What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac rehabilitation (Phase II or III) (n=49). Intervention: Physical performance measures (gait speed, 5 times sit to stand, hand grip strength). Primary outcome: Reliability (Intraclass correlation coefficient) and minimal detectable change (MDC95).

March 1, 2013Cardiopulmonary Physical Therapy Journal65 citationsOpen Access

Reliability and Responsiveness of Gait Speed, Five Times Sit to Stand, and Hand Grip Strength for Patients in Cardiac Rehabilitation

MPMichael L. Puthoff DSDan Saskowski

Key Result

Gait speed, 5 times sit to stand, and hand grip strength showed high reliability in cardiac rehabilitation patients, with intraclass correlation coefficients ranging from 0.87 to 0.97.

Study Design

Type

Observational (n=49)

Multicenter

Structured PICO

Are gait speed, 5 times sit to stand, and hand grip strength reliable and responsive measures for patients in cardiac rehabilitation?

Population

49 medically stable adults (mean age 68.7 years, 40.8% female) enrolled in phase II or III cardiac rehabilitation, assessed over two sessions on the same day.

Exposure

Measurement of gait speed, 5 times sit to stand (5 STS), and hand grip strength over two sessions held on the same day

Outcome

Reliability (Intraclass correlation coefficient) and responsiveness (minimal detectable change, MDC95) of gait speed, 5 STS, and hand grip strength

Gait speed, 5 times sit to stand, and hand grip strength are highly reliable and responsive measures for assessing physical performance in patients undergoing cardiac rehabilitation.

Limitations

Both measurement sessions were completed on the same day, which may not reflect true changes in mobility over a longer period.
Small sample size limits the ability to draw definitive conclusions when comparing phase II and phase III patients.
The study assessed reliability and responsiveness but did not address the prognostic value of the physical performance measures.

Abstract

PURPOSE: Following a cardiac event patients are at risk for deficits in mobility and function. However, measures of physical performance are not commonly used and have not been extensively studied in patients enrolled in cardiac rehabilitation. The purpose of this study was to determine the reliability and the minimal detectable change (MDC) of gait speed, 5 times sit to stand (5 STS) and hand grip strength for individuals enrolled in cardiac rehabilitation. METHODS: Forty-nine individuals enrolled in phase II or III cardiac rehabilitation participated in the study. Gait speed, 5 STS, and hand grip strength were measured over two sessions held on the same day. Intraclass correlation coefficient was used to determine reliability and MDC95 was calculated to measure responsiveness. RESULTS: All 3 measures showed high reliability (ICC for gait speed = 0.96, 5 STS = 0.87, right hand grip strength = 0.97, left hand grip strength = 0.97). The MDC95 for gait speed was 0.16 meters/second, 3.12 seconds for 5 STS, 5.2 kilograms for right and 5.1 kilograms for left hand grip strength. CONCLUSION: Gait speed, 5 STS, and hand grip strength are reliable and responsive measures for patients in cardiac rehabilitation. Findings support their use in clinical practice and future cardiac rehabilitation studies.

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