Modified sphygmomanometer test for the assessment of strength of the trunk, upper and lower limbs muscles in subjects with subacute stroke: reliability and validity.

BACKGROUND: Limitations in activities have been related to weakness of the upper limbs (UL), lower limbs (LL) and trunk muscles after stroke. Therefore, the measurement of strength after stroke becomes essential. The Modified Sphygmomanometer Test (MST) is an alternative method for the measurement of strength, since it is cheap and provides objective values. However, no studies have investigated the measurement properties of the MST in sub-acute stroke. AIM: To investigate the test-retest and inter-rater reliabilities and criterion-related validity of the MST for the measurement of strength of the UL, LL, and trunk muscles in subjects with sub-acute stroke, and verify whether the number of trials would affect the results. DESIGN: Diagnostic accuracy. SETTING: Local community, out-patient clinics, and university laboratory. POPULATION: Sixty- five subjects with sub-acute stroke (62±14 years) participated of the present study. METHODS: The strength of 36 muscular groups was measured with the MST and dynamometers (criterion standard). To investigate whether the number of trials would affect the results, analysis of variance was applied. For the test-retest and inter-rater reliabilities and criterion-related validity of the MST, intra-class correlation coefficients (ICC), Pearson correlation coefficients, and coefficients of determination were calculated. RESULTS: Similar results were found for all muscular groups and number of trials (0.01≤F≤0.14; 0.87≤p≤0.99) with significant and adequate values of test-retest (0.57≤ICC≥0.98) (exception: first trial of the non-paretic ankle dorsiflexors) and inter-rater (0.50≤ICC≥0.99) (exception: non-paretic ankle plantar flexors) reliabilities and validity (0.70≤r≥0.95; p≤0.001). The values obtained with the MST were good predictors of those obtained with the dynamometers (0.54≤r2≤0.90). CONCLUSIONS: In general, the MST showed adequate reliabilities and criterion-related validity for measuring strength of subjects with sub-acute stroke, and only one trial, after familiarization, provided adequate values. CLINICAL REHABILITATION IMPACT: The MST can be used by health professionals within several clinical contexts to objectively measure strength of the UL, LL, and trunk muscles in subjects with sub-acute stroke. Besides providing objective, reliable, and valid strength measures, the MST is also feasible. The aneroid sphygmomanometer used for the MST assessment is portable, easily found worldwide, and commonly acquired by health professionals. Furthermore, its adaptation is simple, reversible, and cheap.

Measurement properties and feasibility of clinical tests to assess sit-to-stand/stand-to-sit tasks in subjects with neurological disease: a systematic review.

BACKGROUND: Subjects with neurological disease (ND) usually show impaired performance during sit-to-stand and stand-to-sit tasks, with a consequent reduction in their mobility levels. OBJECTIVE: To determine the measurement properties and feasibility previously investigated for clinical tests that evaluate sit-to-stand and stand-to-sit in subjects with ND. METHOD: A systematic literature review following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol was performed. Systematic literature searches of databases (MEDLINE/SCIELO/LILACS/PEDro) were performed to identify relevant studies. In all studies, the following inclusion criteria were assessed: investigation of any measurement property or the feasibility of clinical tests that evaluate sit-to-stand and stand-to-sit tasks in subjects with ND published in any language through December 2012. The COSMIN checklist was used to evaluate the methodological quality of the included studies. RESULTS: Eleven studies were included. The measurement properties/feasibility were most commonly investigated for the five-repetition sit-to-stand test, which showed good test-retest reliability (Intraclass Correlation Coefficient:ICC=0.94-0.99) for subjects with stroke, cerebral palsy and dementia. The ICC values were higher for this test than for the number of repetitions in the 30-s test. The five-repetition sit-to-stand test also showed good inter/intra-rater reliabilities (ICC=0.97-0.99) for stroke and inter-rater reliability (ICC=0.99) for subjects with Parkinson disease and incomplete spinal cord injury. For this test, the criterion-related validity for subjects with stroke, cerebral palsy and incomplete spinal cord injury was, in general, moderate (correlation=0.40-0.77), and the feasibility and safety were good for subjects with Alzheimer's disease. CONCLUSIONS: The five-repetition sit-to-stand test was used more often in subjects with ND, and most of the measurement properties were investigated and showed adequate results.

