Abstracts

Introduction

According to the World Health Organization¹1. World Health Organization - WHO. What are neurological disorders? [online]. Geneva: World Health Organization; 2007 [cited 2007]. Available from: www.who.int/features/qa/55/en/.
Available from: www.who.int/features/qa/... , neurological diseases (NDs) are conditions that affect the central or peripheral nervous system of humans. With the decrease in mortality rates, there are increasingly more individuals affected by ND who have major disabilities, such as limitations in daily activities²2. World Health Organization - WHO. Neurological disorders: public health challenges [online]. Geneva: World Health Organization; 2006. [cited 2006]. Available from: www.who.int/mental_health/neurology/neurodiso/en/.
www.who.int/mental_health/neurology/neur... . Standing and sitting on a chair are among the most affected activities and are considered crucial for independence in the daily routine³3. Lomaglio MJ, Eng JJ. Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke. Gait Posture. 2005;22:126-31. PMid:16139747 PMCid:PMC3167866. http://dx.doi.org/10.1016/j.gaitpost.2004.08.002
http://dx.doi.org/10.1016/j.gaitpost.200... . The inability to perform these actions may lead to disability⁴4. Ng SSM. Balance ability, not muscle strength and exercise endurance, determines the performance of hemiparetic subjects on the timed-sit-to-stand test. Am J Phys Med Rehabilitation. 2010;89:497-504. PMid:20216059. http://dx.doi.org/10.1097/PHM.0b013e3181d3e90a
http://dx.doi.org/10.1097/PHM.0b013e3181... . Therefore, recovering or improving the performance of these activities is a major goal for rehabilitation teams⁴4. Ng SSM. Balance ability, not muscle strength and exercise endurance, determines the performance of hemiparetic subjects on the timed-sit-to-stand test. Am J Phys Med Rehabilitation. 2010;89:497-504. PMid:20216059. http://dx.doi.org/10.1097/PHM.0b013e3181d3e90a
http://dx.doi.org/10.1097/PHM.0b013e3181... . To do so, practitioners need clinical tools that assess these activities⁵5. Sim J, Arnell P. Measurement validity in physiscal therapy research. Phys Ther. 1993;73(2):48-61. with adequate measurement properties (such as validity and reliability)⁴4. Ng SSM. Balance ability, not muscle strength and exercise endurance, determines the performance of hemiparetic subjects on the timed-sit-to-stand test. Am J Phys Med Rehabilitation. 2010;89:497-504. PMid:20216059. http://dx.doi.org/10.1097/PHM.0b013e3181d3e90a
http://dx.doi.org/10.1097/PHM.0b013e3181... ^{, 6}6. Tyson S, Connell L. The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review. Clin Rehabil. 2009;23:1018-33. PMid:19786420. http://dx.doi.org/10.1177/0269215509339004
http://dx.doi.org/10.1177/02692155093390... .

In 1985, Czuka and McCarty⁷7. Czuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strenght. Am J Med.1985;78:77-81. http://dx.doi.org/10.1016/0002-9343(85)90465-6
http://dx.doi.org/10.1016/0002-9343(85)9... proposed and documented the first standardized test to clinically assess the sit-to-stand movement, originally called timed-stands test. This test determined the time spent to perform 10 repetitions of the sit-to-stand movement⁷7. Czuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strenght. Am J Med.1985;78:77-81. http://dx.doi.org/10.1016/0002-9343(85)90465-6
http://dx.doi.org/10.1016/0002-9343(85)9... . Subsequent variations were developed, including the "20-second sit-to-stand test" (sit-to-stand test)⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... and the "five-repetition sit-to-stand test" (five times sit-to-stand test)⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... . The latter has demonstrated good clinical feasibility in the elderly¹⁰10. Tiedemann A, Shimada H, Sherrington C, Murray S, Lord SR. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing. 2008;37:430-5. PMid:18487264. http://dx.doi.org/10.1093/ageing/afn100
http://dx.doi.org/10.1093/ageing/afn100... and good test-retest reliability in healthy individuals between 14 and 85 years of age¹¹11. Bohannon RW, Bubela DJ, Magasi SR, Gershon RC. Relative reliability of three objectives tests of limb muscle strength. Isokinet Exerc Sci. 2011;19:77-81..

