The Use of a Single-Time Sit-To-Stand Test in Ambulatory Individuals With Spinal Cord Injury by Primary Health Care Providers

Abstract

Background The uncertain health care situations, such as that created by the COVID-19 pandemic, has limited hospital access and facilitated a paradigm shift in health care toward an increased demand for standard home visits and community-based rehabilitation services, including by ambulatory individuals with spinal cord injury (SCI). Objectives This 6-month prospective study explored the validity and reliability of a single-time sit-to-stand (STSTS) test when used by primary health care (PHC) providers, including a village health volunteer, caregiver, individual with SCI, and health professional. Methods Eighty-two participants were assessed for the STSTS using four arm placement conditions (arms on a walking device, arms on knees, arms free by the sides, and arms crossed over the chest) and standard measures, with prospective fall data follow-up over 6 months. Thirty participants involved in the reliability study were also assessed and reassessed for the ability to complete the STSTS conditions by PHC providers. Results Outcomes of the STSTS test, except the condition with arms on a walking device, could significantly discriminate lower extremity muscle strength (LEMS) and mobility of the participants (rpb = −0.58 to 0.69) with moderate concurrent validity. Outcomes of the tests without using the arms also showed moderate to almost-perfect reliability (kappa = 0.754–1.000) when assessed by PHC raters. Conclusion The findings suggest the use of an STSTS with arms free by the sides as a standard practical measure by PHC providers to reflect LEMS and mobility of ambulatory individuals with SCI in various clinical, community, and home-based settings.