Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States of America.
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, United States of America.
PLoS One. 2023 Feb 10;18(2):e0279543. doi: 10.1371/journal.pone.0279543. eCollection 2023.
The Five-time Sit-to-Stand (5xSTS) Test is a performance-based measure used by clinicians and researchers to assess the body functions needed to accomplish sit-to-stand transitions (e.g., lower limb strength, balance, and trunk control). The current requirements for performance of the 5xSTS Test (i.e., crossing arms over the chest) may not be appropriate for many, if not most lower limb prosthesis (LLP) users. The study aims were to (1) develop a modified five-time sit-to-stand (m5xSTS) Test protocol; (2) to examine initial evidence of known-groups construct validity among LLP users by comparing differences in performance by amputation level, amputation etiology, and functional level; and (3) to assess initial evidence of convergent construct validity by examining the correlations between m5xSTS performance with self-reported mobility (Prosthetic Limb Users Survey of Mobility (PLUS-M)), self-reported balance confidence (Activities-balance Confidence Scale (ABC)) and functional capability (comfortable walking speed). Three-hundred sixty-one LLP users participated in this cross-sectional study. The investigators developed a m5xSTS Test protocol that allows tested individuals to use different assistance strategies (i.e., use of upper limbs to push off thighs, push up from the armrests, or use a walker) when needed to perform the test. The investigators recorded m5xSTS Test times and assistance strategies. Significant differences in m5xSTS Test times were found between those who did and did not use an assistance strategy, as well as between participants grouped by different amputation level, etiology, and functional level. Significant moderate negative correlations were found between m5xSTS Test times and PLUS-M T-score (ρ = -0.42, p<0.001), ABC score (ρ = -0.42, p<0.001), and comfortable walking speed (ρ = -0.64, p<0.001), respectively. The m5xSTS Test allows LLP users to perform sit-to-stand transitions in a manner that accounts for their functional impairments, is consistent with post-amputation training, and is safe for the tested individual. Results from this study provide preliminary evidence of known groups and convergent construct validity for the m5xSTS Test with a large national sample of LLP users.
五次坐站测试（5xSTS）是一种基于表现的测量方法，临床医生和研究人员用它来评估完成坐站转换所需的身体功能（例如，下肢力量、平衡和躯干控制）。目前，5xSTS 测试的性能要求（即双臂交叉在胸前）可能不适合许多（如果不是大多数）下肢假肢（LLP）使用者。本研究的目的是：（1）制定改良的五次坐站测试（m5xSTS）方案；（2）通过比较截肢水平、截肢病因和功能水平的测试表现差异，初步检验 LLP 用户中已知组别的结构有效性；（3）通过检查 m5xSTS 测试表现与自我报告的移动性（假肢使用者移动性调查（PLUS-M））、自我报告的平衡信心（活动平衡信心量表（ABC））和功能能力（舒适步行速度）之间的相关性，初步检验收敛结构有效性的证据。361 名 LLP 使用者参与了这项横断面研究。研究人员制定了 m5xSTS 测试方案，允许被测试者在需要时使用不同的辅助策略（即使用上肢推大腿、从扶手处撑起或使用助行器）来完成测试。研究人员记录了 m5xSTS 测试时间和辅助策略。结果发现，使用和不使用辅助策略的被测试者之间，以及根据不同截肢水平、病因和功能水平分组的参与者之间，m5xSTS 测试时间存在显著差异。m5xSTS 测试时间与 PLUS-M T 评分（ρ=-0.42，p<0.001）、ABC 评分（ρ=-0.42，p<0.001）和舒适步行速度（ρ=-0.64，p<0.001）呈显著中度负相关。m5xSTS 测试允许 LLP 使用者以考虑其功能障碍的方式进行坐站转换，与截肢后训练一致，并且对被测试者安全。本研究结果为具有大量全国性 LLP 用户样本的 m5xSTS 测试提供了已知组和收敛结构有效性的初步证据。