Considering that measurement and feasibility properties depend on the protocol used and are specific to the population studied¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009., the adequate results shown for some properties of the test in certain populations do not guarantee that these tests will be similarly suitable for individuals with ND. Thus, the present study aimed to determine the measurement or feasibility properties previously investigated in clinical trials that evaluated the sit-to-stand/stand-to-sit movement in individuals with ND.

Method

The present study is a systematic literature review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) protocol¹³13. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;339:332-6. ^{, 14}14. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies tha evaluate health care interventions: explanation and elaboration. Ann Inter Med. 2009;151(4):65-94. http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00136
http://dx.doi.org/10.7326/0003-4819-151-... . All stages were performed by two independent raters who, at the end of each stage, reached a consensus on the results obtained. A third rater was involved in case of disagreement between the first two raters¹³13. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;339:332-6. ^{, 14}14. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies tha evaluate health care interventions: explanation and elaboration. Ann Inter Med. 2009;151(4):65-94. http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00136
http://dx.doi.org/10.7326/0003-4819-151-... .

In the first stage, electronic searches were performed on the MEDLINE, SCIELO, LILACS and PEDro databases to identify studies, using a search strategy adequate for databases with combinations of terms relative to the tests of interest and measurement or feasibility properties (^{Appendix 1} Appendix 1. Search strategy. ). Subsequently, the studies were assessed for the inclusion criteria: studies that investigated any measurement property or the feasibility of any clinical trial that assessed sit-to-stand and stand-to-sit tasks in individuals diagnosed with ND and studies that were published in any language through December 2012.

In the second stage, the titles of the studies were evaluated, and studies that clearly did not meet the inclusion criteria were excluded. The same procedure was used in the third stage, in which the abstracts of the studies included in the second stage were analyzed. In the fourth stage, all studies included in the third stage were fully read, and those that met the inclusion criteria were included. In the fifth stage, an active manual search was performed of all the references from the studies included in the electronic search, following the previously mentioned procedures¹³13. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;339:332-6. ^{, 14}14. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies tha evaluate health care interventions: explanation and elaboration. Ann Inter Med. 2009;151(4):65-94. http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00136
http://dx.doi.org/10.7326/0003-4819-151-... .

The sixth stage consisted of assessing the methodological quality of the studies using the Consensus-based standards for the selection of health Measurement Instruments (COSMIN)¹⁵15. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments. BMC Med Res Methodol. 2006;6:2. PMid:16433905 PMCid:PMC1368990. http://dx.doi.org/10.1186/1471-2288-6-2
http://dx.doi.org/10.1186/1471-2288-6-2...

16. Balemans AC, Fragala-Pinkham MA, Lennon N, Thorpe D, Boyd RN, O'neil ME, et al. Systematic review of the clinimetric properties of laboratory-and field-based aerobic and anaerobic fitness measures in children with cerebral palsy. Arch Phys Med Rehabil. 2013;94:287-301. PMid:23022091. http://dx.doi.org/10.1016/j.apmr.2012.09.012
http://dx.doi.org/10.1016/j.apmr.2012.09... ^{- 17}17. Dobson F, Hinman RS, Terwee CB, Ross EM, Bennell KL. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2012;20:1548-62. PMid:22944525. http://dx.doi.org/10.1016/j.joca.2012.08.015
http://dx.doi.org/10.1016/j.joca.2012.08... , which features standardized criteria¹⁸18. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality os studies on measurement properties of healty status measurement instruments: an international Delphi study. Qual Life Res. 2010;19: 539-49. PMid:20169472 PMCid:PMC2852520. http://dx.doi.org/10.1007/s11136-010-9606-8
http://dx.doi.org/10.1007/s11136-010-960... and allows the classification of the methodological quality of studies that investigate the measurement properties of an instrument¹⁵15. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments. BMC Med Res Methodol. 2006;6:2. PMid:16433905 PMCid:PMC1368990. http://dx.doi.org/10.1186/1471-2288-6-2
http://dx.doi.org/10.1186/1471-2288-6-2...

16. Balemans AC, Fragala-Pinkham MA, Lennon N, Thorpe D, Boyd RN, O'neil ME, et al. Systematic review of the clinimetric properties of laboratory-and field-based aerobic and anaerobic fitness measures in children with cerebral palsy. Arch Phys Med Rehabil. 2013;94:287-301. PMid:23022091. http://dx.doi.org/10.1016/j.apmr.2012.09.012
http://dx.doi.org/10.1016/j.apmr.2012.09...

