Purpose
The 2 Minute Step Test is used to assess an individual’s aerobic capacity and evaluate their level of functional fitness.
The 2 Minute Step Test is used to assess an individual’s aerobic capacity and evaluate their level of functional fitness.
1
2 minutes
Adult
60 - 64
yearsOlder Adults
65 +
yearsRiley Caughlin, BS, MS, SPT
Bayler Andrews, BS, SPT
Mike Richardson, PT, DPT, DHSc, Board Certified Geriatric Clinical Specialist
Leslie Ayres, PT, DPT, Board Certified Cardiovascular and Pulmonary Clinical Specialist
Kenneth L Miller, PT, DPT, Board Certified Geriatric Clinical Specialist
The original study for the 2 Minute Step Test did not specify if the use of assistive devices (i.e. walkers or canes) were allowed; however, various subsequent studies have allowed for the use of assistive devices to maintain balance while conducting the test.
Older Adults: (Uher & Liba, 2017; N = 112; age range = 64-65 years; Slovakian sample)
Older Adults: (Rikli & Jones, 2013; N = 2,140; age range = 60-94 years)
Cut-off scores for predicting physical independence:
Age (Years) |
Step count (Male participants) |
Step count (Female participants) |
60-64 |
106 |
97 |
65-69 |
101 |
93 |
70-74 |
95 |
89 |
75-79 |
88 |
84 |
80-84 |
80 |
78 |
85-89 |
71 |
70 |
90-94 |
60 |
60 |
Older Adults: (Rikli & Jones, 1999b; N = 7,183; age range = 60-94 years)
Normative data for males (n = 2,135):
Age Range (years) |
Participants (n) |
Step Count (SD) |
60-64 |
241 |
101 (21) |
65-69 |
482 |
101 (23) |
70-74 |
515 |
95 (23) |
75-79 |
464 |
91 (27) |
80-84 |
241 |
87 (24) |
85-89 |
116 |
75 (24) |
90-94 |
76 |
69 (26) |
Normative data for females (n = 5,048):
Age Range (years) |
Participants (n) |
Step Count (SD) |
60-64 |
620 |
91 (24) |
65-69 |
1,084 |
90 (26) |
70-74 |
1,298 |
84 (25) |
75-79 |
987 |
84 (24) |
80-84 |
543 |
75 (23) |
85-89 |
354 |
70 (22) |
90-94 |
158 |
58 (21) |
Percentiles for males:
Age (Years) |
10th Percentile (steps) |
25th Percentile (steps) |
50th Percentile (steps) |
75th Percentile (steps) |
90th Percentile (steps) |
60-64 |
74 |
87 |
101 |
115 |
128 |
65-69 |
72 |
86 |
101 |
116 |
130 |
70-74 |
66 |
80 |
95 |
110 |
125 |
75-79 |
56 |
73 |
91 |
109 |
125 |
80-84 |
56 |
71 |
87 |
103 |
118 |
85-89 |
44 |
59 |
75 |
91 |
106 |
90-94 |
36 |
52 |
69 |
86 |
102 |
Percentiles for females:
Age (Years) |
10th Percentile (steps) |
25th Percentile (steps) |
50th Percentile (steps) |
75th Percentile (steps) |
90th Percentile (steps) |
60-64 |
60 |
75 |
91 |
107 |
122 |
65-69 |
57 |
73 |
90 |
107 |
123 |
70-74 |
53 |
68 |
84 |
101 |
116 |
75-79 |
52 |
68 |
84 |
100 |
115 |
80-84 |
46 |
60 |
75 |
91 |
104 |
85-89 |
42 |
55 |
70 |
85 |
98 |
90-94 |
31 |
44 |
58 |
72 |
85 |
Older Adults: (Rikli & Jones, 2013; N = 2,140; age range = 60-94 years)
Step counts for older adults defined as “moderate functioning” via the Composite Physical Function Scale:
Age (Years) |
Participants (n) |
Males: Step Count (SD) |
Females: Step Count (SD) |
60-64 |
144 |
