Gam Søren, Petz Anders K, Bjerre Lukas R, Bøgild Jeppe, Nielsen Anders B, Sørensen Rikke N, Kolind Mikkel I, Gram Bibi, Hansen Stinus, Aagaard Per
Department of Diabetes and Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Scand J Med Sci Sports. 2025 Jan;35(1):e70008. doi: 10.1111/sms.70008.
Reliable and sensitive testing of physical function is crucial for assessing the effects of treatment or exercise intervention in various patient populations. The present study investigated the test-retest reliability and sensitivity (smallest detectable difference: SDD) of selected physical performance tests commonly used in clinical rehabilitation, including tests of habitual and maximal walking speed, walking endurance capacity, handgrip strength (HGS), and lower limb muscle power (Sit-to-Stand (STS), stair climb) in adults with severe obesity meeting the criteria for bariatric surgery. Thirty-two adults (BMI 43.8 ± 6.6 kg/m) were enrolled in the study. Participants were assessed in three separate test sessions performed at the same time of day (±2 h) separated by 3 to 7 days. Habitual and maximal walking speed, walking endurance capacity, lower limb muscle power evaluated by stair climb and STS performance, and HGS demonstrated good-to-excellent inter-session reproducibility (ICC: 0.84-0.98, CV and SEM: 2.9%-11.3%) with individual sensitivity (SDD) ranging from 11.8% to 31.2%. Systematic learning effects from test session 1-2 were observed for the STS test and the 3- and 10-m habitual walk speed tests, manifested by increases of 6%-9%, 7%, and 3%, respectively (p < 0.05). Performing a familiarization session (test 1) fully prevented these learning effects (test 2 vs. 3). A majority of physical function tests showed improved reproducibility and sensitivity after the familiarization session. In conclusion, physical function can be assessed in a reliable manner in adults with severe obesity. Further, familiarization sessions prior to actual testing result in improved test-retest reliability and increased sensitivity.
对身体功能进行可靠且灵敏的测试对于评估各种患者群体的治疗或运动干预效果至关重要。本研究调查了临床康复中常用的选定身体性能测试的重测信度和灵敏度（最小可检测差异：SDD），这些测试包括习惯性和最大步行速度、步行耐力能力、握力（HGS）以及符合减肥手术标准的重度肥胖成年人的下肢肌肉力量（从坐到站（STS）、爬楼梯）测试。32名成年人（BMI 43.8±6.6kg/m²）参与了该研究。参与者在一天中相同时间（±2小时）进行的三个单独测试环节中接受评估，测试环节间隔3至7天。习惯性和最大步行速度、步行耐力能力、通过爬楼梯和STS表现评估的下肢肌肉力量以及HGS表现出良好至优秀的测试环节间再现性（ICC：0.84 - 0.98，CV和SEM：2.9% - 11.3%），个体灵敏度（SDD）范围为11.8%至31.2%。在STS测试以及3米和10米习惯性步行速度测试中观察到了从测试环节1到2的系统性学习效应，分别表现为增加了6% - 9%、7%和3%（p < 0.05）。进行一次预测试环节（测试1）可完全防止这些学习效应（测试2与测试3）。大多数身体功能测试在预测试环节后显示出再现性和灵敏度的提高。总之，重度肥胖成年人的身体功能可以通过可靠的方式进行评估。此外，在实际测试前进行预测试环节可提高重测信度并增加灵敏度。
