Original Editor - Muhammad Osama
Top Contributors - Ilona Malkauskaite, Muhammad Osama, Kim Jackson and Amrita Patro
- 1Description
- 1.1What is Autogenic and Reciprocal Inhibition?
- 1.1.2Autogenic Inhibition MET
- 1.1What is Autogenic and Reciprocal Inhibition?
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Description
Muscle Energy Technique (MET) is a form af a manual therapy which uses a muscle’s own energy in the form of gentle isometric contractions to relax the muscles via autogenic or reciprocal inhibition, and lengthen the muscle. As compared to static stretching which is a passive technique in which therapist does all the work, MET is an active technique in which patient is also an active participant. MET is based on the concepts of Autogenic Inhibition and Reciprocal Inhibition. If a sub-maximal contraction of the muscle is followed by stretching of the same muscle it is known as Autogenic Inhibition MET, and if a submaximal contraction of a muscle is followed by stretching of the opposite muscle than this is known as Reciprocal Inhibition MET [1].
What is Autogenic and Reciprocal Inhibition?
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Autogenic and reciprocal inhibition both occur when certain muscles are inhibited from contracting due to the activation of the Golgi tendon organ (GTO) and the muscle spindles. These two musculotendinous proprioceptors located in and around the joints and muscles respond to changes in muscle tension and length, which helps manage muscular control and coordination.
The GTO, located between the muscle belly and its tendon, senses increased tension when the muscle contracts or stretches. When the muscle contracts, the GTO is activated and responds by inhibiting this contraction (reflex inhibition) and contracting the opposing (antagonist) muscle group. This process is known as autogenic inhibition.
The GTO response plays an important role in flexibility. When the GTO inhibits the (agonist) muscle’s contraction and allows the antagonist muscle to contract more readily, the muscle can be stretched further and easier. Autogenic inhibition is often seen during static stretching, such as during a low-force, long-duration stretch. After 7 to 10 seconds, muscle tension increases and activates the GTO response, causing the muscle spindle in the stretched muscle to be inhibited temporarily, which makes it possible to stretch the muscle further.
The muscle spindle is located within the muscle belly and stretches along with the muscle itself. When this occurs, the muscle spindle is activated and causes a reflexive contraction in the agonist muscle (known as the stretch reflex) and relaxation in the antagonist muscle. This process is known as reciprocal inhibition.
Types of MET:[1]
Figure showing the reflex neuro-muscular inhibition phenomenon
1.Autogenic Inhibition MET
1a. Post Isometric Relaxation (PIR)[2]
1b.Post Facilitation Stretching (PFS)[3]
2. Reciprocal Inhibition MET
Autogenic Inhibition MET
As already mentioned Autogenic Inhibition METs work on the principle of autogenic inhibition. The two major and well known types of MET that are based on the concept of autogenic inhibition are Post Isometric Relaxation (PIR)[2] and Post facilitation Stretching (PFS). [3]
Post Isometric Relaxation (PIR)
Post Isometric Relaxation is a technique developed by Karel Lewitt [2].Post Isometric Relaxation (PIR) is the effect of the decrease in muscle tone in a single or group of muscles, after a brief period of submaximalisometric contraction of the same muscle[1]. PIR works on the concept of autogenic inhibition.
The PIR technique is performed as follows[1]:
- The hypertonic muscle is taken to a length just short of pain, or to the point where resistance to movement is first noted.
- A submaximal (10-20%) contraction of the hypertonic muscle is performed away from the barrier for between 5 and 10 seconds and the therapist applies resistance in the opposite direction . The patient should inhale during this effort.
- After the isometric contraction the patient is asked to relax and exhale while doing so.Following this a gentle stretch is applied to take up the slack till the new barrier.
- Starting from this new barrier, the procedure is repeated two or three times.
Post Facilitation Stretch (PFS)
Post Facilitation Stretch (PFS) is a technique developed by Janda [3]. This technique is more aggressive than PIR but is also based on the concept of autogenic inhibition.
The PFS technique is performed as follows:
- The hypertonic and shortened muscle is placed between a fully stretched and a fully relaxed state.
- The patient is asked to contract the agonist using a maximum degree of effort for 5–10 seconds while the therapist resists thepatients force.
- The patient is then asked to relax and release the effort, whereas the therapist applies a rapid stretch to a new barrier and is held for 10 seconds.
- The patient relaxes for approximately 20 seconds and the procedure is repeated between three to five times and five times more.