Measurement properties and feasibility of clinical tests to assess sit-to-stand/stand-to-sit tasks in subjects with neurological disease: a systematic review / Propriedades de medida e de aplicabilidade de testes clínicos para avaliação do levantar/sentar em cadeira em indivíduos com doença neurológica: revisão sistemática da literatura

BACKGROUND: Subjects with neurological disease (ND) usually show impaired performance during sit-to-stand and stand-to-sit tasks, with a consequent reduction in their mobility levels. OBJECTIVE: To determine the measurement properties and feasibility previously investigated for clinical tests that evaluate sit-to-stand and stand-to-sit in subjects with ND. METHOD: A systematic literature review following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol was performed. Systematic literature searches of databases (MEDLINE/SCIELO/LILACS/PEDro) were performed to identify relevant studies. In all studies, the following inclusion criteria were assessed: investigation of any measurement property or the feasibility of clinical tests that evaluate sit-to-stand and stand-to-sit tasks in subjects with ND published in any language through December 2012. The COSMIN checklist was used to evaluate the methodological quality of the included studies. RESULTS: Eleven studies were included. The measurement properties/feasibility were most commonly investigated for the five-repetition sit-to-stand test, which showed good test-retest reliability (Intraclass Correlation Coefficient:ICC=0.94-0.99) for subjects with stroke, cerebral palsy and dementia. The ICC values were higher for this test than for the number of repetitions in the 30-s test. The five-repetition sit-to-stand test also showed good inter/intra-rater reliabilities (ICC=0.97-0.99) for stroke and inter-rater reliability (ICC=0.99) for subjects with Parkinson disease and incomplete spinal cord injury. For this test, the criterion-related validity for subjects with stroke, cerebral palsy and incomplete spinal cord injury was, in general, moderate (correlation=0.40-0.77), and the feasibility and safety were good for subjects with Alzheimer's disease. CONCLUSIONS: The five-repetition sit-to-stand test was used more often in subjects with ND, ...

CONTEXTUALIZAÇÃO: Indivíduos acometidos por doença neurológica (DN) comumente apresentam limitação no desempenho do levantar/sentar em cadeira, com consequente redução do nível de mobilidade. OBJETIVO: Determinar as propriedades de medida/aplicabilidade de testes clínicos que avaliam o levantar/sentar em cadeira em indivíduos com DN. MÉTODO: Trata-se de revisão sistemática da literatura, seguindo o PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). As bases de dados (MEDLINE/SCIELO/LILACS/PEDro) foram pesquisadas pela combinação de termos referentes aos testes e propriedades. Os critérios de inclusão foram: investigar propriedade de medida/aplicabilidade de testes clínicos que avaliem o levantar/sentar em cadeira em indivíduos com DN, publicado em qualquer idioma até dezembro/2012; qualidade metodológica avaliada pelo COSMIN. RESULTADOS: Foram incluídos onze estudos. Grande parte das propriedades investigadas foi para o "teste de cinco repetições de levantar/sentar", que apresentou principalmente boa confiabilidade teste-reteste (coeficiente de correlação intraclasse: CCI=0,94-0,99) para acidente vascular encefálico (AVE), paralisia cerebral e demência e, para esse último, obteve valores de CCI superiores aos do "teste de número de repetições de levantar/sentar em 30s" (CCI=0,84). O teste de cinco repetições apresentou ainda boa confiabilidade inter/intraexaminador (CCI=0,97-0,99) para AVE e inter (CCI=0,99) para Doença de Parkinson e lesão medular incompleta (LMI), validade de critério para AVE, paralisia cerebral, LMI e esclerose múltipla, com resultados predominantemente moderados (correlação=0,4-0,77), e boa aplicabilidade clínica/segurança para Doença de Alzheimer. ...