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A new proposal for unsupported upper limb test in individuals with post-COVID-19 syndrome
Thiago Henrique da Silva Martins1, Cristino Carneiro Oliveira2, Isis Santos Araújo3
1Graduate Student, Rehabilitation Sciences Program, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brasil.
Introduction:
Unsupported upper limb exercise (UULEX) is an incremental test that assesses upper limb (UL) exercise capacity. Individuals with post-COVID-19 syndrome commonly present UL fatigue and reduced functional capacity, needing a valid assessment tool.
Objective:
To verify the concurrent validity of the UULEX-modified version (UULEX-M) to assess the UL exercise capacity in individuals with post-COVID-19 syndrome.
Methods:
This was a cross-sectional validation study conducted at post COVID-19 ambulatory (UFMG), between 07/2020 and 11/2020. Individuals selected underwent UULEX and UULEX-M tests in random order on a single day, with a 30-minute interval between tests. UULEX-M proposed a fixed load without warm-up and fewer incremental levels. Pearson and Spearman correlation tests assessed concurrent validity. Comparison between tests was performed with the t-independent and the Wilcoxon tests.
Results:
Sixty-four individuals aged 61±14 years were included. Test time, heart rate at the test peak, and female sex were strongly correlated between tests (r = 0.872; 95%CI: 3.4 to 4.55 min; p < 0.001; r = 0.774; 95%CI: 1-7 bpm; p < 0.001; r = 0.887; 95%CI: 2.35 to 3.92 min; p < 0.001, respectively). Moderate correlation was found for dyspnea (r = 0.566; 95%CI: -2.8 to -1.8; p < 0.001), fatigue (r = 0.605; 95%CI: -0.5 to 0.3; p < 0.001) and male sex (r = 0.744; 95%CI:3.9 to 5.5 min; p < 0.001). The mean testing time was 36% shorter for women than for men.
Conclusion:
The UULEX-M test was valid and reliable for assessing UL exercise capacity in individuals with post-COVID-19 syndrome. The UULEX-M test time was shorter and induced the same symptoms and physiological responses in both sexes. Moreover, this test is low-cost and may be an alternative in clinical practice.