92.6 (20.8) |
85.9 (24.5) |
65-69 |
369 |
89.3 (25.1) |
85.1 (24.2) |
70-74 |
538 |
92.5 (20.6) |
83.5 (21.9) |
75-79 |
515 |
90.1 (27.0) |
83.1 (23.0) |
80-84 |
306 |
81.2 (27.1) |
78.5 (19.7) |
85-89 |
180 |
75.5 (28.5) |
74.2 (18.4) |
90-94 |
88 |
60.0 (22.1) |
60.4 (22.1) |
Older Adults with Obesity: (Guede-Rojas et al., 2020; N = 75; mean age (SD) = 79.1 (5.6) years; Chilean sample)
Gender |
Age (SD) |
BMI (SD) |
Steps (SD) |
Males (n = 19) |
72.5 (6.2) |
32.7 (4.5) |
64.79 (16.56) |
Females (n = 56) |
71.8 (5.4) |
31.8 (5.2) |
46.16 (18.81) |
Older Adults in community or nursing home settings: (Kazoglu & Yuruk, 2020; N = 118; Turkish sample)
Setting |
Participants (n) |
Age (SD) |
Steps (SD) |
Nursing Home |
n = 59 |
70.2 (2.3) |
80.3 (7.1) |
Community |
n = 59 |
70.3 (3.9) |
66.5 (11.2) |
Older Adults: (Uher & Liba, 2017; N = 112; age range = 64-65 years; Slovakian sample)
Living Environment |
Participants (n) |
Steps (SD) |
Home |
n = 55 |
68.71 (34.36) |
Facility |
n = 57 |
29 (20.54) |
Older Adults: (Bhattacharya et al., 2017; N = 400; mean (SD) age for males = 69.80 (3.82) years; mean (SD) age for females = 67.25 (2.57) years; Indian sample)
Normative data for males (n = 284):
Age (years) |
Participants (n) |
Steps (SD) |
65-69 |
147 |
67.4 (21.9) |
70-74 |
117 |
56.1 (21.4) |
75-79 |
12 |
53.4 (12.2) |
> 80 |
8 |
47.2 (14) |
Normative data for females (n = 116):
Age (years) |
Participants (n) |
Steps (SD) |
65-69 |
100 |
62.7 (16.9) |
70-74 |
14 |
51.7 (10.5) |
75-79 |
2 |
37.0 (0) |
Percentiles for males:
Age (Years) |
10th Percentile (steps) |
25th Percentile (steps) |
50th Percentile (steps) |
75th Percentile (steps) |
90th Percentile (steps) |
99th Percentile (steps) |
65-69 |
39.0 |
51.0 |
67.0 |
82.0 |
99.0 |
120.0 |
70-74 |
30.8 |
41.0 |
54.0 |
70.0 |
87.0 |
116.6 |
75-79 |
35.0 |
48.0 |
53.5 |
60.0 |
75.2 |
80.0 |
> 80 |
20.0 |
39.0 |
50.0 |
60.0 |
60.0 |
60.0 |
Percentiles for females:
Age (years) |
10th Percentile (steps) |
25th Percentile (steps) |
50th Percentile (steps) |
75th Percentile (steps) |
90th Percentile (steps) |
99th Percentile (steps) |
65-69 |
43.0 |
49.3 |
64.0 |
76.5 |
85.0 |
98.9 |
70-74 |
35.0 |
45.3 |
52.0 |
60.8 |
64.0 |
64.0 |
75-79 |
37.0 |
37.0 |
37.0 |
37.0 |
37.0 |
37.0 |
Older Adults: (Kim et al., 2020; N = 1009; Nepalese sample)
Normative data for males (n = 449):
Age (years) |
Participants (n) |
Steps (SD) |
60-64 |
121 |
57.7 (18.96) |
65-69 |
140 |
56.2 (19.18) |
70-74 |
85 |
49.5 (18.48) |
75-79 |
66 |
44.5 (18.60) |
> 80 |
37 |
42.5 (19.33) |
Normative data for females (n = 560):
Age (years) |
Participants (n) |
Steps (SD) |
60-64 |
198 |
44.8 (16.39) |
65-69 |
185 |
42.3 (15.74) |
70-74 |
101 |
41.9 (11.85) |
75-79 |
50 |
37.7 (13.90) |
> 80 |
26 |
34.5 (13.73) |
Older adults: (Hsiao et al., 2017; N = 442; Taiwanese sample)
Older Adults: (Rikli & Jones, 2013)
Older Adults: (Rikli & Jones, 1999a; N = 82; Mean (SD) age = 71.8 (6.9) years)
Older Adults: (Rikli & Jones, 2013)
