CLINICAL RESEARCH ARTICLE

Validity and Reliability of the 6-min Pegboard and Ring Test in Patients With Duchenne Muscular Dystrophy

Corresponding Author

Çağtay Maden

[email protected]

orcid.org/0000-0003-4444-5717

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey

Correspondence:

Çağtay Maden ([email protected])

Contribution: Investigation, Methodology, Formal analysis, Writing - review & editing, Writing - original draft, Project administration, Supervision, Validation, Conceptualization, Data curation, Resources, Funding acquisition

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Demet Gözaçan Karabulut,

Demet Gözaçan Karabulut

orcid.org/0000-0001-9235-1059

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey

Contribution: Investigation, Writing - original draft, Writing - review & editing, Methodology, Funding acquisition, Validation, Visualization, Software, Supervision, Resources, Data curation

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Sedat Yiğit,

Sedat Yiğit

orcid.org/0000-0001-7134-8379

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep University, Gaziantep, Turkey

Contribution: Investigation, Writing - review & editing, Validation, Visualization, Formal analysis, Software, Data curation, Supervision, Resources, Funding acquisition

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Çağtay Maden,

Corresponding Author

Çağtay Maden

[email protected]

orcid.org/0000-0003-4444-5717

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey

Correspondence:

Çağtay Maden ([email protected])

Search for more papers by this author

Demet Gözaçan Karabulut,

Demet Gözaçan Karabulut

orcid.org/0000-0001-9235-1059

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey

Contribution: Investigation, Writing - original draft, Writing - review & editing, Methodology, Funding acquisition, Validation, Visualization, Software, Supervision, Resources, Data curation

Search for more papers by this author

Sedat Yiğit,

Sedat Yiğit

orcid.org/0000-0001-7134-8379

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep University, Gaziantep, Turkey

Contribution: Investigation, Writing - review & editing, Validation, Visualization, Formal analysis, Software, Data curation, Supervision, Resources, Funding acquisition

Search for more papers by this author

First published: 11 December 2024

https://doi.org/10.1002/mus.28314

Funding: The authors received no specific funding for this work.

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ABSTRACT

Introduction/Aims

Tests for assessing upper extremity (UE) functional capacity in patients with Duchenne muscular dystrophy (DMD) are limited. This study aimed to evaluate the validity and reliability of the 6-min pegboard and ring test (6PBRT) as a practical tool for this purpose.

Methods

Children with DMD (n = 22) were evaluated using the 6PBRT for UE functional capacity, the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) for functionality, the Pediatric Quality of Life Inventory (PedsQL) for quality of life, and a dynamometer for handgrip strength and UE muscle strength.

Results

The 6PBRT showed excellent test–retest reliability, with an intraclass correlation coefficient (ICC) of 0.978 (95% confidence interval, 0.946–0.984). A very strong positive correlation was observed between the test and retest 6PBRT mean scores (r = 0.981). The mean 6PBRT score exhibited moderate-to-strong correlations with handgrip strength (r = 0.653, r = 0.646, right/left, respectively), muscle strength (shoulder flexors [r = 0.793, r = 0.797, right/left, respectively], shoulder abductors (r = 0.763, r = 0.743, right/left, respectively), elbow flexors [r = 0.743, r = 0.755, right/left, respectively]), mean Q-DASH score (r = −0.555), and mean PedsQL score (r = 0.611).

Discussion

The 6PBRT appears to be a valid and reliable measure for assessing upper extremity functional capacity in patients with DMD. This test is suitable for patients who are able to lift both hands above their heads.

Trial Registration: NCT06174025

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

Research data are not shared.

