Archives of physical medicine and rehabilitation · 2026
Comparing Physiological Cost Index Between the 2- and 6-Minute Walk Tests Across Neurologic Rehabilitation Cohorts.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Ho Amelia, Tay Ming Yi, Lim Yoke Sim
Аннотация
OBJECTIVE: To compare the Physiological Cost Index (PCI) across stroke, traumatic brain injury (TBI), and non-TBI groups; evaluate within-group changes in the PCI during inpatient rehabilitation; assess agreement between the PCI derived from the 2-minute walk test (2MWT) and the 6-minute walk test (6MWT); and estimate a distribution-based minimal clinically important difference.
DESIGN: Retrospective cohort study.
SETTING: Hospital.
PARTICIPANTS: Two hundred and twenty seven (N=227) adults undergoing inpatient neurorehabilitation, including individuals with stroke (n=117), TBI (n=71), and non-TBI neurologic conditions (n=39).
INTERVENTIONS: None..
MAIN OUTCOME MEASURES: The PCI (beats·m⁻¹) derived from the 2MWT and 6MWT at admission and discharge.
RESULTS: Individuals with non-TBI showed higher admission 6MWT-derived PCI values than those with stroke and TBI (global P=.0012; ε² effect size=0.073; post hoc: non-TBI>stroke P=.015; non-TBI>TBI P=.002). Stroke improved from admission to discharge (2MWT mean ± SD Δ, -0.13±0.41; 6MWT mean ± SD Δ, -0.17±0.59), while TBI/non-TBI changes were small/nonsignificant. Across groups and time points, PCI was higher for the 2MWT than for the 6MWT; the Bland-Altman mean bias was +0.35 (admission) and +0.26 (discharge) beats·m⁻¹.
CONCLUSIONS: The 2MWT yields systematically higher PCI values than the 6MWT, likely reflecting non-steady-state cardiovascular responses inherent to shorter-duration walking. Patients with stroke demonstrated clinically meaningful efficiency gains approaching an exploratory distribution-based minimal clinically important difference (∼0.2 beats·m⁻¹); anchor-validated thresholds require larger, diagnosis-specific cohorts.
DESIGN: Retrospective cohort study.
SETTING: Hospital.
PARTICIPANTS: Two hundred and twenty seven (N=227) adults undergoing inpatient neurorehabilitation, including individuals with stroke (n=117), TBI (n=71), and non-TBI neurologic conditions (n=39).
INTERVENTIONS: None..
MAIN OUTCOME MEASURES: The PCI (beats·m⁻¹) derived from the 2MWT and 6MWT at admission and discharge.
RESULTS: Individuals with non-TBI showed higher admission 6MWT-derived PCI values than those with stroke and TBI (global P=.0012; ε² effect size=0.073; post hoc: non-TBI>stroke P=.015; non-TBI>TBI P=.002). Stroke improved from admission to discharge (2MWT mean ± SD Δ, -0.13±0.41; 6MWT mean ± SD Δ, -0.17±0.59), while TBI/non-TBI changes were small/nonsignificant. Across groups and time points, PCI was higher for the 2MWT than for the 6MWT; the Bland-Altman mean bias was +0.35 (admission) and +0.26 (discharge) beats·m⁻¹.
CONCLUSIONS: The 2MWT yields systematically higher PCI values than the 6MWT, likely reflecting non-steady-state cardiovascular responses inherent to shorter-duration walking. Patients with stroke demonstrated clinically meaningful efficiency gains approaching an exploratory distribution-based minimal clinically important difference (∼0.2 beats·m⁻¹); anchor-validated thresholds require larger, diagnosis-specific cohorts.