Loaded and unloaded timed stair tests as tools for assessing advanced functional mobility in people with stroke.
Shamay S Ng, Tai-Wa Liu, Peiming Chen and 9 others
PMID 36745156WHAT IT FOUND
The Timed Stair Test reliably measures advanced mobility in stroke survivors.
Walking with a 5% body-weight vest took 45 seconds on average, compared to 17 seconds for healthy adults. A completion time over 26 seconds strongly indicates stroke-related mobility limitations.
Key findings
01The Timed Stair Test showed excellent intra-rater reliability in people with stroke under both loaded (ICC=0.991) and unloaded (ICC=0.985) conditions.
02People with stroke took significantly longer to complete the test than healthy adults in both conditions, with a mean composite time of 45.20 seconds loaded and 41.47 seconds unloaded.
03A cut-off score of 26.3 seconds for the loaded test and 23.4 seconds for the unloaded test differentiated people with stroke from healthy adults with high sensitivity and specificity.
STILL TO COME
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What it does not show
The study only measured completion time, not the quality or strategy of stair movement, so it cannot distinguish between slow but safe performance versus unsafe compensatory strategies. Cognitive factors affecting the sequencing of the multi-step task were not investigated, so poor performance could stem from executive dysfunction rather than purely motor deficits. Muscle strength was assessed only at the ankle, ignoring hip and knee contributions which are critical for stair climbing. The study was cross-sectional, so it cannot demonstrate whether changes in TST time reflect recovery or progression over time.
The easy way to misread this
Do not interpret a slow TST time as purely a motor or balance deficit. The test requires complex sequencing of multiple actions (sit-to-stand, walk, turn, climb stairs), and the study did not assess cognitive contribution, meaning executive dysfunction could also prolong completion time.