References

1J. R. Mendell and M. Lloyd-Puryear, “Report of MDA Muscle Disease Symposium on Newborn Screening for Duchenne Muscular Dystrophy,” Muscle & Nerve 48, no. 1 (2013): 21–26, https://doi.org/10.1002/mus.23810.
10.1002/mus.23810
PubMed Web of Science® Google Scholar
2M. M. Janssen, A. Bergsma, A. C. Geurts, et al., “Patterns of Decline in Upper Limb Function of Boys and Men With DMD: An International Survey,” Journal of Neurology 261 (2014): 1269–1288, https://doi.org/10.1007/s00415-014-7316-9.
10.1007/s00415-014-7316-9
PubMed Web of Science® Google Scholar
3M. M. Janssen, J. Harlaar, B. Koopman, et al., “Dynamic Arm Study: Quantitative Description of Upper Extremity Function and Activity of Boys and Men With Duchenne Muscular Dystrophy,” Journal of Neuroengineering and Rehabilitation 14 (2017): 1–14, https://doi.org/10.1186/s12984-017-0259-5.
10.1186/s12984-017-0259-5
PubMed Google Scholar
4M. M. Janssen, J. C. Hendriks, A. C. Geurts, et al., “Variables Associated With Upper Extremity Function in Patients With Duchenne Muscular Dystrophy,” Journal of Neurology 263 (2016): 1810–1818, https://doi.org/10.1007/s00415-016-8193-1.
10.1007/s00415-016-8193-1
PubMed Web of Science® Google Scholar
5M. Pane, E. S. Mazzone, L. Fanelli, et al., “Reliability of the Performance of Upper Limb Assessment in Duchenne Muscular Dystrophy,” Neuromuscular Disorders 24, no. 3 (2014): 201–206, https://doi.org/10.1016/j.nmd.2013.11.014.
10.1016/j.nmd.2013.11.014
PubMed Web of Science® Google Scholar
6A. M. Seferian, A. Moraux, M. Annoussamy, et al., “Upper Limb Strength and Function Changes During a One-Year Follow-Up in Non-Ambulant Patients With Duchenne Muscular Dystrophy: An Observational Multicenter Trial,” PLoS One 10, no. 2 (2015): e0113999, https://doi.org/10.1371/journal.pone.0113999.
10.1371/journal.pone.0113999
PubMed Web of Science® Google Scholar
7M. H. Brooke, R. C. Griggs, J. R. Mendell, G. M. Fenichel, J. B. Shumate, and R. J. Pellegrino, “Clinical Trial in Duchenne Dystrophy. I. The Design of the Protocol,” Muscle & Nerve 4, no. 3 (1981): 186–197, https://doi.org/10.1002/mus.880040304.
10.1002/mus.880040304
CAS PubMed Web of Science® Google Scholar
8A. Mayhew, E. S. Mazzone, M. Eagle, et al., “Development of the Performance of the Upper Limb Module for Duchenne Muscular Dystrophy,” Developmental Medicine and Child Neurology 55, no. 11 (2013): 1038–1045, https://doi.org/10.1111/dmcn.12213.
10.1111/dmcn.12213
CAS PubMed Web of Science® Google Scholar
9C. Bérard, C. Payan, I. Hodgkinson, J. Fermanian, and The MFM Collaborative Study Group, “A Motor Function Measure Scale for Neuromuscular Diseases. Construction and Validation Study,” Neuromuscular Disorders 15, no. 7 (2005): 463–470, https://doi.org/10.1016/j.nmd.2005.03.004.
10.1016/j.nmd.2005.03.004
PubMed Web of Science® Google Scholar
10A. M. Connolly, E. C. Malkus, J. R. Mendell, et al., “Outcome Reliability in Non-Ambulatory Boys/Men With Duchenne Muscular Dystrophy,” Muscle & Nerve 51, no. 4 (2015): 522–532, https://doi.org/10.1002/mus.24346.
10.1002/mus.24346
PubMed Web of Science® Google Scholar
11T. Janaudis-Ferreira, M. K. Beauchamp, R. S. Goldstein, and D. Brooks, “How Should We Measure Arm Exercise Capacity in Patients With COPD? A Systematic Review,” Chest 141, no. 1 (2012): 111–120, https://doi.org/10.1378/chest.11-0475.
10.1378/chest.11-0475
PubMed Web of Science® Google Scholar
12C. M. McDonald, E. K. Henricson, J. J. Han, et al., “The 6-Minute Walk Test in Duchenne/Becker Muscular Dystrophy: Longitudinal Observations,” Muscle & Nerve 42 (2010): 966–974, https://doi.org/10.1002/mus.21808.
10.1002/mus.21808
PubMed Web of Science® Google Scholar