- Instead of starting from a new barrier, the muscle is placed between a fully stretched and a fully relaxed state before every repetition.
Reciprocal Inhibition MET
Reciprocal Inhibition MET is different from the above two techniques that it involves the contraction of one muscle followed by stretching of the opposite muscle, because contrary to PIR and PFS, Reciprocal Inhibition MET as the name implies is based on the concept of Reciprocal Inhibition.
The Reciprocal Inhibition MET technique is performed as follows[1]:
- The affected muscle is placed in a mid-range position.
- The patient pushes towards the restriction/barrier whereas the therapist completely resists this effort (isometric) or allows a movement towards it (isotonic).
- This is followed by relaxation of the patient along with exhalation, and the therapist applies a passive stretch to the new barrier.
- The procedure is repeated between three to five times and five times more.
Indication
Muscle Energy Techniques can be used for any condition in which the goal is to cause relaxation and lengthening of the muscles and improve range of motion (ROM) in joints. Muscle energy techniques can be applied safely to almost any joint in the body. Many athletes use MET as a preventative measure to guard against future injury of muscles and joints. It is mainly used by individuals who have a limited ROM due to facet joint dysfunction in the neck and back, and for broader areas such as shoulder pain, scoliosis, sciatica, asymmetrical legs, hips or arms, or to treat chronic muscle pain, stiffness or injury [4].
Evidence of Muscle Energy Techniques in Physiotherapy
Franke H et al in a systematic review examined the effectiveness of MET in the treatment of patients with non-specific low back pain (LBP) in comparisson with control interventions. It was found a poor quality of randomized control trial (RCT) studies of MET treatment in patient population with a non specific LBP. This indicates that more better quality studies are needed to confirm the effectiveness of MET for non-specific LBP [5]. In a randomized control trial performed by Szulc et al the efficacy of combined method of Mckenzie and MET was analyzed for patients with LBP. The study showed positive results of a combination of Mckenzie and MET therapies in terms of significantly decreased outcomes in Oswestry Disability Index , significant alleviation of pain in Visual Analogue Scale (VAS) , and significantly reduced size of spinal disc herniation. The combined method can be effectively used in the treatment of chronic LBP [6].
Phadke et al in a RCT investigated the effect of MET and static stretching on pain and functional disability on patients with mechanical neck pain. It was found that MET was better than static stretching technique in terms of outcomes in VAS and Neck Disability Index (NDI)[7].
An immediate effect of MET on Posterior Shoulder Tightness was found in basketball players in a RCT performed by Moore et al. There were improvements of glenohumeral joint range of motion in horizontal adduction and internal rotation [8].
Resources
Muscle Energy Techniques by Leon Chaitow
References
- ↑ 1.01.11.21.31.4Chaitow L, Crenshaw K. Muscle energy techniques. Elsevier Health Sciences; 2006.
- ↑ 2.02.12.2Lewit K, Simons DG. Myofascial pain: relief by post-isometric relaxation. Archives of Physical medicine and rehabilitation. 1984 Aug;65(8):452-6.
- ↑ 3.03.13.2Janda, V. 1988. Muscles and Cervicogenic Pain Syndromes. In Physical Therapy of the Cervical and Thoracic Spine, ed. R. Grand. New York: Churchill Livingstone.
- ↑https://leggehealth.ca/portfolio-item/muscle-energy-technique-met/ (accessed 23 March 2018).
- ↑Franke H, Fryer G, Ostelo RWJG, Kamper SJ. Muscle energy technique for non-specific low-back pain. Cochrane Database of Systematic Reviews 2015;(2):CD009852.
- ↑Szulc P, Wendt M, Waszak M, Tomczak M, Cieślik K, Trzaska T. Impact of McKenzie Method Therapy Enriched by Muscular Energy Techniques on Subjective and Objective Parameters Related to Spine Function in Patients with Chronic Low Back Pain.Med Sci Monit 2015; 29;21:2918-32.
- ↑Apoorva Phadke, Nilima Bedekar, Ashok Shyam, Parag Sancheti. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong Kong Physiotherapy Journal 2016; 35:5-11.
- ↑Moore SD, Laudner KG, McLoda TA, Shaffer MA.The Immediate Effects of Muscle Energy Technique on Posterior Shoulder Tightness: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2011;41(6):400-7.
