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Validation and reliability of three functional tests in hospitalized burned subjects
Angela Ayumi Hoshino1, Andrea Akemi Morita1, Cristiane de Fatima Travensolo2
1Associate Postgraduate Program in Rehabilitation Sciences at the State University of Londrina (UEL) and Pitágoras Unopar University (UNOPAR), Londrina, Paraná, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Paraná, Brazil; Burn Treatment Center, University Hospital of Londrina, Londrina, Paraná, Brazil.
Aim:
To study the validity, reliability, standard error of the mean (SEM), minimum detectable change (MDC95), and learning effect of three functional capacity tests in hospitalized burn victims: 5-repetition Sit-to-Stand (STS_5r), 1-minute Sit-to-Stand (STS_1min) and Timed up-and-go (TUG).
Methods:
In a cross-sectional study, 64 subjects were evaluated. The tests were randomly applied by two evaluators in three assessment moments: twice by the same evaluator (intra-rater) with a 1-day interval; and once by a second evaluator after the first assessment (inter-rater). 6-minute walk test (6MWT) and assessment of quadriceps femoris (QF) muscle strength were also performed. For analysis of the learning effect, all tests were repeated two times at each assessment moment.
Results:
The TUG showed very strong correlation with the 6MWT (r = -0.90, p < 0.0001), whereas for the STS_5r and STS_1min the correlation was moderate (r = -0.55 and 0.60, respectively; p < 0.0001). As for the QF muscle strength test, there was moderate correlation with the TUG (r = -0.41, p = 0.0008) and rather modest correlations with the STS_5r (r = -0.30, p = 0.013) and the STS_1min (r = 0.21, p = 0.091). Intraclass correlation coefficient values were good to excellent in all intra- and inter-rater tests (0.88-0.97). MDC95 values ranged from 19% to 23%. Moreover, a small but statistically significant learning effect was observed in all tests.
Conclusions:
The STS_5r, STS_1min and TUG tests are valid and reliable to assess functional capacity of hospitalized burn victims, despite a small learning effect indicating the need to perform two tests. SEM and MDC values here described can be used in clinical practice to improve interpretability of the tests' results.