17. Dobson F, Hinman RS, Terwee CB, Ross EM, Bennell KL. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2012;20:1548-62. PMid:22944525. http://dx.doi.org/10.1016/j.joca.2012.08.015
http://dx.doi.org/10.1016/j.joca.2012.08... ^{- 18}18. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality os studies on measurement properties of healty status measurement instruments: an international Delphi study. Qual Life Res. 2010;19: 539-49. PMid:20169472 PMCid:PMC2852520. http://dx.doi.org/10.1007/s11136-010-9606-8
http://dx.doi.org/10.1007/s11136-010-960... . COSMIN has been most commonly used to assess the methodological quality of questionnaire-based instruments and was developed for this purpose¹⁸18. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality os studies on measurement properties of healty status measurement instruments: an international Delphi study. Qual Life Res. 2010;19: 539-49. PMid:20169472 PMCid:PMC2852520. http://dx.doi.org/10.1007/s11136-010-9606-8
http://dx.doi.org/10.1007/s11136-010-960...

19. Bloemendaal M, Water ATM, Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-21. http://dx.doi.org/10.3109/09638288.2012.680649
http://dx.doi.org/10.3109/09638288.2012.... ^{- 20}20. Terwee CB, Mokkink LB, Knol DL, Ostelo RWJG, Bouter LM, Vet HCW. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res. 2012;21:651-7. PMid:21732199 PMCid:PMC3323819. http://dx.doi.org/10.1007/s11136-011-9960-1
http://dx.doi.org/10.1007/s11136-011-996... . However, the tests investigated in the present study are performance-based. In the classification system proposed by Bloemendaal et al.¹⁹19. Bloemendaal M, Water ATM, Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-21. http://dx.doi.org/10.3109/09638288.2012.680649
http://dx.doi.org/10.3109/09638288.2012.... , the final score depends on the percentage of items scored in COSMIN, and this classification system had already been used in a systematic review of the measurement properties of other performance-based tests¹⁹19. Bloemendaal M, Water ATM, Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-21. http://dx.doi.org/10.3109/09638288.2012.680649
http://dx.doi.org/10.3109/09638288.2012.... . This classification system seemed adequate and was therefore used. Thus, the COSMIN criteria were used by two independent raters, who reached a consensus on the final classification of the methodological quality of the included studies, and a third rater was involved in case of disagreement¹⁹19. Bloemendaal M, Water ATM, Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-21. http://dx.doi.org/10.3109/09638288.2012.680649
http://dx.doi.org/10.3109/09638288.2012.... .

Results

In total, 141 studies were found in the electronic search, 125 of which were excluded in the second stage of the analysis because they did not assess individuals with ND or were not related to clinical sit-to-stand and stand-to-sit tests. In the third stage, six studies were excluded because they did not refer to the population of interest or any test of interest or did not evaluate any property of the test used. In the fourth stage, all ten analyzed studies met the inclusion criteria and remained in the study. An active manual search was performed in these ten studies, which resulted in one more study being included, for a total of 11 studies (Figure 1). Considering the COSMIN classification system proposed by Bloemendaal et al.¹⁹19. Bloemendaal M, Water ATM, Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-21. http://dx.doi.org/10.3109/09638288.2012.680649
http://dx.doi.org/10.3109/09638288.2012.... , most of the studies included (96%)⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... ^{, 9}9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160...

22. Blankevoort CG, Heuvelen MJG, Scherder EJA. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2012;93:69-78. PMid:22976448. http://dx.doi.org/10.2522/ptj.20110164
http://dx.doi.org/10.2522/ptj.20110164...

23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11....

25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126...

26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000...

27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... ^{- 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... had a sufficient methodological quality, and one study (4%)²⁹29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... had a good methodological quality (Table 1).

Three distinct tests were used to evaluate the sit-to-stand and stand-to-sit tasks: 82% of the studies (9/11)⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11....

25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... ^{- 26}26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... used the "five-repetition sit-to-stand test" (five times sit-to-stand test, 5-repetition sit-to-stand test ²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , sit-to-stand ²⁷27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... ), 9% of the studies (11/1)⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... used the "20-second sit-to-stand test" (sit-to-stand test), and 9% (1/11)²²22. Blankevoort CG, Heuvelen MJG, Scherder EJA. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2012;93:69-78. PMid:22976448. http://dx.doi.org/10.2522/ptj.20110164
http://dx.doi.org/10.2522/ptj.20110164... used the "30-second sit-to-stand test" (chair rise test) (Table 2).