Retrieved from 'https://www.physio-pedia.com/index.php?title=Muscle_Energy_Technique&oldid=217128'
Purpose
The Five Times Sit to Stand Test measures one aspect of transfer skill. The test provides a method to quantify functional lower extremity strength and/or identify movement strategies a patient uses to complete transitional movements.
Area of Assessment
Functional MobilityStrength
Administration Mode
Paper & PencilDiagnosis/Conditions
- Cerebral Palsy
- Parkinson's Disease + Neurologic Rehabilitation
- Stroke Recovery
- Vestibular Disorders
Populations
- The chair should be free-standing
- Test Administration:
1) Patient sits with arms folded across chest and with their back against the chair. With patients who have had a stroke, it is permissible to have the impaired arm at the side or in a sling
2) Use a standard chair with arms (keep testing chair consistent for each retest). Chair heights recorded in literature vary, generally 43-45 cm
3) Ensure that the chair is not secured (i.e. against the wall or mat)
4) Patient Instructions: 'I want you to stand up and sit down 5 times as quickly as you can when I say 'Go'.'
5) Timing begins at 'Go' and ends when the buttocks touches the chair after the 5th repetition.
6) Provide one practice trial before measurements are recorded.
7) Inability to complete five repetitions without assistance or use of upper extremity support indicates failure of test. (Any modifications should be documented)
8) Document speed and assist level (CGA, supervision, Mod I, or I) in the PT Standing Balance Section - Instruct patient to stand fully between repetitions of the test and not to touch the back of the chair during each repetition.
- It is OK if the patient does touch the back of the chair, but it is not recommended.
- Try NOT to talk to the patient during the test (may decrease patient’s speed).
- If you are concerned that the patient may fatigue with a practice trial, it is OK to demonstrate to the patient and have the patient do two repetitions to ensure they understand the instructions.
- Subjects are allowed to place their feet comfortably under them during testing.
Equipment Required
- Standard height chair (43-45 cm, 17-18 inches) with a backrest
- Stopwatch
Less than 5 minutes
Depends on the number of trials
Age Ranges
Elderly Adult
65 +
yearsInstrument Reviewers
Initially reviewed by Susan Deems-Dluhy, PT, NCS in 2010; Updated with references from the Parkinson's Disease and Cerebral Palsy populations by Yamit Saadia-Redleaf, SPT and Julian Scheff, SPT in 11/2012; Updated by Alicia Esposito, PT, NCS and the PD EDGE task force of the Neurology Section of the APTA in 2013.Reviewed and updated by Karen Lambert, PT, MPT, NCS and Linda Horn, PT, DscPT, MHS, NCS and the Vestibular EDGE task force of the Neurology Section of the APTA 6/2013.
ICF Domain
ActivityProfessional Association Recommendation
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
Abbreviations: | |
HR | Highly Recommend |
R | Recommend |
LS / UR | Reasonable to use, but limited study in target group / Unable to Recommend |
NR | Not Recommended |
Recommendations for use based on acuity level of the patient:
Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) | Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) | Chronic (> 6 months) (Vestibular > 6 weeks weeks post) | |
SCI EDGE | |||
StrokEDGE | R | R | R |
Vestibular EDGE | LS | LS | LS |
Recommendations Based on Parkinson Disease Hoehn and Yahr stage:
I | II | III | IV | V | |
PD EDGE | HR | HR | HR | HR | NR |
Recommendations based on level of care in which the assessment is taken:
Acute Care | Inpatient Rehabilitation | Skilled Nursing Facility | Outpatient Rehabilitation | Home Health | |
MS EDGE | UR | UR | UR | UR | UR |
StrokEDGE | R | R | R | R | R |
Recommendations based on EDSS Classification:
EDSS 0.0 – 3.5 | EDSS 4.0 – 5.5 | EDSS 6.0 – 7.5 | EDSS 8.0 – 9.5 | |
MS EDGE | UR | UR | UR | NR |
Recommendations based on vestibular diagnosis
Peripheral | Central | Benign Paroxysmal Positional Vertigo (BPPV) | Other | |
Vestibular EDGE | LS | LS | LS | LS |
Recommendations for entry-level physical therapy education and use in research:
Students should learn to administer this tool? (Y/N) | Students should be exposed to tool? (Y/N) | Appropriate for use in intervention research studies? (Y/N) | Is additional research warranted for this tool (Y/N) | |
MS EDGE | No | No | No | Yes |
PD EDGE | Yes | Yes | Yes | Not reported |
StrokEDGE | No | Yes | Yes | Not reported |
Vestibular EDGE | Yes | Yes | No | Yes |
Considerations
- The Five Times Sit to Stand Test (FTSST) is a quick and easy to administer test of an individuals's ability to transition between sitting and standing five times in a row.