Predictive Validity:
Taiwanese Older adults: (Hsiao et al., 2017)
Older Obese Adults: (Guede-Rojas et al., 2020)
Concurrent Validity:
Older Adults: (Dugas, 1996; N = 24; mean (SD) age = 69.6 (6.5) years)
Older Adults: (Johnston, 1998; N = 25; mean (SD) age = 72.1 (6.2) years)
Older Obese Adults: (Guede-Rojas et al., 2020)
Older Adults: (de Oliviera Brito et al., 2014; N = 37; mean (SD) age = 70 (7) years)
Older Adults: (Rikli & Jones, 1999b)
Moderate effect size of step counts between men and women (0.37)
Convergent validity:
Mild to Moderate Chronic Obstructive Pulmonary Disease: (Priya et al., 2019; N = 30; age range 20-75 years)
Hypertensive Older Adults: (Guedes et al., 2015; N = 101; mean (SD) age = 69.80 (7.55) years; 59% Normotensive (BP < 139/89), 41% Hypertensive (BP > 140/90); Brazilian sample)
Cutoff point of hypertensive elderly for normal functional capacity was 69 steps (sensitivity of 80% and specificity of 54%).
Cutoff point of hypertensive elderly with associated conditions for normal functional capacity was 65 steps (sensitivity of 83% and specificity of 67%).
Hypertensive Older Adults: (Chhajed, 2014; N = 30; mean (SD) age = 71.13 (7.17) years; mean (SD) systolic blood pressure = 134.77 (9.72); mean (SD) diastolic blood pressure = 79.27 (9.13))
Heart Failure: (Wegrzynowska-Tedorczyk et al., 2016; N = 168; mean (SD) age: 59 (12) years; New York Heart Association Classification: Class I n = 28, Class II n = 85, Class III n = 49, Class IV n = 6; mean (SD) Left Ventricular Ejection Fraction = 32% (8%); Polish sample)
New York Heart Association Classification Scale |
Steps (SD) |
NYHA Class I-II (n = 113) |
92.3 (21.2) |
NYHA Class III-IV (n = 55) |
79.4 (19.7) |
NYHA Class I-IV (n = 168) |
88.0 (22.1) |
Heart Failure: (Alosco et al., 2012; N = 145; mean (SD) age = 68.97 (9.31) years; New York Heart Association Classification Class II-III at time of study)
Gender |
Steps (SD) |
Males (n = 89) |
60.85 (23.13) |
Females (n = 56) |
55.79 (21.91) |
Group (n = 145) |
58.90 (22.73) |
Heart Failure: (Alosco et al., 2013; N = 69; mean (SD) age = 68.07 (8.02) years; mean (SD) Left Ventricular Ejection Fraction = 42.32% (14.11%))
Gender |
Steps (SD) |
Males (n = 40) |
70.30 (22.17) |
Females (n = 29) |
57.34 (18.37) |
Group (n = 69) |
64.86 (21.50) |
Hypertensive Older Adults: (Guedes et al., 2015; N = 101; mean (SD) age = 69.80 (7.55) years; 59% Normotensive (BP < 139/89), 41% Hypertensive (BP > 140/90); Brazilian sample)
Hypertensive Older Women: (Pedrosa & Holanda, 2009; N = 32; mean (SD) age = 65.4 (5.4) years; mean (SD) time since diagnosis = 17.7 (9.2) years)
Predictive validity:
Hypertensive Older Adults: (Guedes et al., 2015; N = 101; mean (SD) age = 69.80 (7.55) years; 59% Normotensive (BP < 139/89), 41% Hypertensive (BP > 140/90); Brazilian sample)
Concurrent validity:
Heart Failure: (Alosco et al., 2012; N = 145; mean (SD) age = 68.97 (9.31) years; New York Heart Association Classification Class II-III at time of study)
