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Validity of a Submaximal 6-min Recumbent Stepper Test for Cardiac Rehabilitation

Donaldson, Seth, MS; Wright, Lanecia, MS; Day, Amanda, BS; Weiford, Brian, MD

Journal of Cardiopulmonary Rehabilitation and Prevention: March 2019 - Volume 39 - Issue 2 - p E14–E17
doi: 10.1097/HCR.0000000000000413
Brief Reports

Purpose: Submaximal exercise tests, such as the 6-min walk test (6MWT), are used to assess and determine changes in cardiorespiratory fitness in cardiopulmonary rehabilitation (CR) programs. However, other modalities such as recumbent steppers are frequently utilized in rehabilitation settings and suit individuals of all ability levels; yet, no self-paced submaximal test has been developed for this exercise modality. The aim of this study was to produce a self-paced, submaximal 6-min recumbent stepper test (6MRST) that is comparable with the 6MWT and can be used as pre- and post-CR assessments.

Methods: Seventy subjects participating in CR performed a 6WMT and a 6MRST at the beginning and end of their CR program. Distance exercised, blood pressure, heart rate, and perceived exertion were measured to determine whether the 6MRST was comparable with the 6MWT.

Results: Significant correlations were found between the distance exercised in the 6MWT and the 6MRST during both pre- and post-CR testing (r = 0.540 and r = 0.700, respectively; P < .001). The distance for the 6MRST increased from 1599 to 2101 ft after CR. Heart rate and rating of perceived exertion showed strong correlations between the 6MWT and the 6MRST at both testing time points.

Conclusions: The 6MRST was found to produce similar results to that of the 6MWT in a CR setting. The 6MRST could therefore serve as an alternative to the 6MWT in those patients who cannot adequately perform a 6MWT, in a facility where space may be too limited, and a walking track is not available or simply due to patient or staff preference.

A self-paced, submaximal recumbent stepper test (6MRST) for cardiac rehabilitation was developed and tested on 70 patients who completed pre- and post-CR testing consisting of both the 6MRST and a 6-minute walk test (6MWT). Significant correlations were found between distance exercised and patient effort in the 6MWT and the 6MRST.

Cardiac Rehabilitation Program, The University of Kansas Health System, Kansas City.

Correspondence: Seth Donaldson, MS, Cardiac Rehabilitation Program, The University of Kansas Hospital, 4000 Cambridge St, Kansas City, KS 66160 (

The authors report no conflicts of interest.

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