{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:53:19Z","timestamp":1785772399125,"version":"3.56.0"},"reference-count":44,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: To compare timed stair test performance between individuals with knee osteoarthritis and healthy older adults, examine reliability under loaded and unloaded conditions, explore correlations with functional measures, and identify optimal cut-off times.\nDesign: Cross-sectional study.\nSubjects\/Patients: Sixty individuals with knee osteoarthritis and 30 healthy older adults.\nMethods: Participants completed unloaded and loaded timed stair test trials 7 days apart. Knee strength, balance, mobility, and self-reported outcomes were assessed.\nResults: Mean completion times for osteoarthritis participants were 23.91 s (unloaded) and 25.40 s (loaded). Intra-rater (ICC3,1\u2009=\u20090.951\u20130.990 across raters and assessment days) and inter-rater (ICC3,2\u2009=\u20090.999 [unloaded] to 1.000 [loaded]) reliabilities were excellent. Test\u2013retest reliability was good for loaded (0.835) and excellent for unloaded (0.918) conditions. Times correlated negatively with affected side knee strength, balance, and confidence, and positively with pain severity, mobility tests, and daily activity difficulty. Optimal cut-offs were 18.67 s (unloaded) and 19.94 s (loaded), demonstrating sensitivities of 70.0% (unloaded) and 68.3% (loaded), a specificity of 86.7%, and area under the curve values of 0.78 (unloaded) and 0.77 (loaded).\nConclusion: The timed stair test is a reliable, valid, and practical measure of functional performance in knee osteoarthritis, effectively distinguishing movement capability under loaded and unloaded conditions.<\/jats:p>","DOI":"10.2340\/jrm.v58.46246","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:56:40Z","timestamp":1785769000000},"page":"jrm46246","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric properties of loaded and unloaded timed stair tests in assessing people with knee osteoarthritis"],"prefix":"10.2340","volume":"58","author":[{"given":"Shamay S.M.","family":"Ng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9024-2225","authenticated-orcid":false,"given":"Siyue","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey K.L.","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoi-Ying","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi M.Y.","family":"Tse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia Y.Y.","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"164640","doi-asserted-by":"crossref","unstructured":"Michael JWP, Schl\u00fcter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int 2010; 107: 152\u2013162.","DOI":"10.3238\/arztebl.2010.0152"},{"key":"164641","doi-asserted-by":"crossref","unstructured":"Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29\u201330: 100587.","DOI":"10.1016\/j.eclinm.2020.100587"},{"key":"164642","doi-asserted-by":"crossref","unstructured":"Stensdotter AK, V\u00e5rbakken K, Roeleveld K. Factors associated with self-rated difficulty to descend stairs in persons with knee osteoarthritis. PM R 2023; 15: 9\u201319.","DOI":"10.1002\/pmrj.12698"},{"key":"164643","doi-asserted-by":"crossref","unstructured":"Moreira J, Teles IDS, Cunha B, F\u00e9lix J, Guedes DC, Alves LAT, et al. Principal component analysis of stair negotiation and floor transition kinematics in older adults with and without functional disability: cross-sectional study. JMIR Aging 2025; 8: e71530.","DOI":"10.2196\/71530"},{"key":"164644","doi-asserted-by":"crossref","unstructured":"Iijima H, Eguchi R, Shimoura K, Aoyama T, Takahashi M. Stair climbing ability in patients with early knee osteoarthritis: defining the clinical hallmarks of early disease. Gait Posture 2019; 72: 148\u2013153.","DOI":"10.1016\/j.gaitpost.2019.06.004"},{"key":"164645","doi-asserted-by":"crossref","unstructured":"Dobson F, Hinman RS, Roos EM, Abbott JH, Stratford P, Davis AM, et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013; 21: 1042\u20131052.","DOI":"10.1016\/j.joca.2013.05.002"},{"key":"164646","doi-asserted-by":"crossref","unstructured":"Marsh