- Individuals with a balance disorder performed the FTSST slower than controls (Whitney, 2005) and was more sensitive in a younger (< 60 years old) population.
- The FTSST is responsive to change in balance over time (Merretta, 2006)
- Both DGI and ABC were more sensitive than the FTSST to detect individuals with balance disorders.
- Many variations exist:
- Ten Times Stand Test
- Single leg sit-to-stand test
- 1-minute sit-to-stand test 1
- 0 Second Sit to Stand Test
- Six Times Sit to Stand Test
- 30 second sit to stand
- Measurements of time are more precise (5x sit to stand; 10x sit to stand) then count of repetitions (30 second sit to stand; 10 second sit to stand). Individuals who are weak however may not be able to complete the requisite number of repetitions and consequently counting the number of repetitions in a pre set amount of time may be preferable for certain patient populations.
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Standard Error of Measurement (SEM)
Children with Cerebral Palsy:
(Wang et al, 2011; n = 170 children, 108 with spastic diplegia and 62 with typical development, 22 of the children with spastic diplegia were tested twice within one week for test-retest reliability; mean age = 8.1 (1.8) for children with spastic diplegia and 8.7 (1.6) for children with typical development)
- SEM = 0.02 (using the average of three trials)
- SEM = 0.04 (using the first trial only)
Minimal Detectable Change (MDC)
Children with Cerebral Palsy:
(Wang et al, 2011, Children with Cerebral Palsy)
- MDC = 0.06 (using the average of three trials)
- MDC = 0.11 (using the first trial only)
Test/Retest Reliability
Children with Cerebral Palsy:
(Wang et al, 2011, Children with Cerebral Palsy)
- Excellent test-retest reliability (ICC = 0.99) using the average of 3 trials
- Excellent test-retest reliability (ICC = 0.97) using the first trial only
(Wang et al, 2011, Children with Cerebral Palsy)
- Excellent intra-session reliability (ICC = 0.95)
Construct Validity
Children with Cerebral Palsy:
(Wang et al, 2011, Children with Cerebral Palsy)
Convergent Validity of the Five-Repetition Sit-to-Stand Test and Mean Values of all Criterion Tests in Children with Spastic Diplegia | |||
n | mean(SD) | r(rho) | |
1-RM of LSTS* | 91 | 0.47(0.21) | 0.59*** |
Isometric Muscle Strength | |||
Hip Flexors* | 18 | 0.27(0.08) | 0.78*** |
Hip Extensors* | 18 | 0.23(0.13) | 0.68** |
Hip Abductors* | 18 | 0.27(0.09) | 0.76*** |
Hip Adductors* | 18 | 0.29(0.08) | 0.30 |
Knee Flexors* | 40 | 0.18(0.08) | 0.50*** |
Knee Extensors* | 40 | 0.31(0.11) | 0.45** |
Ankle Dorsiflexors* | 18 | 0.09(0.06) | 0.57** |
Ankle Plantar Flexors* | 18 | 0.46(0.12) | 0.68** |
Trunk Extensors (sec) | 41 | 33.7(37.7) | (0.43)** |
Functional Measures | |||
GMFM-D (%) | 64 | 81.8(13.1) | (0.65)*** |
GMFM-E (%) | 64 | 68.9(21.1) | (0.75)*** |
Walking Speed (m/min) | 45 | 57.2(15.0) | 0.41** |
PCI (beats/m) | 45 | 1.0(0.5) | (-0.40)** |
**P < 0.05; ***P < 0.001; correlation coefficients by Pearson (r) or Spearman (rho) correlation analysis; * values were normalized by body weight. 1-RM, 1-repetition maximum; GMFM, Gross Motor Functino Measure; LSTS, loaded sit-to-stand test; PCI, physiological cost index. |
Parkinson's Disease
back to PopulationsStandard Error of Measurement (SEM)
Parkinson's Disease:
