Objective: To examine whether balance mediates the relationship between aerobic capacity and walking endurance in individuals with Parkinson’s disease (PD)

Background: Impaired walking capacity contributes to functional limitations and reduced quality of life in PD. The Six-Minute Walk Test (6MWT) is used to assess walking endurance but may be limited by time and space constraints in clinical settings. The Two-Minute Step Test (2MST) is an alternative requiring minimal space and has demonstrated validity as a marker of walking capacity in PD. Because the 2MST requires repeated single limb stance and dynamic postural control, performance reflects both aerobic capacity and balance. However, the relationships among aerobic capacity, balance, and walking endurance in PD remain unclear.

Method: 25 individuals with PD participating in a community based wellness assessment completed the 2MST, Mini-BESTest, and 6MWT. Spearman correlations examined associations among aerobic capacity (2MST), balance (Mini-BESTest), and walking endurance (6MWT). Linear regression evaluated the association between 2MST and 6MWT performance, with Mini-BESTest entered as a potential mediator. Exploratory bootstrapped mediation analyses were conducted due to the modest sample size.

Results: 2MST performance showed a stronger association with walking endurance than with balance. Moderate correlations were observed between 2MST and 6MWT (ρ=0.60,p=0.003) and between 2MST and Mini-BESTest (ρ=0.42,p=0.045). Mini-BESTest demonstrated an association with 6MWT (ρ=0.39, p=0.072). Regression analysis indicated that 2MST significantly predicted 6MWT performance (β=2.03 m/step, p=0.008). When Mini-BESTest was included, the 2MST–6MWT relationship remained significant, while balance was not independently associated with walking endurance. Bootstrapped mediation analyses did not demonstrate a significant indirect effect.

Conclusion: In this sample, 2MST performance was more strongly related to walking endurance than balance, supporting its role as a functional indicator of aerobic capacity. The moderate association with Mini-BESTest suggests balance may also contribute. These findings support the clinical utility of the 2MST as a brief in-office assessment capturing multiple mobility components in PD. Larger studies are needed to clarify contributions of aerobic capacity and balance to walking performance in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-balance-mediate-the-relationship-between-aerobic-capacity-and-walking-endurance-in-parkinsons-disease/