Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Jun;91(6):932-8.
doi: 10.1016/j.apmr.2010.02.003.

Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty

Gustavo J Almeida  1 , Carolyn A Schroeder, Alexandra B Gil, G Kelley Fitzgerald, Sara R Piva
Affiliations
Randomized Controlled Trial

Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty

Gustavo J Almeida et al. Arch Phys Med Rehabil. 2010 Jun.

Abstract

Objective: (1) To determine the interrater reliability and measurement error of an 11-step stair ascend/descend test (STTotal-11) and stair up (ascend) test (STUp-11); (2) to seek evidence for the STTotal-11 and STUp-11 as valid measures of physical function by determining if they relate to measures of physical function and do not relate to measures not of physical function; and (3) to explore if the STTotal-11 and STUp-11 scores relate to lower-extremity muscle weakness and knee range of motion (ROM) in subjects with total knee arthroplasty (TKA).

Design: Cross-sectional study.

Setting: Academic center.

Participants: Subjects (N=43, 30 women; mean age, 68+/-8y) with unilateral TKA.

Interventions: Not applicable.

Main outcome measures: STTotal-11 and STUp-11 were performed twice, and scores were compared with scores on 4 lower extremity performance-based tasks, 2 patient-reported questionnaires of physical function, 3 psychologic factors, knee ROM, and strength of quadriceps, hip extensors, and abductors.

Results: Intraclass correlation coefficient was .94 for both the STTotal-11 and STUp-11, standard error of measurements were 1.14 seconds and .82 seconds, and minimum detectable change associated with 90% confidence interval was 2.6 seconds and 1.9 seconds, respectively. Correlations between stair tests and performance-based measures and knee and hip muscle strength ranged from Pearson correlation coefficient (r)=.40 to .78. STTotal-11 and STUp-11 had a small correlation with one of the patient-reported measures of physical function. Stair tests were not associated with psychologic factors and knee extension ROM and were associated with knee flexion ROM.

Conclusions: STTotal-11 and STUp-11 have good interrater reliability and minimum detectable changes adequate for clinical use. The pattern of associations supports the validity of the stair tests in TKA.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bland and Altman plots of the differences (vertical axes) versus means (horizontal axes) of rater 1 (R1) and rater 2 (R2) scores during 11-step stair ascend/descend test (STTotal-11) and stair up (ascend) test (STUp-11). NOTE. Solid lines represent the mean difference between raters. Lines with small dashes just above and below the mean difference represent the 95% CI of the mean difference. The lines over 0 (zero) are the lines of equality.
See this image and copyright information in PMC

References

    1. Walsh M, Woodhouse LJ, Thomas SG, Finch E. Physical impairments and functional limitations: A comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys Ther. 1998;78(3):248–258. - PubMed
    1. Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskeletal Disorders. 2005;6:3. - PMC - PubMed
    1. Lamb SE, Frost H. Recovery of mobility after knee arthroplasty - Expected rates and influencing factors. J Arthroplasty. 2003;18(5):575–582. - PubMed
    1. Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35(7):424–436. - PubMed
    1. Joint Committee on Standards for Educational and Psychological Testing of the American Educational Research Association, American Psychological Association, National Council on Measurement in Education. Standards for educational and psychological testing. Washington (DC): American Educational Research Association; 2002.

Publication types