(Paul et al, 2012; n = 31; age (years) = 65.9 (8.8), range = 44 - 87; PD duration (years) = 7.1 (4.6), range = 1 - 19; Mini Mental State Examination Score (0 - 30) = 29.6 (0.9), range = 27 - 30; 'ON' MDS-UPDRS motor score (0 - 132) = 25.0 (10.4), range = 8 - 47; H and Y stage (0 - 5) = 2.0 (0.8), range = 1 - 4; dyskinesia (>/ = 1 of item 4.1 of the MDS-UPDRS): n = 15; disabling dyskinesia (> 1 of item 4.3 of the MDS-UPDRS: n = 6; motor fluctuations (> 1 of item 4.3 of the MDS-UPDRS: n = 16)
Cut-Off Scores
Parkinson's Disease:
(Duncan et al, 2011; n = 80; 59% men; mean age = 67 (9.0) years; mean Hoehn & Yahr Stage = 2.4 (0.6), (range 1 – 4); Individuals in each H & Y stage (I = 2, II = 2, III = 2 and IV = 1) were unable to perform FTSTS because they were unable to arise from a chair without using the upper extremities so these participants were given a score of 60 seconds, which was approximately 1 SD higher than the slowest performance time among those who were able to perform the task)
- > 16.0 seconds indicates the risk of falls
- Cut off score of 16 second discriminates fallers from non-fallers
Normative Data
Parkinson's Disease:
(Duncan et al, 2011, Parkinson's Disease)
Correlation Coefficients Between FTSTS Test and All Variables | |||
Variable | Correlation | P | |
Demographics | Age | 0.37 | 0.001 |
BMI | -0.10 | 0.40 | |
Questionnaires | PASE | -0.38 | 0.001 |
PDQ-Mobility | 0.58 | <0.001 | |
FOGQ | 0.44 | <0.001 | |
PDQ-SI | 0.38 | 0.001 | |
ABC | -0.54 | <0.001 | |
Mobility Measures | Mini-BEST | -0.71 | < 0.001 |
Quadriceps MVIC | -0.33 | 0.003 | |
9HPT | 0.55 | <0.001 | |
6MWT | -0.60 | <0.001 | |
NOTE. Pearson correlations were used for all measures. Abbreviations: BMI, body mass index; MVIC, maximal voluntary isometric contraction. |
- (Paul et al, 2012)Mean time = 20.25 seconds (14.12)
- Mean score at baseline = 9.67 (1.79), range = 5.9 - 13.5
- Mean score at retest = 9.48 (2.04), range = 6 - 15.2
Test/Retest Reliability
Parkinson's Disease:
(Duncan et al, 2011)
- Excellent test-retest reliability (ICC = 0.76)
(Paul et al, 2012)
- Excellent test retest reliability (ICC = 0.91 (0.82 - 0.96))
Interrater/Intrarater Reliability
Parkinson's Disease:
(Duncan et al, 2011, Parkinson’s Disease)
- Excellent interrater reliability (ICC = 0.99)
Criterion Validity (Predictive/Concurrent)
Parkinson's Disease:
(Duncan et al, 2011, Parkinson’s Disease)
Predictors of FTSTS Test Performance in PD | |||
Regression Analyses: | |||
Model | CumulativeR2 | β | P |
Model 1 | |||
Mini-BEST | 0.500 | -0.58 | < 0.001 |
9HPT | 0.528 | 0.21 | 0.03 |
Model 2 | |||
Mini-BEST | 0.506 | -0.69 | <0.001 |
9HPT | 0.535 | 0.22 | 0.05 |
PDQ-SI | 0.545 | -0.12 | 0.34 |
Quadriceps MVIC | 0.548 | -0.06 | 0.52 |
PASE | 0.552 | 0.06 | 0.58 |
FOGQ | 0.553 | -0.06 | 0.61 |
6MWT | 0.554 | -0.06 | 0.73 |
Age | 0.555 | -0.03 | 0.77 |
ABC | 0.555 | 0.00 | 0.99 |
Abbreviation: MVIC, maximal voluntary isometric contraction. Cumulative R2 = total R2 when the variable in question plus all preceding variables have been entered into the model. β = standardized regression coefficients. |
- Adequate correlation with Physical Activity Scale for the Elderly (PASE), (r = -0.38 (p = 0.001))
- Adequate correlation with Parkinson's Disease Questionnaire-mobility (PDQ-mobility), (r = 0.58 (p < 0.001))
- Adequate correlation with the Freezing of Gait Questionnaire (FOGQ), (r = 0.44 (p < 0.001))
- Adequate correlation with Parkinson's Disease Questionnaire-summary index (PDQ-SI), (r = 0.38 (p = 0.001))
- Adequate correlation with the Activities-Specific and Balance Confidence Scale (ABC), (r = 0.54 (p < 0.001)
