Validity and reliability of the 6-min stepper test in hypertensive individuals

BACKGROUND: Hypertension is a common public health problem characterized by high blood pressure (BP) and associated with complications such as coronary artery disease, stroke, and renal failure. Physical activity and exercise regulate BP, and assessment of exercise capacity is a cornerstone of exercise training. OBJECTIVE: The aims of this study were to evaluate the validity and reliability of the 6-min stepper test (6MST) in hypertensive individuals and compare their physiological responses during the 6MST and 6-min walk test (6MWT). METHODS: Forty individuals with hypertension were included. Participants performed the 6MWT and 6MST in separate morning and afternoon sessions. In each session, the test was repeated twice with a 30-min rest interval. Heart rate (HR), BP, perceived dyspnea, general fatigue, and leg fatigue were measured pre and posttest. Intraclass correlation coefficient (ICC), Bland-Altman plots, and standard error of measurement (SEM) were used to assess reliability. Pearson correlation analysis was used for convergent validity. RESULTS: There was a strong and significant correlation between 6MWT distance and 6MST score ( r = 0.689, P < 0.001). Physiological responses during the 6MST had ICC values ranging from 0.70 to 0.89, suggesting good to excellent test-retest reliability. The SEM and minimum detectable difference (MDD) indicated the 6MST had low measurement error and high sensitivity. CONCLUSION: The 6MST is a valid and reliable tool for assessing exercise capacity in people with HTN. Its practicality and ease of use make it a suitable alternative to the 6MWT for this population.