Validity and Reliability of the 6‐Minute Pegboard and Ring Test in Patient With Cardiac Implantable Electrical Devices

ABSTRACT Background Patients with cardiac implantable electronic devices (CIEDs) have diminished arm exercise capacity due to preexisting heart disease and prolonged postimplantation immobility. Objectives This study aimed to investigate the reliability and validity of the 6 min pegboard and ring test (6PBRT) for assessing arm functional capacity in patients with CIEDs. Methods This cross‐sectional study included 27 patients with CIEDs (mean age: 59.88 ± 10.99 years). The Charlson Comorbidity Index (CCI) and Tampa Scale of Kinesiophobia for Heart (TSK‐HEART) were recorded. The 6PBRT was performed twice with a one‐hour interval to assess test–retest reliability. The intraclass correlation coefficient (ICC) was calculated. Convergent validity was evaluated using peak oxygen consumption (VO 2peak ) and peak work rate (WR peak ) obtained from arm ergometer test, handgrip strength (HGS), the Performance Measure for Activities of Daily Living‐8 (PMADL‐8), and the MacNew Heart Disease Health‐Related Quality of Life Questionnaire (MacNew QoL). Results The 6PBRT demonstrated good test–retest reliability (ICC = 0.881; 95% CI: 0.182–0.965; p < 0.001), with a strong correlation between repeated measurements ( r = 0.894, p < 0.001). The minimal detectable change was 41.56 rings. The 6PBRT score showed significant correlations with VO 2peak ( r = 0.497), WR peak ( r = 0.437), PMADL‐8 ( r = −0.459), TSK‐HEART ( r = −0.467), and CCI ( r = −0.414) (all p < 0.05). Conclusions The 6PBRT is a valid, reliable, and practical tool for evaluating arm functional capacity in patients with CIEDs. Higher 6PBRT scores are associated with higher independence in daily activities and lower levels of kinesiophobia and comorbidity. Trial Registration Clinicaltrials.gov: NCT06783023