- Excellent correlation with the Mini-Balance Evaluation Systems Test (Mini-BESTest), (r = 0.71 (p < 0.001))
- Adequate correlation with quadriceps maximal voluntary isometric contraction (MVIC), (r = -0.33 (p = 0.003))
- Adequate correlation with the 9 Hole Peg Test (9 HPT), (r = 0.55 (p < 0.001))
- Adequate correlation with the 6 Minute Walk Test (6 MWT), (r = 0.60 (p < 0.001))
- Adequate predictive validity: Cut off score of 16 seconds discriminated fallers and nonfallers (area under the curve = 0.77; sensitivity = 0.75; specificity = 0.68)
Floor/Ceiling Effects
Parkinson's Disease:
(Duncan et al, 2011)
- Individuals in each H & Y stage (I = 2, II = 2, III = 2 and IV = 1) were unable to perform FTSTS because they were unable to arise from a chair without using the upper extremities
Minimally Clinically Important Difference (MCID)
Vestibular Disorders:
(Meretta, 2006; n = 117 patients, 45 men, 72 women with peripheral, central or mixed vestibular dysfunction; mean age = 62.7 years, Vestibular Disorders)
- MCID = Greater than or equal to 2.3 seconds
Cut-Off Scores
Balance or Vestibular Disorders:
(Whitney et al, 2005; n = 81 controls (mean age younger = 41 (11) years and older = 73 (5) years) and n = 93 with balance disorders (mean age younger = 48 (10) years and older = 75 (7) years)
- Entire sample: 13 sec
- Older (> 60 years): 14.2 sec
(Buatois, 2008; n = 2,735 consecutive voluntary subjects aged 65 and older in apparently good state of health consulting for a medical examination, Vestibular Disorders in the Elderly)
- Cutoff score of 15 sec was predictive of fallers in elderly
Normative Data
Vestibular Patients:
(Whitney, 2005; n = 32 younger subjects without balance disorders, 47 younger subjects with balance disorders, 49 older subjects without balance disorders and 46 subjects with balance disorders; mean age = 41 (11) for younger subjects without balance disorders, 48 (10) for younger subjects with balance disorders, 75 (5) for older subjects without balance disorders and 75 (7) for older subjects with balance disorders, Vestibular Patients)
Descriptive Data for FTSST
Variable | Younger control subjects (n = 32) | Younger subjects with balance dysfunction (n = 47) | Older control subjects(n = 49) | Older subjects with balance dysfunction (n = 46) |
Age (y) | ||||
Mean | 41 | 48 | 73 | 75 |
SD | 11 | 10 | 5 | 7 |
Range | 23-57 | 14-59 | 63-84 | 61-90 |
Sex | ||||
Men | 16 | 15 | 23 | 18 |
Women | 16 | 32 | 26 | 28 |
FTTS Score | ||||
Mean | 8.2 | 15.3 | 13.4 | 16.4 |
SD | 1.7 | 7.6 | 2.8 | 4.4 |
Range | 4.9-12.7 | 6.4-56.6 | 7.5-19.6 | 9.6-27.5 |
95% CI | 7.5-8.8 | 13.1-17.6 | 12.5-14.1 | 15.1-17.7 |
Criterion Validity (Predictive/Concurrent)
Balance/vestibular disorders:
(Whitney, 2005, Balance/Vestibular Disorders)
- Excellent correlation with ABC (rho = -0.68)
- Adequate correlation with DGI (rho = -0.58)
(Meretta, 2006; n = 117 patients (45 men, 72 women with peripheral, central or mixed vestibular dysfunction; mean age = 62.7 years, Balance/Vestibular Disorders)
- Adequate correlation with TUG (r = 0.59)
- Adequate correlation with Gait speed (r = -0.53)
Construct Validity
Vestibular Disorders:
(Whitney, 2005, Vestibular Patients)
- FTSST correctly identified 65% of patients with balance disorders (correctly identified 81% of individuals with balance disorders in younger patients (< 60 years old)).
- Both ABC (80%) and DGI (78%) were better at identifying individuals with balance disorders.
