Interrater Reliability and Validity of the Stair Ascend/Descend Test in Subjects With Total Knee Arthroplasty

Gustavo J. Almeida, Carolyn A. Schroeder, Alexandra B. Gil, G. Kelley Fitzgerald, Sara R. Piva

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Almeida GJ, Schroeder CA, Gil AB, Fitzgerald GK, Piva SR. Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty. Objective: (1) To determine the interrater reliability and measurement error of an 11-step stair ascend/descend test (STTotal-11) and stair up (ascend) test (STUp-11); (2) to seek evidence for the STTotal-11 and STUp-11 as valid measures of physical function by determining if they relate to measures of physical function and do not relate to measures not of physical function; and (3) to explore if the STTotal-11 and STUp-11 scores relate to lower-extremity muscle weakness and knee range of motion (ROM) in subjects with total knee arthroplasty (TKA). Design: Cross-sectional study. Setting: Academic center. Participants: Subjects (N=43, 30 women; mean age, 68±8y) with unilateral TKA. Interventions: Not applicable. Main Outcome Measures: STTotal-11 and STUp-11 were performed twice, and scores were compared with scores on 4 lower extremity performance-based tasks, 2 patient-reported questionnaires of physical function, 3 psychologic factors, knee ROM, and strength of quadriceps, hip extensors, and abductors. Results: Intraclass correlation coefficient was .94 for both the STTotal-11 and STUp-11, standard error of measurements were 1.14 seconds and .82 seconds, and minimum detectable change associated with 90% confidence interval was 2.6 seconds and 1.9 seconds, respectively. Correlations between stair tests and performance-based measures and knee and hip muscle strength ranged from Pearson correlation coefficient (r)=.40 to .78. STTotal-11 and STUp-11 had a small correlation with one of the patient-reported measures of physical function. Stair tests were not associated with psychologic factors and knee extension ROM and were associated with knee flexion ROM. Conclusions: STTotal-11 and STUp-11 have good interrater reliability and minimum detectable changes adequate for clinical use. The pattern of associations supports the validity of the stair tests in TKA.

Original languageEnglish (US)
Pages (from-to)932-938
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Issue number6
StatePublished - Jun 2010
Externally publishedYes


  • Arthroplasty, replacement, knee
  • Muscle weakness
  • Rehabilitation
  • Task performance and analysis

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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