Inter-rater Reliability of a Clinical Test of Standing Function

Abstract

The Functional Standing Test (FST) has been proposed and described as an evaluative tool to assess a person's ability to perform one-handed reaching tasks while standing. The test items, several of which are identical to those in the Jebson Test of Hand Function, require the manipulation of objects on a counter top and on simulated kitchen shelves while the person is standing. The purpose of this study was to assess the inter-rater reliability of FST when it is administered to adolescents with spinal cord injuries who stand with braces, and to able-bodied young adults. Two testers administered the FST separately to three individuals with spinal cord injuries (SCI) below T-2 who stood with knee-ankle-foot orthoses (KAFOs) and to 10 able-bodied people who stood unassisted. The order in which the testers operated was randomized and the Intraclass Correlation Coefficient (ICC (2,1)) was used to analyze inter-rater reliability. Eighty percent of the subtests were found to be moderately to very reliable when applied to either group on the same day. Half of the test items were categorized as having the same level of inter-rater reliability between the two sample populations. A modified version of the test eliminating unreliable components could serve as a valuable and inexpensive means of evaluating the effectiveness of various therapies and technologies to provide or assist standing function. Validity and specificity of the test remain the focus of future research.