Responsiveness
Vestibular Disorders:
(Meretta, 2006; n = 117 patients; 45 men, 72 women with peripheral, central or mixed vestibular dysfunction; mean age = 62.7 years, Vestibular Disorders)
- Moderate responsiveness in patients with vestibular disorders (0.58) and 2.3 sec. change predicted 49% of change on DHI
(Whitney, 2005, Vestibular Disorders)
- Was not as sensitive as ABC or DGI in identifying people with balance disorders who had vestibular dysfunction (ability to discriminate people with balance deficits):
- FTSTS = 65%
- ABC = 80%
- DGI = 78%
Stroke
back to PopulationsCut-Off Scores
Stroke:
(Mong, 2010, Chronic Stroke)
- Cutoff score of 12 seconds is discriminatory between healthy, elderly, and subjects with chronic stroke.
Test/Retest Reliability
Stroke:
(Mong, 2010, Stroke)
- Excellent test-retest reliability (ICC = 0.994)
Interrater/Intrarater Reliability
Stroke:
(Mong, 2010, Stroke)
- Excellent intrarater (ICC = 0.970)
- Excellent Interrater: (ICC = 0.999)
Criterion Validity (Predictive/Concurrent)
Stroke:
(Beninato, 2009; n = 27; mean age = 57.2(12.4) years, Chronic Stroke)
- Excellent correlation with the muscle strength of affected and unaffected knee flexors (r = -0.753 - 0.830)
(Mong, 2010, Chronic Stroke)
- Excellent correlation with bilateral knee flexor strength
- Affected (r = -0.753)
- Unaffected (r = -0.830)
- Not correlated with balance ability as tested with BBS
Test/Retest Reliability
Low Back Pain:
(Simmonds, 1998; n = 44 patients with low back pain and 48 healthy, pain-free control subjects, Low Back Pain)
- Poor test-retest (ICC = 0.45)
Interrater/Intrarater Reliability
Low back pain:
(Simmonds,1998, Low Back Pain)
- Excellent interrater reliability (ICC = 0.99)
Criterion Validity (Predictive/Concurrent)
Low back pain:
(Novy, 2002; n = 133 consecutive adult patients with low back pain who were referred for physical therapy assessment; mean age = 45 (12.88) years)
- Excellent correlation with speed and coordination activities with quickly changing spinal loads (r = 0.91)
Construct Validity
Low Back Pain:
(Simmonds,1998, Low Back Pain)
- Excellent correlation with 5 minute walk (r = -0.78, p < 0.01), 50 ft walk (r = 0.87) and repeated trunk flexion (r = 0.64)
- Adequate correlation with lumbar flexion ROM (r = -0.45)
Arthritis
back to PopulationsTest/Retest Reliability
Osteo-arthritis:
(Lin, 2001; n = 106 sedentary subjects with hip and/or knee OA, mean duration = 12.2 (11) years; mean age = 69.4 (5.9) years, Elderly with Osteo-Arthritis)
- Excellent test-retest-excellent (ICC = 0.960)
Criterion Validity (Predictive/Concurrent)
Osteo-arthritis:
(Christiansen, 2010; n = 50 people with end-stage unilateral knee OA and healthy people 17 healthy people; mean age = 64.1(8.4) years, Osteo-arthritis of the Knee)
- Adequate correlation with weight bearing asymmetry (r = -0.44)
Construct Validity
Rheumatoid Arthritis:
(Newcomer, 1993; n = 147 patients with rheumatoid arthritis (RA) or other chronic diseases; using 10 x Sit to Stand Test, Rheumatoid Arthritis)
- Excellent correlation with 50 foot walk test (r = 0.66, p = 0.0001) and lower extremity manual muscle strength (r = 0.47, p = 0.0001)
Criterion Validity (Predictive/Concurrent)
Total knee arthroplasty:
(Piva, 2011; n = 31 people with Total Knee Arthroplasty; mean age = 68 years, Total Knee Arthroplasty)
- Adequate correlation with hip abductor strength (r =-0.56, p < 0.01) and quadriceps strength (r = 0.44, p < 0.01)
Pulmonary Diseases
back to PopulationsConstruct Validity
COPD:
(Ozalevli, 2007; n = 53 patients with stable COPD and 15 healthy individuals; mean age = 71 (12) years for patients with COPD and 63 (8) years for health individuals; using 1 Minute Sit to Stand Test, COPD)
- Excellent correlation with 6MWT (r = 0.75, p < 0.001) and quadriceps strength (r = 0.65, p < 0.01)
Cut-Off Scores
Community-dwelling elderly:
(Tiedemann, 2008; n = 362 older community-dwelling people aged 74-98 years, Community-Dwelling Elderly)
- Initial screening tool-cut off score of greater than or equal to 12 seconds to identify need of further assessment for fall risk.
