports and Exercise",
issn = "0195-9131",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - The 6-min push test is reliable and predicts low fitness in spinal cord injury

AU - Cowan, Rachel E

AU - Callahan, Morgan K.

AU - Nash, Mark S

PY - 2012/10/1

Y1 - 2012/10/1

N2 - PURPOSE: The objective of this study is to assess 6-min push test (6MPT) reliability, determine whether the 6MPT is sensitive to fitness differences, and assess if 6MPT distance predicts fitness level in persons with spinal cord injury (SCI) or disease. METHODS: Forty individuals with SCI who could self-propel a manual wheelchair completed an incremental arm crank peak oxygen consumption assessment and two 6MPTs across 3 d (37% tetraplegia (TP), 63% paraplegia (PP), 85% men, 70% white, 63% Hispanic, mean age = 34 ± 10 yr, mean duration of injury = 13 ± 10 yr, and mean body mass index = 24 ± 5 kg•m). Intraclass correlation and Bland-Altman plots assessed 6MPT distance (m) reliability. Mann-Whitney U test compared 6MPT distance (m) of high and low fitness groups for TP and PP. The fitness status prediction was developed using N = 30 and validated in N = 10 (validation group (VG)). A nonstatistical prediction approach, below or above a threshold distance (TP = 445 m and PP = 604 m), was validated statistically by binomial logistic regression. Accuracy, sensitivity, and specificity were computed to evaluate the threshold approach. RESULTS: Intraclass correlation coefficients exceeded 0.90 for the whole sample and the TP/PP subsets. High fitness persons propelled farther than low fitness persons for both TP/PP (both P < 0.05). Binomial logistic regression (P < 0.008) predicted the same fitness levels in the VG as the threshold approach. In the VG, overall accuracy was 70%. Eighty-six percent of low fitness persons were correctly identified (sensitivity), and 33% of high fitness persons were correctly identified (specificity). CONCLUSION: The 6MPT may be a useful tool for SCI clinicians and researchers. 6MPT distance demonstrates excellent reliability and is sensitive to differences in fitness level. 6MPT distances less than a threshold distance may be an effective approach to identify low fitness in person with SCI.

AB - PURPOSE: The objective of this study is to assess 6-min push test (6MPT) reliability, determine whether the 6MPT is sensitive to fitness differences, and assess if 6MPT distance predicts fitness level in persons with spinal cord injury (SCI) or disease. METHODS: Forty individuals with SCI who could self-propel a manual wheelchair completed an incremental arm crank peak oxygen consumption assessment and two 6MPTs across 3 d (37% tetraplegia (TP), 63% paraplegia (PP), 85% men, 70% white, 63% Hispanic, mean age = 34 ± 10 yr, mean duration of injury = 13 ± 10 yr, and mean body mass index = 24 ± 5 kg•m). Intraclass correlation and Bland-Altman plots assessed 6MPT distance (m) reliability. Mann-Whitney U test compared 6MPT distance (m) of high and low fitness groups for TP and PP. The fitness status prediction was developed using N = 30 and validated in N = 10 (validation group (VG)). A nonstatistical prediction approach, below or above a threshold distance (TP = 445 m and PP = 604 m), was validated statistically by binomial logistic regression. Accuracy, sensitivity, and specificity were computed to evaluate the threshold approach. RESULTS: Intraclass correlation coefficients exceeded 0.90 for the whole sample and the TP/PP subsets. High fitness persons propelled farther than low fitness persons for both TP/PP (both P < 0.05). Binomial logistic regression (P < 0.008) predicted the same fitness levels in the VG as the threshold approach. In the VG, overall accuracy was 70%. Eighty-six percent of low fitness persons were correctly identified (sensitivity), and 33% of high fitness persons were correctly identified (specificity). CONCLUSION: The 6MPT may be a useful tool for SCI clinicians and researchers. 6MPT distance demonstrates excellent reliability and is sensitive to differences in fitness level. 6MPT distances less than a threshold distance may be an effective approach to identify low fitness in person with SCI.

KW - cardiovascular fitness

KW - field test

KW - spinal cord injury

KW - Wheelchair

UR - http://www.scopus.com/inward/record.url?scp=84866540529&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866540529&partnerID=8YFLogxK

U2 - 10.1249/MSS.0b013e31825cb3b6

DO - 10.1249/MSS.0b013e31825cb3b6

M3 - Article

C2 - 22617394

AN - SCOPUS:84866540529

VL - 44

SP - 1993

EP - 2000

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

SN - 0195-9131

IS - 10

ER -