Validity and reliability of the unsupported upper‐limb exercise test in individuals with rheumatoid arthritis

Abstract

Background Rheumatoid arthritis (RA) is a chronic disease which affects the performance of the upper extremities. There is no method to evaluate the specific upper extremity endurance of individuals with this disease. The unsupported upper‐limb exercise test (UULEX) is a performance test that evaluates upper extremity performance (functionality and endurance). Aim The aim of this study was to examine the reliability and validity of UULEX and the minimal detectable change (MDC) in individuals with RA. Methods and Materials The study included 71 patients (15 male, 56 female) with a mean age of 52.15 ± 10.11 years. The intraclass correlation coefficient (ICC) was used to assess the reliability of UULEX. MDC estimates were calculated using baseline data. Correlations of UULEX with the Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), 30‐second push‐up test and 6 pegboard ring test (6PBRT) were assessed for concurrent validity. Results The level, weight and duration scores of the UULEX test were found to be excellent for intra‐rater reliability (ICC = 0.922, 0.960, 0.958). Intra‐rater MDC values were determined to be 0.35, 2.04, and 0.80 seconds, respectively. Moderate‐excellent correlations were found between UULEX and DASH, HAQ, 30‐second push‐up test and 6PBRT (P < .05). Conclusion The results of this study showed that UULEX test is a valid and reliable method for the assessment of upper extremity performance in individuals with RA.

Convergent Validity and Test-Retest Reliability of the Unsupported Upper Limb Exercise Test in Patients with Chronic Neck Pain

“…Higher test scores were correlated with better shoulder girdle muscle performance and lower disability levels in patients with CNP. The UULEX was developed on COPD patients (Takahashi et al, 2003), and its validity and reliability studies were conducted on patients with RA (Cetin et al, 2019) and with healthy individuals (Lima et al, 2018). Prior studies have shown that the UULEX had high test-retest reliability in different groups (Cetin et al, 2019; Lima et al, 2018; Oliveira et al, 2018; Takahashi et al, 2003).…”

“…Participants in this study were patients, aged 18–65, years with neck pain lasting at least three months due to such causes such as cervical strain or sprain, cervical disc lesions, cervical spondylosis, facet joint dysfunction, and myofascial pain syndrome (Misailidou et al, 2010). Participant exclusion criteria were: (a) the presence of additional diseases that could affect UE and hand functions, (b) having undergone UE or cervical region surgery, (c) having experienced cervical radiculopathy, rheumatic disease, or presence of neurological symptoms, (d) activity-related neck pain severity below 3, according to the Visual Analog Scale, (e) having acute or chronic respiratory disease and/or cardiac disease, (f) showing a problem in perceiving verbal commands, and (g) pregnancy (Takahashi et al, 2003; Cetin et al, 2019; Marques et al, 2020; Lima et al, 2018).…”

Upper Extremity Functioning in Individuals with Type 2 Diabetes Mellitus: A Comparative Study

“…The first report of UULEX in literature was to assess upper extremity functional level in individuals with chronic obstructive pulmonary disease (17,18). Although UULEX has been shown to be a valid and reliable test for healthy and rheumatoid individuals (26)(27)(28), there are no studies in literature illustrating that this test is valid and reliable for diabetic individuals. This can be considered a limitation of this study.…”

Upper limbs: how physically limited is your patient?

“…(10) We find it interesting that the UULEX test has recently been validated for patients with rheumatoid arthritis. (11) The mean UULEX completion time was 8.26 min (95% CI: 2.30-11.00), which is below the normative value of 12.50 min (95% CI: 9.48-15.00) for women in the 51-to 60-year age group, (7) corresponding to 66% of the predicted value. Although these are only illustrative examples, because the samples of patients were in countries not included in the development of the normative values, this analysis is a way of showing their applicability not only in research but also in clinical practice.…”