Heart Failure: (Garcia et al., 2013; N = 41; mean (SD) age 68.34 (8.41) years; mean (SD) Left Ventricular Ejection Fraction = 39.00% (10.79%)
Convergent validity:
Heart Failure: (Wegrzynowska-Tedorczyk et al., 2016; N = 168; mean (SD) age: 59 (12) years; New York Heart Association Classification: Class I n = 28, Class II n = 85, Class III n = 49, Class IV n = 6; Left Ventricular Ejection Fraction (SD) = 32% (8%); Polish sample)
Hypertensive Older Adults: (Chhajed, 2014; N = 30; mean (SD) age = 71.13 (7.17) years; mean (SD) systolic blood pressure = 134.77 (9.72); mean (SD) diastolic blood pressure = 79.27 (9.13))
Hypertensive Older Women: (Pedrosa & Holanda, 2009)
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
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Activity Level |
Average (SD) age (years) |
SEM (steps) for interrater reliability |
SEM (steps) for intrarater reliability |
Sedentary (age 18-24) |
21.69 (1.53) |
3.47 |
3.98 |
Active (age 18-24) |
21.92 (1.45) |
6.87 |
8.70 |
Sedentary (age 25-44) |
29.44 (5.17) |
4.41 |
7.17 |
Active (age 25-44) |
30.80 (5.72) |
5.08 |
6.85 |
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
Activity Level |
Average (SD) age (years) |
MDC95 (steps) |
Sedentary (age 18-24) |
21.69 (1.53) |
9.61-11.05 |
Active (age 18-24) |
21.92 (1.45) |
19.05-24.10 |
Sedentary (age 25-44) |
29.44 (5.17) |
12.21-19.80 |
Active (age 25-44) |
30.80 (5.72) |
14.09-18.99 |
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
Young Adults: (Freitas et al., 2020; N = 60; 33.33% eutrophic, 33.33% overweight, 33.33% obese type I; mean (SD) age of eutrophic population = 21.95 (1.82) years; mean (SD) age of overweight population = 25.05 (8.10) years; mean (SD) age of obese type I population = 26.50 (9.76) years; Brazilian sample)
Body Type |
Average (SD) age (years) |
BMI (SD) |
Steps (SD) |
Eutrophic |
21.95 (1.82) |
21.59 (1.75) |
78.70 (16.37) |
Overweight |
25.05 (8.10) |
26.51 (1.06) |
83.65 (10.77) |
Obese |
26.50 (9.76) |
31.34 (1.39) |
79.15 (13.92) |
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
Activity Level |
Interrater Reliability (ICC) |
Intrarater Reliability (ICC) |
Sedentary (age 18-24) |
Excellent (0.90) |
Excellent (0.87) |
Active (age 18-24) |
Excellent (0.92) |
Excellent (0.90) |
Sedentary (age 25-44) |
Excellent (0.92) |
Excellent (0.83) |
Active (age 25-44) |
Excellent (0.96) |
Excellent (0.91) |
Predictive validity:
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
Poor predictive validity of the 2MST at predicting levels of activity according to the Baecke Questionnaire (AUC = 0.67)
Concurrent validity:
Healthy Adults: (Nogueira et al., 2021; N = 200; 25% sedentary between ages 18-24, 25% active between ages 18-24, 25% sedentary between ages 25-44, 25% active between ages 25-44; Brazilian sample)
Adequate correlation between the 2MST and the Baecke Questionnaire (r = 0.34)
Concurrent validity:
Cancer Patients: (Quinn et al., 2020; N = 103; mean (SD) age = 64.7 (11.6) years)