The populations of the included studies ranged from children to the elderly, and the "five-repetition sit-to-stand test" was used by most studies on the following individuals: those with stroke, ambulating independently (3/11)²¹21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ; those with dementia, ambulating independently (1/11)²⁷27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... ; those with multiple sclerosis (MS) but without disabilities or ambulating with bilateral weight bearing (1/11)²⁹29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... ; those with incomplete spinal cord injury, ambulating with moderate dependence or independently (1/11)²⁵25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... ; those with Parkinson's disease (PD) with minimal dysfunctions (1/11)⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ; those with Alzheimer's disease (AD), ambulating independently²⁶26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... and those with cerebral palsy (CP) whose functional level was not described²⁸28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... (Table 2). Individuals with Down Syndrome ambulating independently were also evaluated with the "20-second sit-to-stand test"⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... , and individuals with dementia, whose functional level was not described, were also evaluated with the "30-second sit-to-stand test"²²22. Blankevoort CG, Heuvelen MJG, Scherder EJA. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2012;93:69-78. PMid:22976448. http://dx.doi.org/10.2522/ptj.20110164
http://dx.doi.org/10.2522/ptj.20110164... (Table 2).

Among the studies that investigated the "five-repetition sit-to-stand test", 77% used chairs with a fixed seat height⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{, 26}26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... ^{, 27}27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , and 11% used a seat height adjustable to the individual's leg length⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... (Table 3). Most of the studies (77%) reported that there were no arm rests on the chair⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... ^{, 9}9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{- 25}25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , and 66% used chairs with backrests⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{- 25}25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... ^{, 27}27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... . No study that used this test allowed the use of the upper limbs⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{- 25}25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... ^{, 27}27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , and in 90% of the studies, the upper limbs of the individual were crossed²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 26}26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... ^{, 27}27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... over the chest⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... or over the torso²⁴24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... . Approximately 33% of the studies gave the patients a test demonstration²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... , 55.5% reported the number of repetitions performed in the test²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{- 25}25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , and 88.8% reported the instructions provided²¹21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11....

25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126...

26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000...

27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008...

28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... ^{- 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... (Table 2).

Studies evaluating individuals with stroke²¹21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... included participants in the chronic phase, from both genders, with a mean age between 53.4 and 60 years (Table 2). These studies investigated some properties of the "five-repetition sit-to-stand test", such as reliability (test-retest²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... , inter-rater²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... and intra-rater²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ), criterion validity (sensitivity and specificity²¹21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ) and concurrent criterion validity²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... , all with adequate results (Table 4). For this same test used in individuals with MS (Table 2), the concurrent criterion validity was investigated, and moderate to good correlations were obtained between lower limb strength and body sway with eyes open (Table 4).

For the "five-repetition sit-to-stand test", the concurrent criterion validity was investigated with functional independence measures in individuals with incomplete spinal cord injury, using a point biserial correlation coefficient and obtaining a negative value of 0.595²⁵25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... (Tables 2 and 4). In children with CP (Table 2), the convergent criterion validity was investigated, and Pearson's Correlation Coefficient values of 0.4 to 0.78²⁸28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... were obtained (Table 4). For the population with dementia (Table 2), the test-retest reliability was assessed, and an intraclass correlation coefficient (ICC) value of 0.94²⁷27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... (Table 4) was obtained. For individuals with AD (Table 2), the test was considered safe and with good clinical feasibility²⁶26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... (Table 4).

The only study that used the "20-second sit-to-stand test" provided instructions regarding the pace of the test and allowed the participants to use their upper limbs (Table 3). Moreover, this study assessed the test-retest reliability in 21 individuals with Down Syndrome between five and 31 years from both genders who were ambulating independently (Table 2). Significant and at least moderate CCI values (0.54 to 0.76) (Table 4)⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... were obtained. The only study that used the "30-second sit-to-stand test" used a chair with adjustable seat height, performed three repetitions of the test (Table 3) and assessed the test-retest reliability and measurement error in 52 subjects with mild to moderate dementia (Table 2). To investigate the measurement properties, intra-class correlation coefficients (ICC), standard measurement error and minimal detectable change were used, and values of 0.84, 1.26 and 3.49, respectively, were obtained (Table 4)²²22. Blankevoort CG, Heuvelen MJG, Scherder EJA. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2012;93:69-78. PMid:22976448. http://dx.doi.org/10.2522/ptj.20110164
http://dx.doi.org/10.2522/ptj.20110164... .

