Psychometric properties of loaded and unloaded timed stair tests in assessing people with knee osteoarthritis.
Shamay S M Ng, Siyue Li, Peiming Chen and 5 others
A timed stair-climbing test is a reliable, easy-to-administer tool for assessing stair function in knee osteoarthritis — it needs only a staircase and a stopwatch, and can distinguish affected patients from healthy older adults.
Key findings
1The Timed Stair Test showed excellent intra-rater reliability (ICC 0.952–0.990), near-perfect inter-rater reliability (ICC 0.999–1.000), and good-to-excellent test–retest reliability (ICC 0.835–0.918) in knee osteoarthritis patients under both loaded and unloaded conditions.
2Knee osteoarthritis patients took significantly longer to complete the Timed Stair Test than healthy older adults under both loaded and unloaded conditions (p < 0.001), and both groups were significantly slower when wearing a 5% bodyweight vest (p < 0.001).
3The Timed Stair Test showed fair to moderate-to-good correlations with knee strength, balance, functional mobility, and pain measures, and cut-off times of 18.67 s (unloaded) and 19.94 s (loaded) with AUC 0.771–0.782 could distinguish knee osteoarthritis patients from healthy older adults.
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What it does not show
Single-site study in Hong Kong; results may not generalise to populations with different staircase dimensions or cultural contexts. Only unilateral knee osteoarthritis was included and severity was not stratified, so the findings may not apply to patients with bilateral involvement or more advanced disease. The affected knee was not necessarily the dominant limb, which may have added variability. Handrail use was allowed but not standardised, so completion times may reflect different movement strategies. Only completion time was measured; movement quality, compensatory strategies, and safety risks during stair negotiation were not assessed. Inter-rater reliability was established with only two experienced raters who timed each trial simultaneously, so the near-perfect agreement may not hold across a broader pool of clinicians. The sample was predominantly female (42 of 60 in the KOA group), which may limit generalisability given known sex-related differences in knee osteoarthritis. Cross-sectional design: the study establishes test properties at a single time point but does not track how the test performs as a measure of change over a rehabilitation course.
Declared interests
No conflicts of interest declared. Funded by the General Research Grant from the Research Grants Council of the Hong Kong Special Administrative Region (Project No. 15101023), awarded to Prof. Shamay S.M. Ng and her team.
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