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RehabMeasures Instrument

Supine to Stand Test

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Purpose

The STST assesses a person's ability to transition from a supine postition to a standing position.

Acronym STST

Area of Assessment

Activities of Daily Living
Functional Mobility

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Parkinson's Disease + Neurologic Rehabilitation

Key Descriptions

  • Measures the amount of time it takes to rise to standing from the supine position from a mat, not from the floor.
  • A standardized protocol for this exam has not been published.

Number of Items

1

Equipment Required

  • Timer
  • Raised mat

Time to Administer

Less than 5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Terry Ellis, PT, PhD, NCS; Laura Savella, SPT & the PD EDGE Task Force of the Neurology Section of the APTA

ICF Domain

Activity

Measurement Domain

Activities of Daily Living
Motor

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations Based on Parkinson Disease Hoehn and Yahr stage: 

 

I

II

III

IV

V

PD EDGE

NR

NR

NR

NR

NR

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

PD EDGE

No

No

No

Not reported

Vestibular EDGE

No

No

No

 

Considerations

At this point there is limited testing of the psychometric properties of the supine to stand test. Reliability testing is limited to one study in a disabled geriatric population. There are no reliability and validity studies in persons with Parkinson’s disease. However, normative data in PD has been published and responsiveness examined for H&Y Stages 1-3. This test may have ceiling effects in persons in the early stages of PD (H&Y 1-2.5), appears responsive in the mid-stages (H&Y 3) and has not been tested in the later stages (H&Y 4 and 5).

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Parkinson's Disease

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Normative Data

Parkinson’s Disease:

(Schenkman et al., 2011; n = 186; no mean age/range given)

  • Mean time (seconds) to complete supine to stand by H&Y Stage
    • H&Y1 - 1.5 = 3.35 (0.92); Range = 2.44 - 4.53
    • H&Y2 = 3.36 (2.02); Range = 1.85 - 17.62
    • H&Y2.5 = 4.68 (2.01); Rang e=1.81 - 11.53
    • H&Y3 = 6.42 (4.16); Range = 1.75 - 19.71 

 

Parkinson’s Disease: 

(Schenkman et al., 1998; Exercise group: n = 23 subjects with PD; mean age = 70.6 (6.2); H&Y Stage 2: H&Y n = 7; H&Y Stage 2.5: n = 6; H&Y Stage 3: n = 10; Control group: = 23 subjects with PD; mean age = 71.2(7.3); H&Y Stage 2: H&Y n= 3; H&Y Stage 2.5: = 6; H&Y Stage 3: n = 14)

  • Mean Supine to Stand time at baseline (sec) = 6.5 (3.7) 
  • Mean Supine to Stand time at baseline (sec)= 9.4 (7.6) 

(Schenkman et al, 2000; n = 56 community dwelling adults with PD; mean age = 70.7(7.4); H&Y Stages 2 and 3; n = 195 community dwelling adults without PD; mean age = 71.4(5.0))

  • Mean Supine to Stand time (sec) = 7.2 (3.7)
  • Mean Supine to Stand time (sec) = 5.2 (2.0)

Floor/Ceiling Effects

Parkinson's Disease:

(Schenkman et al., 2011)

  • Schenkman report the Supine to Stand Test only revealed limitation in H&Y Stage 3 (not responsive in H&Y Stages 1 - 2.5; not tested in H&Y 4 and 5) or with UPDRS motor scores > 45

Responsiveness

Parkinson’s Disease:

(Shenkman et al., 1998)

  • Exercise group: Mean Supine to Stand time change score(sec): -0.6 (2.09) 
  • Control group: Mean Supine to Stand time change score (sec): -1.01 (2.74) 
  • There was no significant difference between the two groups suggesting that the supine to stand measure may not be responsive to the spinal flexibility intervention

(Shenkman et al., 2011)

  • Shenkman reports the Supine to stand test only revealed limitations in H&Y Stage 3 (not responsive in H&Y Stages 1-2.5; not tested in H&Y 4 and 5) or with UPDRS motor scores > 45
    • Participants at H&Y Stage 3 were on average twice as slow as participants in earlier H&Y stages
    • Large variability of H&Y stage 3 scores suggests that not all persons in H&Y stage 3 will experience limitation on the supine to stand test

Older Adults and Geriatric Care

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Normative Data

Congregate Housing Facility: 

(Alexander et al., 2000; n = 116; mean age = 82.1 (6.6); residents requiring assistance with at least one (transfer, walking, bathing, toileting)

  • Mean time (seconds) to complete supine to stand: 15.2(18.1) seconds
  • 6 of 116 unable to complete (5%)

Test/Retest Reliability

Geriatric:

(Alexander et al., 2000)

  • Excellent test retest reliability for time to complete supine to stand (ICC = 0.9)

Bibliography

Alexander, N. B., Galecki, A. T., et al. (2000). "Chair and bed rise performance in ADL-impaired congregate housing residents." J Am Geriatr Soc 48(5): 526-533. Find it on PubMed

Schenkman, M., Cutson, T. M., et al. (1998). "Exercise to improve spinal flexibility and function for people with Parkinson's disease: a randomized, controlled trial." J Am Geriatr Soc 46(10): 1207-1216. Find it on PubMed

Schenkman, M., Ellis, T., et al. (2011). "Profile of functional limitations and task performance among people with early- and middle-stage Parkinson disease." Phys Ther 91(9): 1339-1354. Find it on PubMed

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