The five times sit to stand test: Responsiveness to change and concurrent validity in adults undergoing vestibular rehabilitation

OBJECTIVE: The purpose of this study was to determine if patients with balance and vestibular disorders would demonstrate clinically meaningful improvement in the Five Times Sit to Stand Test (FTSST) score as a result of vestibular rehabilitation and to determine the concurrent validity of the FTSST. DESIGN: Retrospective chart review of 351 people who underwent individualized outpatient vestibular rehabilitation programs. SETTING: Outpatient tertiary balance and vestibular clinic. SUBJECTS: One hundred and seventeen patients (45 men, 72 women), mean age 62.7 years, with peripheral, central or mixed vestibular dysfunction. MAIN OUTCOME MEASURES: FTSST, gait speed, Timed Up and Go Test (TUG), Dynamic Gait Index (DGI), Dizziness Handicap Inventory (DHI), and Activities-Specific Balance Confidence Scale (ABC). RESULTS: The mean change in FTSST score was 2.7 seconds. Subjects demonstrated statistically significant improvements in the FTSST, gait speed, ABC, DHI, DGI and TUG after vestibular rehabilitation (p < 0.01). The responsiveness-treatment coefficient (RT) was calculated as 0.58 for the FTSST indicating moderate responsiveness. Logistic regression showed that an improvement in the FTSST of greater than 2.3 seconds resulted in an odds ratio of 4.67 for demonstrating clinical improvement in DHI, compared with a change less than 2.3 seconds. The univariate linear regression model for baseline FTSST predicting FTSST change was significant (p < 0.01) and predicted 49% of the change variance. The FTSST scores demonstrated a moderate correlation with gait speed and the TUG (p< 0.01). FTSST improvement subsequent to vestibular rehabilitation was moderately correlated with improvements in the DGI and the TUG scores (p< 0.01). CONCLUSIONS: The FTSST was moderately responsive to change over time and was moderately related to measures of gait and dynamic balance.