• Juliano F Arcuri, Audrey Borghi-Silva, Ivana G Labadessa, Anna C Sentanin, Cecília Candolo, and Valéria A Pires Di Lorenzo.
• Departments of *Physiotherapy; and †Statistics, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
• Clin J Sport Med. 2016 Jan 1; 26 (1): 69-75.

ObjectiveTo determine the 6-minute step test's (6MST) reliability and validity and to establish reference performance values of this test.DesignProspective observational cross-sectional study.SettingSpirometry and Respiratory Physiotherapy Laboratory, Federal University of São Carlos (institutional).ParticipantsNinety-one individuals [42 men and 49 women, mean age = 39 years (SD, 17 years)] without any diagnosed diseases and with normal exercise capacity [6-minute walk test (6MWT) >75% of the predicted normal].Independent VariablesParticipants underwent two 6MST on 1 day and two 6MWT on another day in randomized order. Furthermore, age, gender, height, weight, lower limbs length, abdominal circumference, percentage of body fat, and fat-free mass were obtained.Main Outcome MeasuresTest-retest reliability was assessed by comparing the findings of the two 6MST using the intraclass correlation coefficient (ICC) and Bland-Altman plot. Validity was assessed by comparing outcomes of the 6MST to outcomes of 6MWT using the Pearson correlation coefficient. A multiple regression analysis was conducted using the stepwise method to develop an equation to predict reference values.ResultsThe performance (mean steps ± SD) in the first and second test was 149 ± 34 and 149 ± 36 steps, respectively, which was correlated to distance (in meters) in 6MWT (r = 0.72; P < 0.05). Six-minute step test performance was reliable (ICC = 0.9; 95% confidence interval: 0.85-0.93). The equation to predict reference values for the first 6MST was significant (P < 0.001 and R = 0.48): Performance(steps) = 174 to 1.05 × Age(years) to women and Performance(steps) = 209 to 1.05 × Age(years) to men.ConclusionsSix-minute step test is a reliable and valid test. Moreover, the number of steps may be predicted by demographic and anthropometric variables with moderate strength of prediction.Clinical RelevanceSix-minute step test is an exercise test that is easy to be conducted, more tolerable than a graded exercise test, requires fewer equipments and space, and permits better monitoring of the participants. The assessment of the reliability, validity, and reference values will provide a better interpretability for clinicians to use it, especially in primary care.

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