关键词: 可穿戴设备, 改良 2 分钟踏步测试, 6 分钟步行测试, 数字健康监测, 社区健康管理

Abstract: Background With the continuous growth in demand for community-based health management, the importance of assessing cardiorespiratory fitness in primary healthcare services has become increasingly prominent. Direct measurement of maximal oxygen uptake relies on specialized equipment and complex procedures, while the 6-minute walk test (6MWT) requires relatively large testing space, both of which limit their application in community settings. Therefore, there is an urgent need to develop an efficient cardiorespiratory fitness assessment method that is less constrained by space and equipment and suitable for primary care scenarios. Objective To evaluate the correlation and agreement between the modified 2-minute step test (MS-2MST) and the 6-minute walk test (6MWT) for assessing cardiorespiratory fitness in a community population. Methods Using convenience sampling, 25 residents from Tiantongyuan North Community, Changping District, Beijing, were recruited between September and November 2025. All participants completed both the 6MWT and the MS-2MST. During the MS-2MST, a self-developed wearable multimodal monitoring system was used to record exercise parameters, including the number of effective step-ups, mean step angle, and total exercise volume. The 6MWT was conducted according to the standard 6-minute walk test protocol, with walking distance and number of turns recorded. Resting heart rate, immediate post-exercise heart rate, and heart rate at 2 minutes post-exercise were recorded for both tests. Pearson correlation analysis was used to examine the relationships among variables. The 6MWT distance and the effective step-up count of the MS-2MST were ranked in descending order and divided into high, medium, and low groups based on tertiles, and agreement was analyzed using the chi-square test. Multiple linear regression analysis was performed to explore the relationship between 6MWT distance and MS-2MST total exercise volume and its influencing factors. Results The immediate post-exercise heart rate and post-exercise heart rate change were significantly higher in the MS-2MST than in the 6MWT (P<0.001). At 2 minutes post-exercise, the heart rate and heart rate change in the MS-2MST were also higher than those in the 6MWT (P<0.05). The fatigue score during the MS-2MST was higher than that during the 6MWT (P<0.05). Pearson correlation analysis showed that both the effective step-up count and total exercise volume of the MS-2MST were positively correlated with the 6MWT walking distance (r=0.664, P<0.001; r=0.724, P<0.001). Immediate post-exercise heart rate (r=0.850, P<0.001) and heart rate change (r=0.775, P<0.001), heart rate at 2 minutes post-exercise (r=0.816, P<0.001) and heart rate change (r=0.693, P<0.001), mean heart rate during exercise (r=0.848, P<0.001) and mean heart rate change (r=0.759, P<0.001) were all positively correlated between the two tests. Fatigue scores during the two tests were also positively correlated (r=0.577, P=0.003). Agreement analysis showed consistency between the MS-2MST effective step-up count and 6MWT distance (Kappa=0.459, P=0.001), as well as between MS-2MST total exercise volume and 6MWT distance (Kappa=0.579, P<0.001). Multiple linear regression analysis indicated that MS-2MST total exercise volume (B=0.040, 95%CI=0.022-0.059, P<0.001) and age (B=2.657, 95%CI=0.697-4.618, P=0.011) were independent influencing factors of the 6MWT distance. Conclusion The MS-2MST, combined with wearable devices for accurate acquisition of exercise data, can serve as a simple and efficient method for assessing cardiorespiratory fitness, providing a feasible approach for skeletal muscle health screening and individualized exercise interventions in primary community settings.

Key words: Wearable devices, Modified Standardized 2-minute step test, 6-minute walk test, Digital health monitoring, Community health