Alzheimer’s Dementia: (Plácido et al., 2019; N = 93; age > 60 years; 39% healthy adults, 19% mild cognitive impairment, 27% mild Alzheimer’s Dementia, 15% moderate Alzheimer’s Dementia; Brazilian sample)
Population |
Mean (SD) age (years) |
Steps Count (SD) |
Healthy Adults |
74.2 (9.2) |
87.6 (20.8) |
Mild Cognitive Impairment |
78.0 (5.5) |
75.7 (21.0) |
Mild Alzheimer’s Dementia |
78.5 (7.4) |
63.8 (27.2) |
Moderate Alzheimer’s Dementia |
78.9 (8.3) |
54.6 (26.5) |
Concurrent validity:
Alzheimer’s Dementia: (Plácido et al., 2019; N = 93; age > 60 years; 39% healthy adults, 19% mild cognitive impairment, 27% mild Alzheimer’s Dementia, 15% moderate Alzheimer’s Dementia; Brazilian sample)
Parkinson’s Disease: (Youm et al., 2020; N = 17; Korean sample)
Group Sample |
Mean (SD) age (years) |
Mean (SD) Hoehn & Yahr stage |
Mean (SD) Unified Parkinson’s Disease Rating Scale score |
Baseline 2MST Steps (SD) |
Exercise (n = 10) |
68.0 (6.8) |
2.40 (.32) |
64.55 (18.33) |
93.9 (18.5) |
Control (n = 7) |
72.1 (6.0) |
2.29 (0.39) |
66.00 (10.17) |
83.9 (15.2) |
Parkinson’s Disease: (Youm et al., 2020; N = 17; Korean sample)
Chronic Kidney Disease (Stage 4-5): (Chen et al., 2018; N = 156; Taiwanese sample)
Chronic Kidney Disease (Stage 3-4): (Aoike et al., 2014; N = 29; mean (SD) age = 55.1 (11.6) years; mean (SD) BMI for CKD exercise group = 31.7 (4.5); mean (SD) BMI for CKD control group = 30.7 (4.1); Brazilian sample)
Chronic Non-Specific Low Back Pain: (Vachalathiti et al., 2020; N = 60; 50% Chronic Non-Specific Low Back Pain (CNSLBP), 50% non-CNSLBP; Taiwanese sample)
Category |
Number of participants |
Mean (SD) age (years) |
Mean (SD) 2MST score |
CNSLBP |
30 |
43.5 (8.53) |
82.37 (23.52) |
Non-CNSLBP |
30 |
40.46 (8.66) |
95.50 (16.41) |
Chronic Non-Specific Low Back Pain: (Sakulsriprasert et al., 2019; N = 20; 35% male, 65% female; mean (SD) age = 43.15 (2.03); Chinese sample)
Mean (SD) 2MST score: 77.4 (34.0) steps
Chronic Non-Specific Low Back Pain: (Sakulsriprasert et al., 2019)
Stroke: (Taylor-Piliae et al., 2012; N = 100; age (SD) = 70 (10) years; post stroke time (SD) = 39 (49) months)
Predictive validity:
Stroke: (Taylor-Piliae et al., 2012; N = 100; age (SD) = 70 (10) years; post stroke time (SD) = 39 (49) months)
Concurrent validity:
Stroke: (Taylor-Piliae et al., 2012; N = 100; age (SD) = 70 (10) years; post stroke time (SD) = 39 (49) months)
Frailty: (Furtado et al., 2019; n = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)
Fallers and Non-Fallers: (Zhao & Chung, 2016; N = 78; 62% at risk of falling; mean (SD) age of participants at risk of falling = 69.70 (3.64) years; mean (SD) age of participants not at risk of falling = 70.10 (3.75) years; Chinese sample)
Fallers and Non-Fallers: (Toraman & Y?ld?r?m, 2010; N = 60; mean (SD) age = 73.3 (6.6) years; Turkish sample)
Median 2MST score: 51 steps
Fallers and Non-Fallers: (Zak et al., 2017; N = 102, mean (SD) age = 70 (4.33) years; 49% between ages 65-69, 30% between ages 70-74, 21% between ages 75-79; female post-menopausal Breast Cancer survivors; Polish sample)
