Convergent Validity and Test–Retest Reliability of the 1-Minute Sit-to-Stand Test Compared with the 6-Minute Walk Test in Adults with Cardiovascular Disease: A Systematic Review and Correlation Meta-Analysis

Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality globally. The 6-Minute Walk Test (6MWT) is widely used but requires a corridor of at least 30 meters, limiting its use in telehealth and resource-limited settings. The 1-Minute Sit-to-Stand Test (1-MSTST), requiring only a standard chair and minimal space, offers a practical alternative. This study evaluated the convergent validity and test–retest reliability of the 1-MSTST versus the 6MWT in adults with CVD. Methods: Following PRISMA 2020 guidelines and registered in PROSPERO (CRD420261378362) and OSF, seven electronic databases were searched through March 2026. Eligible studies compared the 1-MSTST and 6MWT in adults with CVD. Risk of bias was assessed using COSMIN, evidence certainty using modified GRADE, and correlation coefficients were pooled via Fisher's z transformation in a random-effects model (REML estimator, Knapp–Hartung adjustment). Results: Six studies (n = 400) were included (coronary artery disease, heart failure, atrial fibrillation, pulmonary hypertension, and pulmonary arterial hypertension associated with congenital heart disease), The pooled correlation was r = 0.70 (95% CI: 0.61–0.78; I² = 60.5%), indicating moderate-to-strong convergent validity. Test–retest reliability was excellent (ICC 0.93–0.98), and two studies reported discriminative cut-offs with AUCs of 0.80–0.94. Publication-bias testing was omitted due to fewer than ten pooled studies. Conclusion: The 1-MSTST shows good convergent validity and high test–retest reliability compared with the 6MWT, supporting its use as a complementary functional assessment when the 6MWT is not feasible.