{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:11:08Z","timestamp":1786122668531,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>The six\u2010minute step test (6MST) is a practical, field\u2010based assessment that may provide useful information about stepping performance in individuals with non\u2010specific chronic low back pain (NSCLBP). However, evidence regarding its measurement properties in this population is limited. The aim of this study was to evaluate the inter\u2010rater reliability and construct validity of the 6MST in individuals with NSCLBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional psychometric study to evaluate the 6MST's inter\u2010rater reliability and construct validity using a known\u2010groups approach. Thirty\u2010one individuals with NSCLBP and 31 age\u2010 and sex\u2010matched healthy controls completed the 6MST. Two blinded raters administered the test independently on separate occasions 7\u00a0days apart. We assessed inter\u2010rater reliability using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and Bland\u2013Altman analysis. Construct validity was examined by comparing 6MST performance between groups using hypothesis testing and effect sizes (Cohen's d). Secondary outcomes included heart rate responses, perceived exertion, pain intensity, disability, pain catastrophizing, and kinesiophobia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 6MST demonstrated excellent inter\u2010rater reliability, with ICCs of 0.915 (95% CI: 0.83\u20130.96) for the NSCLBP group and 0.973 (95% CI: 0.94\u20130.99) for controls. SEM and MDC values were 6 and 17 steps in the NSCLBP group and 3 and 8 steps in the controls, respectively. Bland\u2013Altman analyses revealed good agreement and no evidence of proportional bias. Construct validity was supported by significantly lower performance in the NSCLBP group compared with the control group (mean differences: 37 and 33 steps for raters 1 and 2, respectively, both with\n                      <jats:italic>p<\/jats:italic>\n                      values less than 0.001), with very large effect sizes (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a01.91 and 1.76). Individuals with NSCLBP showed lower attainment of the predefined target heart rate and greater increases in pain intensity following the test, despite similar perceived exertion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The 6MST demonstrated excellent inter\u2010rater reliability and satisfactory construct validity for assessing stepping performance in individuals with NSCLBP. Compared with healthy controls, individuals with NSCLBP completed fewer steps, were less likely to reach the predefined target heart rate during testing, and reported greater increases in pain intensity despite similar perceived exertion. These findings support the use of the 6MST as a practical, low\u2010cost, performance\u2010based assessment of stepping performance in this population. However, the observed heart rate responses should not be interpreted as evidence of differences in exercise tolerance, aerobic capacity, or cardiopulmonary function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70295","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:26:37Z","timestamp":1784287597000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability and Construct Validity of the Six\u2010Minute Step\u00a0Test in Individuals With Non\u2010Specific Chronic Low\u00a0Back Pain"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4292-9430","authenticated-orcid":false,"given":"Francisco Bas\u00edlio da","family":"Silva\u2010J\u00fanior","sequence":"first","affiliation":[{"name":"Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3983-5342","authenticated-orcid":false,"given":"\u2060Andr\u00e9","family":"Pontes\u2010Silva","sequence":"additional","affiliation":[{"name":"Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3081-3335","authenticated-orcid":false,"given":"\u2060Yane","family":"Pelicer\u2010Marques","sequence":"additional","affiliation":[{"name":"School of Public Health University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0310-9329","authenticated-orcid":false,"given":"Sabrina Marinho","family":"Coutinho","sequence":"additional","affiliation":[{"name":"Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o 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