Comparing treadmill and overground versions of the two-minute walk test in people with low back pain

Abstract

Purpose

Individuals with Low Back Pain (LBP) often face significant disabilities, including walking limitations. We use the Two-Minute Walk Test (2MWT) to assess walking performance, comparing overground and treadmill versions for correlation and interchangeability.

Material and methods

A randomised cross-over study of 40 participants with LBP randomly completed the 2MWT in a hallway and on a treadmill. The correlation was analysed by the Spearman Rho correlation coefficient (r), the agreement by the Bland-Altman method, differences between the testing orders by a paired sample t-test, and the association by a univariate regression.

Results

A high correlation was found between the methods (r = 0.76, p < 0.01). The difference between the methods was 45.4 metres (95% CI 33.4: 57.4, p < 0.01) or 29%, with an insignificant 6.8 metres (95% CI −17.4: 31.0, p = 0.57) between the testing orders. Notably, the distance walked in the hallway served as a strong predictor, explaining a substantial portion of the variation observed in the distance covered on the treadmill (R² = 0.61, p < 0.01).

Conclusion

Performance of the 2MWT overground and on a treadmill correlate highly in people with LBP. However, because participants walked 29% further in the hallway, treadmill walking is likely not an interchangeable alternative to testing when the aim is to evaluate performance.

Keywords:

• Low back pain
• walk test
• functional performance
• physiotherapy
• two-minute walk test

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.