Discussion

The present study aimed to determine the measurement or feasibility properties of clinical trials that evaluated the sit-to-stand and stand-to-sit movements in individuals with ND. When assessing the methodological quality, many of the included studies obtained sufficient results by the classification system proposed by Bloemendaal et al.¹⁹19. Bloemendaal M, Water ATM, Port IGL. Walking tests for stroke survivors: a systematic review of their measurement properties. Disabil Rehabil. 2012;34(26):2207-21. http://dx.doi.org/10.3109/09638288.2012.680649
http://dx.doi.org/10.3109/09638288.2012.... . The lower scores were due to a small sample size and a lack of a description of the conditions of the individuals who performed the repeated measures, while the highest scores were related to the use of adequate statistical tests to assess the measurement properties.

Generally, the most commonly used test was the "five-repetition sit-to-stand test", and the most investigated property was the test-retest reliability. Other reliability measures were investigated, such as measurement error and criterion validity (convergent, concurrent, sensitivity/specificity), safety and clinical feasibility, most of which yielded adequate results. This test was performed in children, adults and the elderly, and individuals with stroke were those most commonly evaluated. The test-retest reliability and the measurement error of the "30-second sit-to-stand test" were also investigated in individuals with dementia, and the test-retest reliability of the "20-second sit-to-stand test" was assessed in individuals with Down syndrome, generally with adequate results. Other populations of individuals with ND and other properties were not investigated.

When comparing the results of several studies that evaluated the same property of the same test in populations with different NDs, the present review showed that the "five-repetition sit-to-stand test" showed a higher test-retest reliability in individuals with stroke²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... , dementia²⁶26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... and CP²⁸28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... , although this property was also good for the other populations studied, PD⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... and AD²⁶26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... . Regarding the inter-rater reliability of this same test, the results were adequate¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009. and similar in individuals with stroke²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... , incomplete spinal cord injury²⁵25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... and PD⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... . In the population with stroke, this same test also showed adequate values¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009. of intra-rater reliability, similar to those obtained for inter-rater reliability²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... .

Some studies added informative value to the test-retest reliability measures by also assessing the measurement error by calculating the standard error of the mean and the minimum detectable change, which reflects the variability of the data in the sample¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009.. However, this property was analyzed for more than one population group only for the "five-repetition sit-to-stand test", and the results indicated a lower variability in the measurements of this test in individuals with CP²⁸28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... , followed by individuals with AD²⁶26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... . For individuals with stroke²⁴24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... , the variability was considerably higher. Therefore, the possibility of this test providing more stable measurements with fewer errors is higher¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009. in individuals with CP. In individuals with stroke, the changes observed between assessments performed at different times (such as pre- and post-intervention) should not be related to the measurement error that may occur when using this test¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009..

The concurrent criterion validity of the "five-repetition sit-to-stand test" was assessed in individuals with stroke²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... , multiple sclerosis²⁹29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , incomplete spinal cord injury²⁵25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... and CP²⁸28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... . For individuals with stroke, significant correlations were obtained with isometric strength of the extensor muscles of both knees²³23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... , which were negative and with good magnitude¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009.. For individuals with multiple sclerosis, the correlations found were significant, negative and moderate¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009. for lower limb strength and body sway with eyes open²⁹29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... . For individuals with incomplete spinal cord injury, significant, negative and moderate correlations¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009. with the Functional Independence Measure scores²⁵25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... were reported. Finally, for children with CP, significant correlations were reported, which were positive and good¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009., for isometric muscle strength of hip flexors and abductors²⁸28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... . Therefore, this test showed better validity for the isometric strength of knee extensor muscles in individuals with stroke and hip flexors and abductors in individuals with CP.

Other measurement and feasibility properties were not studied for the same test in different populations, so comparisons similar to those previously performed could not be made. Conversely, a given property was investigated for different tests applied to the same population group. Two studies investigated the test-retest reliability for individuals with dementia, one investigated the "five-repetition sit-to-stand test"²⁷27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... and one investigated the "30-second sit-to-stand test"²²22. Blankevoort CG, Heuvelen MJG, Scherder EJA. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2012;93:69-78. PMid:22976448. http://dx.doi.org/10.2522/ptj.20110164
http://dx.doi.org/10.2522/ptj.20110164... . In this comparison, the "five-repetition sit-to-stand test" showed higher ICC values when compared to the "30-second sit-to-stand test"¹²12. Portney LG, Watkins MP. Foundations of clinical research: applications to practice . 3rd ed. New Jersey: Prentice Hall; 2009.; thus, the former test seems to be the most adequate for individuals with dementia.