AP, Rejeski WJ, Lang W, Miller ME, Messier SP. Baseline balance and functional decline in older adults with knee pain: the observational arthritis study in seniors. J Am Geriatr Soc 2003; 51: 331\u2013339.","DOI":"10.1046\/j.1532-5415.2003.51106.x"},{"key":"164647","doi-asserted-by":"crossref","unstructured":"Lin YC, Davey RC, Cochrane T. Tests for physical function of the elderly with knee and hip osteoarthritis. Scand J Med Sci Sports 2001; 11: 280\u2013286.","DOI":"10.1034\/j.1600-0838.2001.110505.x"},{"key":"164648","doi-asserted-by":"crossref","unstructured":"Maffiuletti N, Tringali G, Patrizi A, Agosti F, Sartorio A. Reproducibility of clinician-friendly physical performance measures in individuals with obesity. J Rehabil Med 2017; 49: 677\u2013681.","DOI":"10.2340\/16501977-2263"},{"key":"164649","doi-asserted-by":"crossref","unstructured":"Ng SS, Liu TW, Chen P, Lau SY, Lee VC, Leung YC, et al. Loaded and unloaded timed stair tests as tools for assessing advanced functional mobility in people with stroke. Eur J Phys Rehabil Med 2023; 59: 14\u201324.","DOI":"10.23736\/S1973-9087.23.07620-7"},{"key":"164650","doi-asserted-by":"crossref","unstructured":"Sharma S, Wilson R, Pryymachenko Y, Pathak A, Chua J, Gwynne - Jones D, et al. Reliability, validity, responsiveness, and minimum important change of the stair climb test in adults with hip and knee osteoarthritis. Arthritis Care Res (Hoboken) 2023; 75: 1147\u20131157.","DOI":"10.1002\/acr.24821"},{"key":"164651","doi-asserted-by":"crossref","unstructured":"Almeida GPLP, Monteiro IOM, Dantas RGdOPT, Tavares MLAMc, Lima POdPP. Reliability, validity and responsiveness of the Step Up and Down (StUD) test for individuals with symptomatic knee osteoarthritis. Musculoskelet Sci Pract 2021; 56: 102454\u2013102454.","DOI":"10.1016\/j.msksp.2021.102454"},{"key":"164652","doi-asserted-by":"crossref","unstructured":"Iijima H, Shimoura K, Eguchi R, Aoyama T, Takahashi M. Concurrent validity and measurement error of stair climb test in people with pre-radiographic to mild knee osteoarthritis. Gait Posture 2019; 68: 335\u2013339.","DOI":"10.1016\/j.gaitpost.2018.12.014"},{"key":"164653","doi-asserted-by":"crossref","unstructured":"Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med 1998; 17: 101\u2013110.","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E"},{"key":"164654","doi-asserted-by":"crossref","unstructured":"Casa\u00f1a J, Calatayud J, Silvestre A, S\u00e1nchez-Frutos J, Andersen LL, Jakobsen MD, et al. Knee extensor muscle strength is more important than postural balance for stair-climbing ability in elderly patients with severe knee osteoarthritis. Int J Environ Res Public Health 2021; 18: 3637.","DOI":"10.3390\/ijerph18073637"},{"key":"164655","doi-asserted-by":"crossref","unstructured":"Perron M, Malouin F, Moffet H. Assessing advanced locomotor recovery after total hip arthroplasty with the timed stair test. Clin Rehabil 2003; 17: 780\u2013786.","DOI":"10.1191\/0269215503cr696oa"},{"key":"164656","doi-asserted-by":"crossref","unstructured":"Sahu PK, Goodstadt N, Ramakrishnan A, Silfies SP. Test\u2013retest reliability and concurrent validity of knee extensor strength measured by a novel device incorporated into a weight stack machine vs. handheld and isokinetic dynamometry. PloS One 2024; 19: e0301872.","DOI":"10.1371\/journal.pone.0301872"},{"key":"164657","doi-asserted-by":"crossref","unstructured":"Dawson N, Dzurino D, Karleskint M, Tucker J. Examining the reliability, correlation, and validity of commonly used assessment tools to measure bal-ance. Health Sci Rep 2018; 1: e98.","DOI":"10.1002\/hsr2.98"},{"key":"164658","doi-asserted-by":"crossref","unstructured":"Chan ACM, Pang MYC. Assessing balance function in patients with total knee arthroplasty. Phys Ther 2015; 95: 1397\u20131407. Epub 2015 Apr 16.","DOI":"10.2522\/ptj.20140486"},{"key":"164659","doi-asserted-by":"crossref","unstructured":"Alghadir A, Anwer S, Brism\u00e9e J-M. The reliability and minimal detectable change of Timed Up and Go