Responsiveness and minimal clinically important difference of the five times sit-to-stand test in ambulatory individuals with spinal cord injury: A six-month prospective cohort study

Objectives To explore the responsiveness and minimal clinically important differences of the five times sit-to-stand test in ambulatory individuals with spinal cord injury. Methods This six-month prospective cohort study was conducted in 109 individuals with spinal cord injury who could walk with or without a walking device for at least 10 meters. Participants were assessed for the five times sit-to-stand test in the four arm-placement conditions and standard measures to determine responsiveness of the test, at baseline, and one, three, and six months. At six months, participants were also interviewed for the global rating of change to estimate the minimal clinically important differences of the five times sit-to-stand test. Results The five times sit-to-stand test showed large internal responsiveness (standardized response means>0.83), with moderate external responsiveness as compared to the 10-meter walk test (rho = -0.28 to -0.48, p < 0.005). The changes in the outcomes >2.27 and >2 s could be used to indicate a level of minimal clinically important change for participants who executed the test with and without hands, respectively. Conclusion The five times sit-to-stand test is a responsiveness measure for ambulatory individuals with spinal cord injury. The levels of minimal clinically important differences found in this study (>2.27 and >2 s) can be applied as a useful benchmark for the decision of clinically relevant changes over time for these individuals.