Measurement properties of the 5-repetition sit-to-stand test in patients with lumbar degenerative disorders: COSMIN systematic review.

BACKGROUND CONTEXT

There has been no recent updated comprehensive review of measurement properties focused on the 5-repetition sit-to-stand test (5R-STS) in patients with lumbar degenerative disorders (LDD) that could aid in better understanding of its clinical and research applicability.

PURPOSE

The aim of this systematic review was to summarize evidence on measurement properties of the 5R-STS in patients with LDD according to COnsensus Based Standards for the Selection of Health Measurement INstruments (COSMIN) guidelines.

DESIGN

Systematic review and meta-analysis.

PATIENT SAMPLE

In Step 1 and 2, 3,363 and 1,287 adult patients with suspected or diagnosed either clinically and/or radiologically LDD were included, respectively. Step 2 involved screening studies from Step 1 that passed the full text-stage and including only those that assessed at least 1 COSMIN measurement property.

OUTCOME MEASURES

Functional Measures (5R-STS, Timed Up and Go Test). Self-report Measures (including Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire, pain scores eg, Visual Analogue Scale) and healthcare quality of life questionnaires (eg, EQ-5D-3L)).

METHODS

In December 2022 Embase, PubMed/Medline, Web of Science and Scopus were searched for studies of 5R-STS of patients with LDD (PROSPERO: CRD42022383095). Quality of evidence was assessed using GRADE and COSMIN Checklist. Results for measurement error were pooled using the weighted mean method. Random effect meta-analysis was performed for studies on reliability and criterion validity.

RESULTS

Thirty-eight full-text articles were included in Step 1 and 19 in Step 2. The overall intraclass correlation coefficient (ICC) of test-retest reliability and inter-rater reliability of the 5R-STS was 0.93 (95% CI 0.37-1.00) and 0.99 (95% CI 0.83-1.00), respectively. The weighted standard error of measurement (SEM) mean value was 2.8s. Estimated r of 5R-STS and ODI, reflecting insufficient criterion validity (since r <0.70), was 0.53 (95% CI 0.17-0.88). Hypothesis testing for construct validity was confirmed for 40% of predefined hypothesis (graded as insufficient since overall, not >70% hypothesis confirmed). Accounting for limited evidence, responsiveness of the test was adequate.

CONCLUSION

This COSMIN systematic review summarizes 5R-STS measurement properties in patients with LDD, including pooled estimates of ICC for reliability, SEM, and correlation between 5R-STS and ODI. The 5R-STS is a reliable and responsive instrument reflecting a new dimension of functional impairment in patients with LDD.