What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Chronic heart failure (n=60). Intervention: Two-minute step test (2MST) vs. Six-minute walk test (6MWT). Primary outcome: Reduced functional capacity (six-minute walk distance ≤350 m) (AUC 0.818, 95% CI 0.712-0.924).

What question did this study set out to answer?

This study aims to establish a two-minute step test (2MST) cut-off for reduced functional capacity in heart failure patients and compare it with the six-minute walk test (6MWT).

June 10, 2026International Journal of Heart FailureOpen Access

Two-minute step test detects reduced functional capacity in CHF using a 94-step cut-off.

Q: What does this research mean for the field?

A two-minute step test cut-off of ≥94 steps demonstrates good discrimination for identifying reduced functional capacity in patients with chronic heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Why the study?

The 6MWT assesses functional capacity in CHF but is limited by space and logistics, whereas the 2MST is a practical alternative requiring an optimal cut-off for reduced functional capacity.

Does the two-minute step test (2MST) accurately assess functional capacity compared to the six-minute walk test (6MWT) in patients with chronic heart failure?

Population

60 clinically stable patients with CHF

Comparison

2MST vs 6MWT

Design

Cross-sectional study

Key result

A two-minute step test cut-off of ≥94 steps demonstrated good discrimination for identifying reduced functional capacity in patients with chronic heart failure, yielding an area under the curve of 0.82.

Authors

PWPitak Wutti ASArunrat Srithawong

Discussion

Member takes

Overview

Supports 2MST feasibility for functional assessment in chronic HF; leaves open need for prospective validation before clinical adoption.

Key Points

This study aims to establish a two-minute step test (2MST) cut-off for reduced functional capacity in heart failure patients and compare it with the six-minute walk test (6MWT).
Cross-sectional study involving 60 clinically stable heart failure patients (mean age 51.45 years, 77% male) who performed the 2MST and 6MWT.
Physiological and perceptual responses were recorded before, immediately after, and five minutes post-test.
Receiver operating characteristic analysis was used to find the optimal 2MST cut-off for reduced functional capacity.
A 2MST cut-off of ≥94 steps accurately identified reduced functional capacity with an area under the curve of 0.82 (95% CI 0.71-0.92).
This cut-off was associated with a greater six-minute walk distance (p=0.001) and lower post-exercise leg fatigue but not with quadriceps strength.
The 2MST resulted in greater post-exercise leg fatigue compared to the 6MWT (p<0.001), while other responses were similar (p>0.05).

Study Design

Type

Cross-Sectional (n=60)

Multicenter

Structured PICO

Does the two-minute step test (2MST) accurately assess functional capacity compared to the six-minute walk test (6MWT) in patients with chronic heart failure?

Population

60 clinically stable adults aged 20-70 years with chronic heart failure and LVEF <40% completed functional assessments in a cross-sectional study to evaluate the two-minute step test.

Exposure

Two-minute step test (2MST)

Comparator

Six-minute walk test (6MWT)

Outcome

Optimal 2MST cut-off for reduced functional capacity (discrimination accuracy)surrogate

Main Result

Effect estimate: AUC 0.818 (95% CI 0.712-0.924)

The two-minute step test with a cut-off of ≥94 steps is a feasible and accurate alternative to the six-minute walk test for assessing functional capacity in stable heart failure patients.

Limitations

Single-center study with a modest sample size
Predominantly younger, clinically stable patients with NYHA class I–II HF, limiting generalizability to older or more advanced HF populations
The 94-step cut-off was derived and evaluated within the same cohort, lacking external validation
Cross-sectional design limits assessment of longitudinal responsiveness or prognostic implications
Potential cumulative fatigue effects from conducting all assessments within a single session
Absence of cardiopulmonary exercise testing (CPET) with direct VO2 peak measurement precludes definitive validation against gold-standard indices

Cite This Study

Wutti et al. (2026) conducted a cross-sectional in Chronic heart failure (n=60). Two-minute step test (2MST) vs. Six-minute walk test (6MWT) was evaluated on Reduced functional capacity (six-minute walk distance ≤350 m) (AUC 0.818, 95% CI 0.712-0.924). A two-minute step test cut-off of ≥94 steps demonstrated good discrimination for identifying reduced functional capacity in patients with chronic heart failure, yielding an area under the curve of 0.82.

synapsesocial.com/papers/6a28fe716f82f25be989bb39 https://doi.org/10.36628/ijhf.2025.0091

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June 10, 2026International Journal of Heart FailureOpen Access

Two-minute step test detects reduced functional capacity in CHF using a 94-step cut-off.

View Full Paper

Ask AI

Bookmark

Why the study?

The 6MWT assesses functional capacity in CHF but is limited by space and logistics, whereas the 2MST is a practical alternative requiring an optimal cut-off for reduced functional capacity.

Does the two-minute step test (2MST) accurately assess functional capacity compared to the six-minute walk test (6MWT) in patients with chronic heart failure?

Population

60 clinically stable patients with CHF

Comparison

2MST vs 6MWT

Design

Cross-sectional study

Key result

Authors

PWPitak Wutti ASArunrat Srithawong

Discussion

Member takes

Overview

Supports 2MST feasibility for functional assessment in chronic HF; leaves open need for prospective validation before clinical adoption.

Key Points

This study aims to establish a two-minute step test (2MST) cut-off for reduced functional capacity in heart failure patients and compare it with the six-minute walk test (6MWT).
Cross-sectional study involving 60 clinically stable heart failure patients (mean age 51.45 years, 77% male) who performed the 2MST and 6MWT.
Physiological and perceptual responses were recorded before, immediately after, and five minutes post-test.
Receiver operating characteristic analysis was used to find the optimal 2MST cut-off for reduced functional capacity.
A 2MST cut-off of ≥94 steps accurately identified reduced functional capacity with an area under the curve of 0.82 (95% CI 0.71-0.92).
This cut-off was associated with a greater six-minute walk distance (p=0.001) and lower post-exercise leg fatigue but not with quadriceps strength.
The 2MST resulted in greater post-exercise leg fatigue compared to the 6MWT (p<0.001), while other responses were similar (p>0.05).

Study Design

Type

Cross-Sectional (n=60)

Multicenter

Structured PICO

Does the two-minute step test (2MST) accurately assess functional capacity compared to the six-minute walk test (6MWT) in patients with chronic heart failure?

Population

60 clinically stable adults aged 20-70 years with chronic heart failure and LVEF <40% completed functional assessments in a cross-sectional study to evaluate the two-minute step test.

Exposure

Two-minute step test (2MST)

Comparator

Six-minute walk test (6MWT)

Outcome

Optimal 2MST cut-off for reduced functional capacity (discrimination accuracy)surrogate

Main Result

Effect estimate: AUC 0.818 (95% CI 0.712-0.924)

The two-minute step test with a cut-off of ≥94 steps is a feasible and accurate alternative to the six-minute walk test for assessing functional capacity in stable heart failure patients.

Limitations

Single-center study with a modest sample size
Predominantly younger, clinically stable patients with NYHA class I–II HF, limiting generalizability to older or more advanced HF populations
The 94-step cut-off was derived and evaluated within the same cohort, lacking external validation
Cross-sectional design limits assessment of longitudinal responsiveness or prognostic implications
Potential cumulative fatigue effects from conducting all assessments within a single session
Absence of cardiopulmonary exercise testing (CPET) with direct VO2 peak measurement precludes definitive validation against gold-standard indices

Cite This Study

synapsesocial.com/papers/6a28fe716f82f25be989bb39 https://doi.org/10.36628/ijhf.2025.0091

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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