Validity and reliability of the six-minute pegboard and ring test for assessing upper limb functional capacity in patients with rheumatoid arthritis

Background Rheumatoid arthritis (RA) is a disease that affects upper extremity function early on, leading to significant limitations in activities of daily living. Therefore, assessing upper extremity function using reliable and valid measurement methods is clinically important. Objective The aim of study was to determine the validity and reliability of the six-minute pegboard and ring test (6-PBRT) in patients with RA. Methods The study included forty RA patients (32 females, 8 males; age 57.90 ± 10.82 years). All patients underwent 6-PBRT twice, and test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Upper extremity aerobic capacity (arm ergometer test (W peak )), handgrip strength (hand dynamometer), and functional status (Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire) were evaluated. Results 6-PBRT demonstrated high test-retest reliability (ICC=0.963). 6-PBRT performance was strongly correlated with arm ergometer W peak (r = 0.798), moderately correlated with maximum sustained exercise time (r = 0.697), dominant (r = 0.583) and non-dominant (r = 0.553) handgrip, and moderately negatively correlated with DASH scores (r = -0.518) (p < 0.05). Significant increases were found in heart rate, systolic blood pressure, respiratory rate, and perceived fatigue in both tests (p < 0.05). Conclusion The 6-PBRT is a reliable and valid tool for assessing upper extremity functional capacity in patients with RA. Because it correlates with aerobic capacity, muscle strength, and functional status, the test can be used as a practical clinical measurement method to multidimensionally assess upper extremity performance. The 6-PBRT offers a simple, low-cost, and clinically practical alternative to laboratory-based upper extremity assessments, making it particularly suitable for routine clinical use in patients with RA. Trial registry Clinical Trials Registry Number: NCT06753851; Registration date: December 31 2024.