The "five-repetition sit-to-stand test" was the only test that showed any of the feasibility properties investigated, which were safety and clinical feasibility in individuals with AD. The results were similar to those reported by studies that investigated these measurement properties for this test in individuals without ND⁷7. Czuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strenght. Am J Med.1985;78:77-81. http://dx.doi.org/10.1016/0002-9343(85)90465-6
http://dx.doi.org/10.1016/0002-9343(85)9... ^{, 10}10. Tiedemann A, Shimada H, Sherrington C, Murray S, Lord SR. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing. 2008;37:430-5. PMid:18487264. http://dx.doi.org/10.1093/ageing/afn100
http://dx.doi.org/10.1093/ageing/afn100... . The test proved to be fast, was easy to perform, demanded little physical space and did not require special equipment. Further studies that clarify the feasibility of tests that assess the sit-to-stand movement in individuals with conditions other than NDs are still necessary.

Unlike already well-established clinical trials³⁰30. Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88(5):559-66. PMid:18292215. http://dx.doi.org/10.2522/ptj.20070205
http://dx.doi.org/10.2522/ptj.20070205... , the protocols of the tests used to evaluate the sit-to-stand movement are still not completely standardized or clearly described by the studies. This limitation hinders the interpretation of the results and the reproduction of the tests in a clinical environment, given that parameters such as instructions, for example, may influence the results of performance-based tests³¹31. Nascimento LR, Caetano LCG, Freitas DCMA, Morais TM, Polese JC, Teixeira-Salmela LF. Different instructions during the ten-meter walking test determined significant increases in maximum gait speed in individuals with chronic hemiparesis. Rev Bras Fisioter. 2012;16(2):122-7. PMid:22378478. http://dx.doi.org/10.1590/S1413-35552012005000008
http://dx.doi.org/10.1590/S1413-35552012... . In addition, in a literature review, Janssen et al.³²32. Janssen WGM, Bussmann HBJ, Stam HJ. Determinants of sit-to-stand movement: a review. Phys Ther. 2002;82(9):866-79. PMid:12201801. identified 19 determinants of the sit-to-stand movement, which have been clearly established and grouped into three categories related to the chair (such as seat height and the presence of arm and torso support), the individual (such as age, underlying disease and the use of shoes) and the strategy (such as speed and the positioning of the feet and upper limbs). These determinants influence the movement performed and may therefore influence the test results. Thus, ideally the sit-to-stand movement should be standardized, taking into consideration these determinants, including the characteristics of the individual³²32. Janssen WGM, Bussmann HBJ, Stam HJ. Determinants of sit-to-stand movement: a review. Phys Ther. 2002;82(9):866-79. PMid:12201801., so that the standardization would not compromise the clinical feasibility of the tests.

One of the determining factors for the sit-to-stand movement is the speed with which these activities are performed: when fast, the muscular demand imposed on the lower limbs of the individual is high³²32. Janssen WGM, Bussmann HBJ, Stam HJ. Determinants of sit-to-stand movement: a review. Phys Ther. 2002;82(9):866-79. PMid:12201801.. Most likely, to require the maximum biomechanical performance, the test speed used in most studies was as high as possible²¹21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160...

22. Blankevoort CG, Heuvelen MJG, Scherder EJA. Reliability of six physical performance tests in older people with dementia. Phys Ther. 2012;93:69-78. PMid:22976448. http://dx.doi.org/10.2522/ptj.20110164
http://dx.doi.org/10.2522/ptj.20110164...

23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11....

25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126...

26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000...

27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008...

