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Reliability, Validity, and Minimal Detectable Change of Four-Step Stair Climb Power Test in Community-Dwelling Older
Meng Ni1, Lorna G Brown2, Danielle Lawler2
1Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138 (USA), and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
Background:
Stair climb power is an important clinical measure of lower-extremity power. The stair climb power test (SCPT) was validated by requiring individuals to climb a full flight of stairs. A 4-step SCPT (4SCPT) would be more clinically feasible and easier to perform, yet its reliability and validity are unknown.
Objective:
To evaluate reliability, validity, and minimal detectable change of 4SCPT among community-dwelling older adults.
Design:
This study is a cross-sectional analysis of baseline data from a clinical trial.
Methods:
Fifty older adults ≥65 years of age, at risk for mobility decline, consented to participate in this ancillary study. Test-retest reliability was derived from 2 measurements within each participant measured by a single assessor. Pearson correlation analyses among leg power measures (4SCPT, SCPT, single leg press power at 40% and 70% of the 1-repetition maximum [SLP40, SLP70]) were performed. Separate multivariate linear regressions were conducted evaluating the associations between each leg power measure and 2 mobility outcomes, the Short Physical Performance Battery (SPPB) and habitual gait speed (HGS). Minimal detectable change was based on a 90% confidence interval (MDC 90 ).
Results:
The 4SCPT had excellent test-retest reliability (ICC(2,1) = 0.951), and strong correlation with SCPT, SLP40, and SLP70 ( r = 0.85-0.96). The 4SCPT explained a greater amount of variance in the SPPB (R 2 = 0.31) than other leg power measurements (R 2 = 0.23-0.25). The 4SCPT (R 2 = 0.41) and SCPT (R 2 = 0.42) described equivalent amounts of variance in HGS, and greater than that with SLP40 (R 2 = 0.28) and SLP70 (R 2 = 0.30). The MDC 90 for 4SCPT was 44.0 watts.
Limitations:
This was a cross-sectional analysis within a small, nonrepresentative sample. Interrater reliability was not evaluated.
Conclusions:
The 4SCPT shows scientific promise as a valid and reliable leg power measurement among community-dwelling older adults.
