Intra- and Inter-examiner Reliability of Quantitative Sensory Testing of Knee Joints in Healthy Subjects

The reliability and validity of a visual analog scale for rating the single leg squat test

Background The single leg squat test (SLST) is commonly used for visual movement assessment in subjects with lower extremity injuries. While current methods utilize ordinal rating categorization, adopting a visual analog scale (VAS) may offer potential advantages. The study aims to determine the intra-rater, inter-rater reliability, and validity of a visual analog scale (VAS) for rating the single leg squat test (SLST) in subjects with lower extremity injuries. Methods 58 subjects with lower extremity injuries participated. Intra-rater reliability was assessed by a physical therapist at 1-week and 2-week intervals. Single session inter-rater reliability was assessed by two physical therapists. A 10 cm VAS was used to measure trunk lateral flexion, hip adduction, and dynamic knee valgus during the SLST. Intra-class correlation coefficients (ICC) assessed intra-rater and inter-rater reliability. Validity was assessed by comparing VAS scores to 2-D kinematic analysis. Results Intra-rater reliability was good at both 1 week (ICC = 0.81–0.92, MDC = 1.2–2.2 cm) and 2 weeks (ICC = 0.77–0.79, MDC = 2.7–3 cm). Inter-rater reliability was good to excellent (ICC = 0.78–0.93, MDD = 1–2.6 cm). The correlation between visual assessment and 2-D kinematic analysis was moderate to good (r = 0.66–0.78). Conclusion Preliminary data indicate that VAS reliably and validly rates SLST in individuals with lower-extremity injuries, allowing calculation of minimal detectable change and minimal detectable difference to support clinical interpretation. The MDC and MDD values established for trunk lateral flexion, hip adduction, and dynamic knee valgus allows clinicians to objectively determine if scores between repeated measurement and two raters are different.

The reliability and validity of the timed up and go test in individuals following lumbar spinal surgery.

BACKGROUND Although the Timed Up and Go (TUG) test is frequently used in lumbar pathologies, its test - retest reliability, convergent validity, and measurement error have not yet been established in the postoperative period. OBJECTIVE The purpose of this study was to comprehensively evaluate the test - retest reliability, convergent validity, andmeasure menterr or of the TUG test in individuals after lumbar spinal surgery. METHODS A cross-sectional study was conducted with 100 individuals (mean age 55.0 ± 8.9 years; 48 women, 52 men) at least 6 weeks after lumbar spinal surgery. Participants performed the TUG, Five-Repetition Sit-to-Stand Test (5xSTS), and 10-Meter Walk Test (10MWT). The TUG was repeated after a 1-hour rest period. Test - retest reliability was evaluated using the intraclasss correlation coefficient (ICC2,1). Measurement error was evaluated using the standard error of measurement (SEM), the minimal detectable change at the 95% confidence level (MDC95), and the Bland - Altman limits of agreement (LoA). Convergent validity was assessed using the Pearson correlation coefficient with the 5xSTS and 10MWT. RESULTS Excellent test - retest reliability was demonstrated (ICC2,1 = 0.99; 95% CI: 0.98-0.99). The SEM and MDC95were 0.26 seconds (s) and 0.72 s, respectively. The mean difference (bias) was -0.00 s (95% CI: -0.80 to 0.70), with lower and upper limits of agreement of -0.74 s (95% CI: -0.87 to -0.61) and 0.73 s (95% CI: 0.60 to 0.86), respectively. The TUG showed strong positive correlations with the 5xSTS (r = 0.95, p < .001) and the 10MWT (r = 0.92, p < .001). CONCLUSION The TUG is a reliable and valid tool for measuring functional mobility in individuals after lumbar spinal surgery, providing objective data to complement subjective assessments.

Reliability and convergent validity of the 6-minute pegboard and ring test in people with Parkinson's disease: a cross-sectional study.

Psychometric properties of the STEP (step-tibia-events-phases) test: an instrument for assessing gait performance in individuals with stroke.