(Buatois, 2010; n = 1,618 community-dwelling people over 65 years of age, Community-Dwelling Elderly)
- To assess risk of recurrent falls-cut off score of > 15 seconds, especially in moderate risk category
(Mong, 2010, Community-Dwelling Elderly)
- To discriminate between healthy elderly and those with chronic stroke, cut off score of 12 seconds
(Bohannon, 2006; individuals greater than 60 years of age, Community-Dwelling Elderly)
- Estimate values for normal performance in community dwelling older adults
- 60-69 years: 11.4 sec (mean time)
- 70-79 years: 12.6 sec
- 80-89 years: 14.8 sec
Normative Data
Community Dwelling Adults:
(Bohannon, 2007; n = community dwelling adults; mean age = 51 (20.8) years, Community-Dwelling Adults)
Descriptive statistics for time (sec) for 5 sit-to-stand repetitions
Measurement (n) | Mean + SD | Minimum-Maximum |
Trial 1: all ages (94) | 7.8 + 2.8 | 4.0 – 16.3 |
Trial 2: all ages (94) | 7.5 + 2.8 | 4.0 – 17.0 |
Mean: all ages (94) | 7.6 + 2.7 | 4.0 – 16.0 |
Mean: 19-49 years (39) | 6.2 + 1.3 | 4.1 – 11.5 |
Mean: 50-59 years (15) | 7.1 + 1.5 | 4.4 – 9.1 |
Mean: 60-69 years (18) | 8.1 + 3.1 | 4.0 – 15.1 |
Mean: 70-79 years (16) | 10.0 + 3.1 | 4.5 – 15.5 |
Mean: 80-89 years (6) | 10.6 + 3.4 | 7.8 – 16.0 |
Descriptive Statistics for demographic and physical functioning data
Variable | Mean +/- SD | Minimum-Maximum |
Age (years) | 51.1 +/- 20.8 | 19 - 84 |
Weight (kg) | 73.0 +/- 16.0 | 49.1 – 127.3 |
Height (m) | 1.68 +/- 0.09 | 1.47 – 1.88 |
Body mass index (kg/m^2) | 25.6 +/- 4.5 | 18.9 – 40.8 |
Physical functioning (%) | 87.2 +/- 18.6 | 0 - 100 |
Test/Retest Reliability
Community-dwelling elderly:
(Tiedemann, 2008; n = 362 older community-dwelling people aged 74-98 years, Community-Dwelling Elderly)
- Adequate test-retest reliability (ICC = 0.890)
(Bohannon, 2007, Community-Dwelling Elderly)
- Excellent test-retest reliability (ICC = 0.957)
Construct Validity
Community-dwelling elderly:
(Lord, 2002; n = 669 community-dwelling men and women aged 75-93 years; mean age = 78.9(4.1), Community-Dwelling Elderly)
- Adequate construct validity with knee flexion and extension isometric force (r = -0.43, p < 0.01)
(Schaubert, 2005; n = 10 community-dwelling elderly individuals; mean age = 75.5 (5.8) years, Community-Dwelling Elderly)
- Excellent correlation with TUG (r = 0.918) and gait speed (r = 0.943)
Floor/Ceiling Effects
Elderly:
(Bohannon et al, 2006; a literative review of 14 studies; individuals 60 years of age or older, Elderly)
- 70-79 y/o = 12.6 sec
Multiple Sclerosis
back to PopulationsConstruct Validity
Multiple Sclerosis:
(Fry, 2006; using 6XSST, Multiple Sclerosis)
- Excellent correlation with 6MWT (r = -0.82, p = 0.001) and functional stair test (r = 0.8, p = 0.001)
- Adequate correlation with Borg RPE (rho = 0.51)
Construct Validity
Renal transplant:
(Bohannon, 1995; n = 110 renal transplant candidates; mean age = 45.1 (11.6 years);using 10 Second Sit to Stand, Renal Transplant)
- Excellent to adequate convergent validity with knee extension isometric force
- non-dominant (r = 0.64)
- dominant (r = 0.59, p < 0.001)
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Si 65 Amg
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Gullerin Sava Si 65
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