13V. P. Lima, M. Velloso, F. D. Almeida, B. Carmona, G. A. Ribeiro-Samora, and T. Janaudis-Ferreira, “Test–Retest Reliability of the Unsupported Upper-Limb Exercise Test (UULEX) and 6-Min Peg Board Ring Test (6PBRT) in Healthy Adult Individuals,” Physiotherapy Theory and Practice 34, no. 10 (2018): 806–812, https://doi.org/10.1080/09593985.2018.1425786.
10.1080/09593985.2018.1425786
PubMed Web of Science® Google Scholar
14E. Calik-Kutukcu, H. Tekerlek, C. Bozdemir-Ozel, et al., “Validity and Reliability of 6-Minute Pegboard and Ring Test in Patients With Asthma,” Journal of Asthma 59, no. 7 (2022): 1387–1395, https://doi.org/10.1080/02770903.2021.1930040.
10.1080/02770903.2021.1930040
PubMed Google Scholar
15B. Ö. Kahraman, İ. Özsoy, A. Tanriverdi, et al., “Validity and Reliability of the 6-Minute Pegboard Ring Test in Patients With Pulmonary Hypertension,” Türk Fizyoterapi ve Rehabilitasyon Dergisi 31, no. 2 (2020): 210–217, https://doi.org/10.21653/tjpr.714503.
10.21653/tjpr.714503
Google Scholar
16S. Zhan, F. J. Cerny, W. J. Gibbons, M. J. Mador, and Y. W. Wu, “Development of an Unsupported Arm Exercise Test in Patients With Chronic Obstructive Pulmonary Disease,” Journal of Cardiopulmonary Rehabilitation 26, no. 3 (2006): 180–187, https://doi.org/10.1097/00008483-200605000-00013.
10.1097/00008483-200605000-00013
PubMed Google Scholar
17G. Kurillo, A. Zupan, and T. Bajd, “Force Tracking System for the Assessment of Grip Force Control in Patients With Neuromuscular Diseases,” Clinical Biomechanics 19 (2004): 1014–1021, https://doi.org/10.1016/j.clinbiomech.2004.07.003.
10.1016/j.clinbiomech.2004.07.003
PubMed Web of Science® Google Scholar
18C. Marchesi, M. Main, M. Kinali, and F. Muntoni, “Correlation of Hand-Held Myometry With Alternative Methods of Assessment of Muscle Strength and Function in DMD Patients,” Neuromuscular Disorders 18 (2008): 741–833.22, https://doi.org/10.1016/j.nmd.2008.06.061.
10.1016/j.nmd.2008.06.061
Google Scholar
19Ç. Ayhan, E. Ünal, and Y. Yakut, “Turkish Version of the Simple Shoulder Test: A Reliability and Validity Study,” Fizyoter Rehabil 21 (2010): 68–74.
Google Scholar
20J. W. Varni, M. Seid, and P. S. Kurtin, “PedsQL 4.0: Reliability and Validity of the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales in Healthy and Patient Populations,” Medical Care 39, no. 8 (2001): 800–812, https://doi.org/10.1097/00005650-200108000-00006.
10.1097/00005650-200108000-00006
CAS PubMed Web of Science® Google Scholar
21N. C. Memik, B. Ağaoğlu, A. Coşkun, et al., “The Validity and Reliability of Pediatric Quality of Life Inventory in 8-12 Year Old Turkish Children,” Turkish Journal of Child and Adolescent Mental Health 15, no. 2 (2008): 87–98.
Google Scholar
22N. C. Memik, B. Agaoglu, A. Coskun, et al., “The Validity and Reliability of the Turkish Pediatric Quality of Life Inventory for Children 13-18 Years Old,” Türk Psikiyatri Dergisi 18, no. 4 (2007): 353–363, https://doi.org/10.1007/s11136-007-9303-4.
10.1007/s11136?007?9303?4
PubMed Web of Science® Google Scholar
23T. K. Koo and M. Y. Li, “A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research,” Journal of Chiropractic Medicine 15, no. 2 (2016): 155–163, https://doi.org/10.1016/j.jcm.2017.10.001.
10.1016/j.jcm.2016.02.012
PubMed Web of Science® Google Scholar
24N. Ö. Doğan, “Bland-Altman Analysis: A Paradigm to Understand Correlation and Agreement,” Turkish Journal of Emergency Medicine 18, no. 4 (2018): 139–141, https://doi.org/10.1016/j.tjem.2018.09.001.
10.1016/j.tjem.2018.09.001
PubMed Web of Science® Google Scholar
