Feasibility of a Child-Friendly 2-Minute Walk Test: A Crossover Randomized Controlled Trial

Abstract

Aims

Most studies that use the NIH Toolbox 2-Minute Walk Test with young children, modify the protocol, compromising the generalizability of outcomes. A standardizable protocol is needed. The purpose of this study was to compare the 2MWT performance of children ages 3–6 years on the standard NIH Toolbox protocol and on a modified protocol designed to support young children.

Methods

Cross-over randomized controlled trial. Fifteen typically developing children ages 3–6 years were randomly assigned to the performance order of the NIH toolbox 2MWT protocol and the Modified Accessibility Path (MAP) 2MWT protocol. Outcome variables and statistical analyses included test completion (McNemar test), distance walked (Wilcoxon signed-rank test), and accuracy (general estimating equation model with Poisson distribution).

Results

All children completed 2 min of walking with the MAP protocol. Only 40% of children completed the NIH Toolbox protocol, with 83% of these NIH completers bolstered by previous exposure to the MAP protocol. Collapsed across the order, children also had significantly fewer errors per lap with the MAP protocol (p < 0.0001), despite walking a significantly greater distance (p = 0.006).

Conclusions

These findings lend preliminary support for standardized application of a 2MWT with young children when the protocol is designed to be child-friendly.

Keywords:

• Child
• development
• endurance
• exercise test
• 2-Minute Walk Test

Acknowledgments

The authors wish to acknowledge Catherine Schaefer, MPT for participation in study design, recruitment, and data collection. They also wish to acknowledge Benjamin Schaefer, DPT for assistance with study design and data collection. Lastly, they acknowledge the children and parents who supported this study and the design of the MAP protocol in all its iterations.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

The participants of this study did not give written consent for their data to be shared publicly. Given that some of the raw data are video data and therefore identifiable, the supporting data are not available.

Additional information

Funding

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

Notes on contributors

Nicholas A. Kanetzke

Nicholas A. Kanetzke, BSN, MS is a PhD student at the University of Wisconsin-Milwaukee. His clinical experience includes cardiothoracic surgery and transplant, as well as Pediatric ICU. His research focuses on rehabilitation and exercise prescription for infants who have had corrective surgery for congenital heart defects.

Jacqueline E. Westerdahl

Jacqueline E. Westerdahl, MS, is a doctoral candidate in Health Sciences at the University of Wisconsin-Milwaukee. Her research focuses on the importance of a caregiver’s physical behaviors to support infant development and infant mental health and on strategies to improve protocols and assessments used with young children receiving physical therapy.

Chris C. Cho

Chi C. Cho, MS is a Biostatistician II in the Joseph J. Zilber College of Public Health, University of Wisconsin-Milwaukee. He has 18 years of experience as a biostatistician in health care research including areas such as public health, cardiology, nursing, kinesiology, and rehabilitation sciences.

Adané N. Durham

Adané N. Durham, BS, is a Doctor of Physical Therapy student at the University of Wisconsin-Milwaukee. Her professional and research interests are related to pediatrics, and she is engaged in research with the Pediatric Neuromotor Laboratory. She’s been a Maternal and Child Health trainee, Advanced Opportunities Fellow, and an OSEP scholar.

Victoria A. Moerchen

Victoria A. Moerchen, PT, PhD, is an Associate Professor in the College of Health Professions and Sciences, University of Wisconsin-Milwaukee. She has 36 years of experience in early intervention and directs the Pediatric Neuromotor Laboratory, with research focused on promotion of physical activity and interaction in infants and young children.