Sarcopenia: (Bj?rkman et al., 2019; N = 262; 74% female; mean (SD) age of males = 83.4 (4.5) years; mean (SD) age of females = 82.4 (4.4) years; Finnish sample)
Frailty: (Furtado et al., 2019; n = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)
Cognitively Impaired Older Adults: (Yang et al., 2018; N = 2096; 32% cognitively impaired, 68% non-cognitively impaired; mean (SD) age of participants with cognitive impairment = 74.40 (5.73) years; mean (SD) age of participants without cognitive impairment = 71.79 (4.63) years)
Predictive validity:
Frailty: (Furtado et al., 2019; N = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)
Adequate predictive validity of the 2MST to predict frailty at a cut-off score of 42 steps (AUC = 0.89)
Fallers and Non-Fallers: (Toraman & Y?ld?r?m, 2010; N = 60; mean (SD) age = 73.3 (6.6) years; Turkish sample)
Less than 50 steps on the 2MST had an odds ratio of 11.59 (95% CI=2.56-52.38) for scoring less than 8.12 seconds on the single leg stance eyes open component of the Berg Balance Test.
Sarcopenia: (Bj?rkman et al., 2019; N = 262; 74% female; mean (SD) age of males = 83.4 (4.5) years; mean (SD) age of females = 82.4 (4.4) years; Finnish sample)
2MST score had an odds ratio of 0.98 (95% CI = 0.97-0.99) for predicting the use of home care services.
Concurrent validity:
Fallers and Non-Fallers: (Toraman & Y?ld?r?m, 2010; N = 60; mean (SD) age = 73.3 (6.6) years; Turkish sample)
Adequate Spearman correlation between 2MST and Berg Balance Test (r = 0.57)
Poor Spearman correlation between 2MST and Mini Mental State Exam (r = -0.02)
Adequate Spearman correlation between 2MST and Right Leg Single Stance with Eyes Open (r = 0.56)
Fallers and Non-Fallers: (Zak et al., 2017; N = 102, mean (SD) age = 70 (4.33) years; 49% between ages 65-69, 30% between ages 70-74, 21% between ages 75-79; female post-menopausal Breast Cancer survivors; Polish sample)
Adequate correlation between the 2MST and the Tinetti POMA (r = 0.49)
Frailty: (Furtado et al., 2019; N = 140; 22% non-frail, 38% pre-frail, 40% frail; mean age = 83.0 years; Portuguese sample)
Adequate Spearman correlation between the 2MST and physical frailty when controlling for educational level (rs = -0.55)
Discriminant validity:
Cognitively Impaired Older Adults: (Yang et al., 2018; N = 2096; 32% cognitively impaired, 68% non-cognitively impaired; mean (SD) age of participants with cognitive impairment = 74.40 (5.73) years; mean (SD) age of participants without cognitive impairment = 71.79 (4.63) years)
Fallers and Non-Fallers: (Zhao & Chung, 2016; N = 78; 62% at risk of falling; mean (SD) age of participants at risk of falling = 69.70 (3.64) years; mean (SD) age of participants not at risk of falling = 70.10 (3.75) years; Chinese sample)
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We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.