Measurement properties of the upright motor control test in adults with subacute stroke.

BACKGROUND: Previous studies have distilled the Upright Motor Control Test Knee Extension and Knee Flexion subscales (UMCT-KE and UMCT-KF, respectively) from the original 6-item instrument and examined these as stand-alone rapid tests of voluntary movement control in the standing position. Systematic review evidence suggests that the UMCT-KE and UMCT-KF may have value in predicting walking ability after stroke.

OBJECTIVE: To examine the interrater and intrarater reliability, and concurrent validity of the UMCT-KE and UMCT-KF, and associations with walking ability in adults with subacute stroke.

METHODS: A prospective repeated assessments design was implemented in a rehabilitation department in a public teaching hospital. A consecutive sample of patients with subacute first-time stroke (N = 50; mean age = 51 ± 12 years; 20 females; mean time post-stroke = 68 ± 48 days) completed the study. Three physical therapists independently administered the UMCT-KE and UMCT-KF on two testing occasions 2 days apart (t1 and t2). On t2, a fourth rater administered the Leg subscale of the Motricity Index (MI-Leg) as criterion standard.

RESULTS: The UMCT-KE and UMCT-KF demonstrated substantial to almost perfect interrater and intrarater reliability (W = 0.77-0.95), with lower limits of 95% confidence intervals extending to no lower than the substantial level. Both the UMCT-KE and UMCT-KF showed high correlations with the MI-Leg (ρ = 0.747-0.775) and significant associations with walking ability. p Values for all tests were <0.001.

CONCLUSIONS: The UMCT-KE and UMCT-KF are reliable and valid tests for rapidly estimating voluntary movement control of the lower limbs in adults with subacute stroke.