Novel Metrics for Assessing Mobility During Ground-Standing Transitions

Transitioning between the ground and standing is a required activity for many professions including skilled trades, law enforcement, and military service. However, available assessments are limited and focus primarily on quality of movement. Thus, we developed two novel assessments of functional mobility specific for ground-to-standing transitions: Stand-Prone-Standx2 (SPS2) and Stand-Kneel-Standx2 (SKS2-L/R) tests. The purpose of this study was to determine the psychometrics of these two new measures in able-bodied (AB) service members and in service members with unilateral lower extremity injury (LEI).

A total of 57 AB service members and 31 service members with a traumatic unilateral LEI wearing a custom carbon-fiber ankle-foot orthosis participated in this study. In total, 36 AB and 18 LEI participants returned for a second session to assess intersession reliability. Intraclass correlation coefficients were calculated for intersession and inter-rater comparisons (two-way random model for consistency and single measure). Additionally, performance was compared between legs and groups.

The SPS2 and SKS2 assessments demonstrated excellent inter-rater and intersession reliability in both the AB and LEI groups with all intraclass correlation coefficient values greater than 0.8. Further, the tests were responsive to deficits associated with LEI, with the LEI group having significantly longer times on all assessments compared to the AB group.

The SPS2 and SKS2 performance measures were found to have excellent inter-rater and intersession reliability in both AB participants and participants with LEI. Further, participants with LEI performed significantly slower than the AB participants. Excellent reliability and responsiveness to deficits associated with LEI support the use of the SPS2 and SKS2 to assess mobility in individuals with LEI. Transitions between the ground and standing occur in many occupational and daily tasks. These reliable performance measures that assess ground-to-stand transitions can be applied widely, in many populations beyond highly functioning service members with LEI.