25J. P. Weir, “Quantifying Test-Retest Reliability Using the Intraclass Correlation Coefficient and the SEM,” Journal of Strength and Conditioning Research 19, no. 1 (2005): 231–240, https://doi.org/10.1519/15184.1.
10.1519/15184.1
PubMed Web of Science® Google Scholar
26B. H. Munro, Statistical Methods for Health Care Research, vol. 1 (Philadelphia: Lippincott Williams & Wilkins, 2005).
Google Scholar
27H. R. Leite, I. P. Queiroz, J. G. Santos, et al., “Measurement Properties of the Six-Minute Pegboard and Ring Test (6PBRT) in Healthy Adolescents,” Journal of Bodywork and Movement Therapies 28 (2021): 56–61, https://doi.org/10.1016/j.jbmt.2021.08.002.
10.1016/j.jbmt.2021.08.002
PubMed Google Scholar
28F. L. Mattar and C. Sobreira, “Hand Weakness in Duchenne Muscular Dystrophy and Its Relation to Physical Disability,” Neuromuscular Disorders 18 (2008): 193–198, https://doi.org/10.1016/j.nmd.2007.11.004.
10.1016/j.nmd.2007.11.004
PubMed Web of Science® Google Scholar
29J. Y. Hogrel, V. Decostre, I. Ledoux, et al., “Normalized Grip Strength Is a Sensitive Outcome Measure Through all Stages of Duchenne Muscular Dystrophy,” Journal of Neurology 267 (2020): 2022–2028, https://doi.org/10.1007/s00415-020-09800-9.
10.1007/s00415-020-09800-9
PubMed Web of Science® Google Scholar
30J. Y. Hogrel, C. Wary, A. Moraux, et al., “Longitudinal Functional and NMR Assessment of Upper Limbs in Duchenne Muscular Dystrophy,” Neurology 86, no. 11 (2016): 1022–1030, https://doi.org/10.1212/wnl.0000000000002464.
10.1212/WNL.0000000000002464
CAS PubMed Web of Science® Google Scholar
31I. Alemdaroğlu, A. Karaduman, Ö. T. Yılmaz, et al., “Different Types of Upper Extremity Exercise Training in Duchenne Muscular Dystrophy: Effects on Functional Performance, Strength, Endurance, and Ambulation,” Muscle & Nerve 51, no. 5 (2015): 697–705, https://doi.org/10.1002/mus.24451.
10.1002/mus.24451
PubMed Web of Science® Google Scholar
32N. Bulut, I. Gürbüz, Ö. Yilmaz, G. Aydin, and A. Karaduman, “The Association of Hand Grip Strength With Functional Measures in Non-ambulatory Children With Duchenne Muscular Dystrophy,” Arquivos de Neuro-Psiquiatria 77, no. 11 (2019): 792–796, https://doi.org/10.1590/0004-282x20190161.
10.1590/0004-282x20190161
PubMed Google Scholar
33M. M. H. P. Janssen, J. Harlaar, B. Koopman, and I. J. M. de Groot, “Unraveling Upper Extremity Performance in Duchenne Muscular Dystrophy: A Biophysical Model,” Neuromuscular Disorders 29, no. 5 (2019): 368–375, https://doi.org/10.1016/j.nmd.2019.03.006.
10.1016/j.nmd.2019.03.006
PubMed Google Scholar
34T. Janaudis-Ferreira, K. Hill, R. S. Goldstein, K. Wadell, and D. Brooks, “Relationship and Responsiveness of Three Upper-Limb Tests in Patients With Chronic Obstructive Pulmonary Disease,” Physiotherapy Canada 65, no. 1 (2013): 40–43, https://doi.org/10.3138/ptc.2011-49.
10.3138/ptc.2011-49
PubMed Web of Science® Google Scholar
35V. P. Lima, P. H. Lopes, H. S. Costa, et al., “The 6–Minute Pegboard and Ring Test (6PBRT) for Evaluation of Upper Limbs Functional Capacity in Hemodialysis Patients: A Validation Study,” Physiotherapy Canada (2023): e20220067, https://doi.org/10.3138/ptc-2022-0067.
10.3138/ptc-2022-0067
Google Scholar

Volume71, Issue2

February 2025

Pages 200-207

Validity and Reliability of the 6-min Pegboard and Ring Test in Patients With Duchenne Muscular Dystrophy

ABSTRACT

Introduction/Aims

Methods

Results

Discussion

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Information

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Validity and Reliability of the 6-min Pegboard and Ring Test in Patients With Duchenne Muscular Dystrophy

ABSTRACT

Introduction/Aims

Methods

Results

Discussion

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Related

Information