PURPOSE This study aimed to evaluate the reliability and validity of the step-tibia-events-phases (STEP) test, a newly developed instrument for assessing gait performance in individuals with stroke, and to determine optimal cutoff scores for clinical applications. METHODS A total of 103 individuals with stroke participated in the study. Participants completed the STEP test to assess gait performance, followed by five clinical measures: the 10-Meter Walk Test (10MWT), Timed Up and Go (TUG) test, Five Times Sit-to-Stand test, One-Leg Stand test, and Mini-Mental State Examination. Reliability was examined using Cronbach's α and intraclass correlation coefficient (ICC2,1), and construct validity was also analyzed. Receiver operating characteristic curve analyses were conducted to determine the optimal cutoff scores. RESULTS The STEP test demonstrated good internal consistency and excellent interrater reliability for the total score. It showed strong correlations with the 10MWT and TUG. Statistical cutoff scores distinguishing household ambulation (<0.4 m/s) and community ambulation (<0.8 m/s) with lower fall-risk potential were identified as 14.50 and 21.50 points, respectively. CONCLUSIONS The STEP test is a reliable and valid tool for evaluating gait and balance in individuals with stroke. A score of ≥ 15 may indicate the capacity for indoor ambulation, whereas a score of ≥ 22 may indicate the potential for independent community ambulation and correspond to a lower fall-risk classification based on TUG performance.

Reliability and construct validity of three movement-evoked pain methods in individuals with knee osteoarthritis.

OBJECTIVES This study aimed to compare three Movement-evoked pain (MEP) calculation methods following commonly used performance-based tests in knee osteoarthritis (KOA) and to investigate their construct validity, test-retest reliability, Standard Error of Measurement (SEM), and Smallest Detectable Change (SDC). DESIGN Test-retest reliability study as secondary analysis from an observational longitudinal study. SETTING Department of Physiotherapy at the Federal University of São Carlos (Brazil). PARTICIPANTS A total of 111 participants. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Three performance-based tests were performed on two visits. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was applied. Pain was measured using the Numeric Pain Rating Scale (NPRS) at rest and immediately after each task. Three MEP calculation methods were evaluated: MEP-index (post-movement minus rest), MEP-max (maximum pain across tasks), and MEP-avg (average post-movement pain). Differences among methods were analyzed using the Friedman test. Construct validity was assessed using Spearman correlation coefficient based on predefined hypotheses and reliability was assessed with intraclass correlation coefficients. SEM and SDC were also calculated. RESULTS Significant differences were found among all MEP methods (p < 0.001). Construct validity was confirmed only for MEP-avg (77.7%). Reliability was excellent for MEP-max (ICC = 0.70, 95% CI 0.59-0.78) and MEP-avg (ICC = 0.84, 95% CI 0.77-0.89), but poor for MEP-index (ICC = 0.38, 95% CI 0.11-0.57). SEM and SDC were 1.43 and 3.9 for MEP-max, 1.33 and 3.7 for MEP-avg, and 1.53 and 4.2 for MEP-index. CONCLUSION MEP-avg showed validity, higher reliability and lower SDC, making it the preferred method for clinical research and practice.

PSYCHOMETRIC PROPERTIES OF LOADED AND UNLOADED TIMED STAIR TESTS IN ASSESSING PEOPLE WITH KNEE OSTEOARTHRITIS

Objective To compare timed stair test performance between individuals with knee osteoarthritis and healthy older adults, examine reliability under loaded and unloaded conditions, explore correlations with functional measures, and identify optimal cut-off times. Design Cross-sectional study. Subjects/Patients Sixty individuals with knee osteoarthritis and 30 healthy older adults. Methods Participants completed unloaded and loaded timed stair test trials 7 days apart. Knee strength, balance, mobility, and self-reported outcomes were assessed. Results Mean completion times for osteoarthritis participants were 23.91 s (unloaded) and 25.40 s (loaded). Intra-rater (ICC3,1 = 0.951–0.990 across raters and assessment days) and inter-rater (ICC3,2 = 0.999 [unloaded] to 1.000 [loaded]) reliabilities were excellent. Test–retest reliability was good for loaded (0.835) and excellent for unloaded (0.918) conditions. Times correlated negatively with affected side knee strength, balance, and confidence, and positively with pain severity, mobility tests, and daily activity difficulty. Optimal cut-offs were 18.67 s (unloaded) and 19.94 s (loaded), demonstrating sensitivities of 70.0% (unloaded) and 68.3% (loaded), a specificity of 86.7%, and area under the curve values of 0.78 (unloaded) and 0.77 (loaded). Conclusion The timed stair test is a reliable, valid, and practical measure of functional performance in knee osteoarthritis, effectively distinguishing movement capability under loaded and unloaded conditions.