Measurement properties of the upright motor control test for adults with stroke: a systematic review

Abstract

BackgroundThe Upright Motor Control Test (UMCT) has been used in clinical practice and research to assess functional strength of the hemiparetic lower limb in adults with stroke. It is unclear if evidence is sufficient to warrant its use. The purpose of this systematic review was to synthesize available evidence on the measurement properties of the UMCT for stroke rehabilitation.MethodsElectronic databases that indexed biomedical literature were systematically searched from inception until October 2015 (week 4): Embase, PubMed, Web of Science, CINAHL, PEDro, Cochrane Library, Scopus, ScienceDirect, SPORTDiscus, LILACS, DOAJ, and Google Scholar. All studies that had used the UMCT in the time period covered underwent hand searching for any additional study. Observational studies involving adults with stroke that explored any measurement property of the UMCT were included. The COnsensus-based Standards for the selection of health Measurement INstruments was used to assess the methodological quality of included studies. The CanChild Outcome Measures Rating Form was used for extracting data on measurement properties and clinical utility.ResultsThe search yielded three methodologic studies that addressed criterion-related validity and contruct validity. Two studies of fair methodological quality demonstrated moderate-level evidence that Knee Extension and Knee Flexion subtest scores were predictive of community-level and household-level ambulation. One study of fair methodological quality provided limited-level evidence for the correlation of Knee Extension subtest scores with a laboratory measure of ground reaction forces. No published studies formally assessed reliability, responsiveness, or clinical utility. Limited information on responsiveness and clinical utility dimensions could be inferred from the included studies.ConclusionsThe UMCT is a practical assessment tool for voluntary control or functional strength of the hemiparetic lower limb in standing in adults with stroke. Although different levels of evidence suggest that the Knee Extension and Knee Flexion subtests may possess criterion and construct validity, the lack of published literature examining content validity, reliability, and responsiveness raises questions regarding the use of the UMCT in routine clinical practice. These key findings highlight the need to further investigate the UMCT’s measurement properties toward enhancing its standardization.

Clinimetrics of the Upright Motor Control Test in chronic stroke

“…This study aimed to investigate the reliability of the UMCT-KE and UMCT-KF administration on adults with chronic stroke who had lower extremity muscle spasticity, and explore the relationship of the UMCT-KE with a clinical measure of muscle function. On the basis of the study findings, both the UMCT-KE and UMCT-KF have at least substantial relative reliability, and the UMCT-KE and FTSST assess related constructs or body functions.The absence of any published study on reliability(Gorgon & Lazaro, 2016) limited direct interpretation of the findings in relation to earlier literature. Interrater agreement and test-retest agreement for all raters were at least substantial, supporting the stability of UMCT-KE and UMCT-KF ratings.…”

“…It has also been used as an outcome measure in stroke clinical trials as a measure of functional muscle strength (Almarez, Macatangay, Santos, & Flores, 2010;Ambrosini, Ferrante, Pedrocchi, Ferrigno, & Molteni, 2011;Ferrante, Pedrocchi, Ferrigno, & Molteni, 2008). A recent systematic review has reported the practical advantages of using the UMCT, such as short administration time, simple instrumentation, and uncomplicated testing procedures (Gorgon & Lazaro, 2016). Therefore, the UMCT can be used in a range of practice settings especially those with limited resources (Gorgon & Lazaro, 2016).…”

“…A recent systematic review has reported the practical advantages of using the UMCT, such as short administration time, simple instrumentation, and uncomplicated testing procedures (Gorgon & Lazaro, 2016). Therefore, the UMCT can be used in a range of practice settings especially those with limited resources (Gorgon & Lazaro, 2016).…”

“…However, no reliability studies have been published to support the reproducibility of test results (Gorgon & Lazaro, 2016 ship with other concepts within the same ICF domain needs to be investigated. Scores on the UMCT have been found to correlate with peak vertical ground reaction forces, a laboratory measure of supportive functions of the leg (Mercer et al, 2009).…”

Utility of ultrasound as a promising diagnostic tool for stroke-related sarcopenia: A retrospective pilot study

“…[ 12 , 13 ] The earlier studies reported that a minimum of grade 3 of knee extensor strength is required for community ambulation. [ 22 , 23 ] Accordingly, we divided the patients into 2 groups based on the grade 3 of the paretic knee extensor power, and compared several parameters between the 2 groups. However, the simple comparison of several parameters of muscle mass between 2 groups had some limitations because it was not possible to correct for all of differences in male-female ratio, age and individual muscle mass.…”