Psychometric properties of lift and carry test in assessing people with stroke

 This is totally fucking useless for most stroke survivors. Your doctor should be able to tell from your objective damage diagnosis whether you could do this. I still can't do anything close to this, spasticity prevents my hand from opening and the left arm from reaching.  WHAT EXACT PROTOCOLS ARE OUT THERE THAT WHEN COMPLETED WILL ALLOW YOU TO DO THIS TASK? That is the research needed, not this crapola! I could easily compensate on this by putting the 4.5kg weight in a tote bag and use my good arm to carry it and sling it to the higher shelf.

Psychometric properties of lift and carry test in assessing people with stroke

Peiming Chen^1,2Mimi M. Y Tse³Shamay S.M. Ng^1,2*Leo C. M. Ho¹Anthony T. C. Kwok¹Sam C. Y. Lam¹Tai Wa Liu³Thomson W. L. Wong^1,2Billy C. L. So^1,2Cynthia Y. Y. Lai¹

• ¹Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
• ²Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
• ³School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China

Objective: To investigate the psychometric properties of the Lift and Carry Test (LCT) time in people with stroke.

Design: Cross-sectional design.

Setting: University based neurorehabilitation laboratory.

Participants: Twenty-four people with stroke and 24 healthy controls.

Outcome measures: Lift and Carry Test (LCT), Fugl-Meyer Assessment of upper extremity and lower extremity, ankle dorsiflexor and plantarflexor muscle strength, Berg Balance Scale (BBS), Timed Up and Go (TUG) and Community Integration Measure.

Results: The mean LCT time (29.70s) in people with stroke was more than double of that in healthy controls (13.70s). The LCT showed excellent intra-rater, inter-rater and test–retest reliability [intraclass correlation coefficient (ICC) = 0.943–1.000]. The LCT times demonstrated a significant negative correlation with the BBS score (r_s = −0.771) and significant positive correlations with the TUG times (r_s = 0.933). There was no significant correlation between LCT times and FMA score (p > 0.05). An optimal cut-off LCT time of 15.48 s (sensitivity = 95.8%, specificity = 87.5%) was identified to differentiate between people with stroke and healthy controls (area under the curve = 0.957).

Conclusion: LCT is an excellent(USELESS!) clinical test for examining advanced functional ability in people with stroke and distinguishing people with stroke from healthy controls.

1 Introduction

Impaired performance in activities of daily living (ADL), especially lifting and carrying tasks, is common in community-dwelling stroke survivors. Such impairment highly constrains a person’s ability to perform daily tasks, such as household routines and shopping in supermarkets. By improving the functional performance of the upper and lower limbs, the associated negative impacts in daily life can be reduced, which is also the main goal of stroke rehabilitation (1). However, there is no comprehensive assessment tool available to measure the performance of ADL with integrated lifting and carrying components in people with stroke.

Lift and Carry Test (LCT) may be useful for evaluating comprehensive ability to perform ADL, which was first developed in 1995 to assess people with knee osteoarthritis (OA), comprises tasks related to walking ability, upper and lower limb function, strength, balance and cognitive function into a single measure (2). The subject is instructed to walk 2.7 m to a set of shelves and lift a 4.5-kg weight from the lower shelf (around knee height); then, they must turn and carry the weight while walking 4.35 m around a cone, return to the shelves, and place the weight on the upper shelf (around shoulder height) as quickly as possible (Figure 1) (2). Previous study showed that LCT completion time had significant negative correlation with tolerance time on the treadmill during modified Naughton treadmill protocol (r = −0.40), peak oxygen consumption (r = −0.38) and the knee strength (r = −0.58) in people with knee OA (3).

Figure 1

Figure 1. Assessment procedure of LCT.

In comparison to individuals with unilateral knee osteoarthritis (OA), people who have had a stroke may exhibit even poorer motor function due to hemiparesis affecting their affected upper and lower limbs. This can lead to difficulties in performing common components of daily activities, such as grasping, carrying weight, and walking. As satisfactory level of motor and cognitive functions is required to complete the sequential tasks of LCT (walk and lift weight with both hands from the lower shelf; then, turn and carry the weight while walking around a cone, return to the shelves, and place the weight on the upper shelf), the LCT could be a holistic outcome measure to assess the multiple components, which included the limb motor functional of the affected side, walking ability, balance function and the cognitive function (e.g., executive function), can simulate the ADL in real-world situation (e.g., carrying object when shopping). It can provide insights for designing rehabilitative interventions for community-dwelling people with stroke. However, its psychometric properties have not been investigated in a sample of community-dwelling stroke survivors.

In order to fill the research gap, this study aimed to investigate the psychometric properties of LCT in people with stroke. Many well-developed and highly reliable tools are available for evaluating specific performance attributes in stroke survivors; these include Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and Timed Up and Go Test (TUG), which, respectively, assess motor control of the affected side, balance and mobility (4–6). These reliable tools provide valuable reference for investigating the reliability and validity of LCT.

The medical profession could benefit from a reliable and valid measurement of sequential and advanced functional mobility during ADL in community-dwelling stroke survivors. Therefore, the aim of this study was to investigate: (i) the intra-rater, inter-rater and test–retest reliabilities of LCT time in people with stroke; (ii) the correlations of LCT time with stroke-specific impairment outcome measures, including FMA scores, ankle dorsiflexion and plantarflexion muscle strength, BBS score, TUG time and Community Integration Measure (CIM) score; and (iii) the minimal detectable change (MDC) in LCT time. The study also aimed to (iv) compare LCT time between people with stroke and healthy controls and (v) identify a cut-off LCT time to distinguish performance between these 2 groups.

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