28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... ^{- 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... . Another determining factor for the sit-to-stand movement is the size of the chair and its other characteristics. The height of the chair has already been shown to interfere with the performance of the sit-to-stand movement³²32. Janssen WGM, Bussmann HBJ, Stam HJ. Determinants of sit-to-stand movement: a review. Phys Ther. 2002;82(9):866-79. PMid:12201801.. One strategy already proposed for standardization is adjusting the chair height to the leg length of the individual, which was adopted only by two studies⁸8. Villamonte R, Vehrs PR, Feland JB, Johnson AW, Seeley MK, Eggett D. Reliability of 16 balance tests in individuals with Down Syndrome. Percept Mot Skills. 2010;111(2):530-42. PMid:21162454. http://dx.doi.org/10.2466/03.10.15.25.PMS.111.5.530-542
http://dx.doi.org/10.2466/03.10.15.25.PM... ^{, 28}28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... . In most of the studies, the seat height was fixed⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10... ^{, 24}24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11.... ^{, 26}26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000... ^{, 27}27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008... ^{, 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... , and the results reflected the grouping of biomechanically favored and disadvantaged individuals according to the relationship between leg length and seat height.

Another determining factor for the sit-to-stand movement is the use of the upper limbs, which decreases the biomechanical demand for the individual, such as the muscular demand of the lower limbs³²32. Janssen WGM, Bussmann HBJ, Stam HJ. Determinants of sit-to-stand movement: a review. Phys Ther. 2002;82(9):866-79. PMid:12201801.. Possibly for this reason, most studies did not allow the use of the upper limbs during the tests⁹9. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's Disease. Arch Phys Med Rehabil. 2011;92:1431-6. PMid:21878213 PMCid:PMC3250986. http://dx.doi.org/10.1016/j.apmr.2011.04.008
http://dx.doi.org/10.1016/j.apmr.2011.04... ^{, 21}21. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-28. PMid:19520733. http://dx.doi.org/10.2522/ptj.20080160
http://dx.doi.org/10.2522/ptj.20080160... ^{, 23}23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand in subjects with chronic stoke: reliability and validity. Arch Phys Med Rehabil. 2010;91:407-13. PMid:20298832. http://dx.doi.org/10.1016/j.apmr.2009.10.030
http://dx.doi.org/10.1016/j.apmr.2009.10...

24. Pardo V, Knuth D, McDermott B, Powell J, Goldberg A. Validity, reliability and minimum detectable change of the maximum step length test in people with stroke. J Neurol Sci. 2013;325:74-78. PMid:23269279. http://dx.doi.org/10.1016/j.jns.2012.11.021
http://dx.doi.org/10.1016/j.jns.2012.11....

25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126...

26. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease. Int Psychogeriatr. 2011;23(7):1152-9. PMid:21489342. http://dx.doi.org/10.1017/S1041610211000639
http://dx.doi.org/10.1017/S1041610211000...

27. Thomas VS, Hageman PA. A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. Int Psychogeriatr. 2002;14(01):17-23. http://dx.doi.org/10.1017/S1041610202008244
http://dx.doi.org/10.1017/S1041610202008...

28. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil. 2011;26(7):664-71. PMid:22080526. http://dx.doi.org/10.1177/0269215511426889
http://dx.doi.org/10.1177/02692155114268... ^{- 29}29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... . Conversely, not using the upper limbs during the test can hinder or prevent its application in individuals with greater motor impairment³³33. Bohannon RW. Five-repetition sit-to-stand test: usefulness for older patients in a home-care setting. Percept Mot Skills. 2011;112(3):803-306. PMid:21853769. http://dx.doi.org/10.2466/15.26.PMS.112.3.803-806
http://dx.doi.org/10.2466/15.26.PMS.112.... , who are often a large portion of the population affected by ND³⁴34. Teixeira-Salmela LF, Oliveira ESG, Santana EGS, Resende GP. Fortalecimento muscular e condicionamento físico em hemiplégicos. Acta Fisiátrica. 2000;7(3):108-18.. These reasons may explain why a clear standardization regarding the positioning of the upper limbs was not observed among these studies, which on the one hand, increased the number of individuals able to perform the tests but on the other hand, created difficulty in comparing the results. Moreover, studies comparing the results of the different tests that assessed the sit-to-stand movement and considered the use of the upper limbs and their positioning were not found. We suggest the establishment of criteria or categories for the analysis that consider the functionality level of the individual when determining the best standardization for the upper limbs in these tests. This guideline would allow a greater proportion of individuals with ND to be included, as they are already included in studies that used the "five-repetition sit-to-stand test" in the elderly³⁵35. Cesari M, Onder G, Zamboni V, Manini T, Shorr RI, Russo A, et al. Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE strudy. BMC Geriatr. 2008;8(34):1-9..

The positioning of the feet (symmetrical, asymmetrical, both in front of and behind the knees) may also modify the biomechanical demand and the strategy for performing the sit-to-stand movement³²32. Janssen WGM, Bussmann HBJ, Stam HJ. Determinants of sit-to-stand movement: a review. Phys Ther. 2002;82(9):866-79. PMid:12201801. ^{, 36}36. Lecours J, Nadeau S, Gravel D, Teixeira-Salmela LF. Interactions between foot placement, trunk frontal position, weight-bearing and knee moment asymmetry at seat-off during rising from a chair in healthy controls and persons with hemiparesis. J Rehabil Med. 2008;40:200-7. PMid:18292922. http://dx.doi.org/10.2340/16501977-0155
http://dx.doi.org/10.2340/16501977-0155... ^{, 37}37. Roy G, Nadeau S, Gravel D, Malouin F, McFadyen BJ, Piotte F. The effect of foot placement and chair height on the asymmetry of vertical forces during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis. Clin Biomech. 2006;21:585-93. PMid:16540217. http://dx.doi.org/10.1016/j.clinbiomech.2006.01.007
http://dx.doi.org/10.1016/j.clinbiomech.... . Only two studies described this feature: the feet were positioned 10 cm behind the knees in individuals with incomplete spinal cord injury²⁵25. Poncumhak P, Saengsuwan J, Kumruecha W, Amatachaya S. Reliability and validity of three functional tests in ambulatory patients with spinal cord injury. Spinal Cord. 2013; 51(3):214-7. http://dx.doi.org/10.1038/sc.2012.126
http://dx.doi.org/10.1038/sc.2012.126... and parallel to each other in individuals with multiple sclerosis²⁹29. Moller AB, Bibby BM, Skjerbaek AG, Jensen E, Sorensen H, Stenager E, et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabil Rehabil. 2012;34(26):2251-8. PMid:22612360. http://dx.doi.org/10.3109/09638288.2012.683479
http://dx.doi.org/10.3109/09638288.2012.... . In the first case, the muscular demand of the lower limbs is lower, and therefore, the time spent on the test may be shorter. The parallel positioning may facilitate or hinder the test performance, depending on the population group. According to a study conducted on individuals with stroke³⁶36. Lecours J, Nadeau S, Gravel D, Teixeira-Salmela LF. Interactions between foot placement, trunk frontal position, weight-bearing and knee moment asymmetry at seat-off during rising from a chair in healthy controls and persons with hemiparesis. J Rehabil Med. 2008;40:200-7. PMid:18292922. http://dx.doi.org/10.2340/16501977-0155
http://dx.doi.org/10.2340/16501977-0155... , the parallel positioning requires symmetry in the biomechanical demand of the lower limbs, which, in this population, could hinder the test performance. However, it is uncertain whether the same effect would apply to individuals with other NDs. Both studies that described the feet positioning used during the test investigated the criterion validity but for distinct constructs, which does not allow comparisons between them.

Final remarks

The clinical evaluation of the sit-to-stand movement in individuals with ND has been performed using three different tests. The "five-repetition sit-to-stand test" is the most widely used and investigated test, and it shows the best reliability in individuals with stroke, dementia and CP, as well as the best criterion validity in individuals with stroke and CP. This test was also considered the most adequate for individuals with dementia when compared to the "30-second sit-to-stand test" because it showed the best test-retest reliability values. The feasibility properties were investigated only for the "five-repetition sit-to-stand test" in individuals with AD, and good results were obtained. There are still not enough data on the main determining factors of the sit-to-stand movement to allow the adequate standardization of the test protocols, which hinders the investigation of measurement properties and intra- and inter-group comparisons. Furthermore, although adequate results were already found for measurement and feasibility properties when evaluating these clinical trials, properties that may better reflect the clinical usefulness of these tests have not yet been investigated, such as responsiveness, or were not thoroughly discussed, such as safety, clinical feasibility and inter- and intra-rater reliability in different NDs.

Acknowledgments

We thank the Minas Gerais Research Foundation (Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG), the Brazilian Federal Agency for Support and Evaluation of Graduate Education (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES), the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq) and the Dean of Research of the Federal University of Minas Gerais (Pró-reitoria de Pesquisa da Universidade Federal de Minas Gerais /Universidade Federal de Minas Gerais - PRPq / UFMG) for the financial support.

References

Appendix 1. Search strategy.

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