test in individuals with grade 1\u20133 knee osteoarthri-tis. BMC Musculoskelet Disord 2015; 16: 174\u2013174.","DOI":"10.1186\/s12891-015-0637-8"},{"key":"164660","unstructured":"Intaruk R, Saengsuwan J, Amatachaya S, Gaogasigam C, Thaweewannakij T. The ability of timed-up and go test and five times sit-to-stand test to screen risk of fall in well-functioning elderly. Health Sci Tech Rev 2021; 14: 54\u201363. https:\/\/li01.tci-thaijo.org\/index.php\/journalup\/article\/view\/247051"},{"key":"164661","doi-asserted-by":"crossref","unstructured":"Paker N, Bugdayci D, Demircioglu UB, Sabirli F, Ozel S. Reliability and validity of the Turkish version of Activities-specific Balance Confidence scale in symptomatic knee osteoarthritis. J Back Musculoskelet Rehabil 2017; 30: 461\u2013466.","DOI":"10.3233\/BMR-150335"},{"key":"164662","doi-asserted-by":"crossref","unstructured":"Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS - PS), Knee Outcome Survey Activities of Daily Living Scale (KOS - ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthri-tis Care Res (Hoboken) 2011; 63: S208\u2013S228.","DOI":"10.1002\/acr.20632"},{"key":"164663","doi-asserted-by":"crossref","unstructured":"Liu T-W, Ng SSM, Ng GYF, Kontodimopoulos N. Translation and initial validation of the Chinese (Cantonese) version of community integration measure for use in patients with chronic stroke. Biomed Res Int 2014; 2014: 1\u20137.","DOI":"10.1155\/2014\/623836"},{"key":"164664","doi-asserted-by":"crossref","unstructured":"Taherzadeh Chenani K, Madadizadeh F. Guideline for selecting types of reliability and suitable intra-class correlation coefficients in clinical research. J Biostat Epidemiol 2021; 7.","DOI":"10.18502\/jbe.v7i3.7301"},{"key":"164665","unstructured":"Portney LG. Foundations of clinical research: applications to evidence-based practice. 4th ed. New York McGraw-Hill Education; 2020."},{"key":"164666","doi-asserted-by":"crossref","unstructured":"Murphy JM, Berwick DM, Weinstein MC, Borus JF, Budman SH, Klerman GL. Performance of screening and diagnostic tests: application of receiver operating characteristic analysis. Arch Gen Psychiatry 1987; 44: 550\u2013555.","DOI":"10.1001\/archpsyc.1987.01800180068011"},{"key":"164667","doi-asserted-by":"crossref","unstructured":"Chow DH, Kwok ML, Au-Yang AC, Holmes AD, Cheng JC, Yao FY, et al. The effect of backpack load on the gait of normal adolescent girls. Ergonomics 2005; 48: 642\u2013656.","DOI":"10.1080\/00140130500070921"},{"key":"164668","doi-asserted-by":"crossref","unstructured":"Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 2000; 133: 635\u2013646.","DOI":"10.7326\/0003-4819-133-8-200010170-00016"},{"key":"164669","doi-asserted-by":"crossref","unstructured":"Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum 2010; 40: 250\u2013266.","DOI":"10.1016\/j.semarthrit.2009.10.001"},{"key":"164670","doi-asserted-by":"crossref","unstructured":"Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteo-arthritis. JAMA 2001; 286: 188\u2013195.","DOI":"10.1001\/jama.286.2.188"},{"key":"164671","doi-asserted-by":"crossref","unstructured":"Kubinski AJ, Higginson JS. Strategies used during a challenging weighted walking task in healthy adults and individuals with knee osteoarthritis. Gait Posture 2012; 35: 6\u201310.","DOI":"10.1016\/j.gaitpost.2011.07.012"},{"key":"164672","doi-asserted-by":"crossref","unstructured":"Tseng H-Y, Liu B-S. Effects of load carrying methods and stair slopes on physiological response and postures during stairs ascending and descending. Industrial Health 2011; 49: 30\u201336.","DOI":"10.2486\/indhealth.MS1100"},{"key":"164673","doi-asserted-by":"crossref","unstructured":"Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 2005; 6: 3.","DOI":"10.1186\/1471-2474-6-3"},{"key":"164674","doi-asserted-by":"crossref","unstructured":"Nightingale EJ, Pourkazemi F, Hiller CE. Systematic review of timed stair tests. J Rehabil Res Dev 2014; 51: 335\u2013350.","DOI":"10.1682\/JRRD.2013.06.0148"},{"key":"164675","doi-asserted-by":"crossref","unstructured":"Lee DK, Kim HS, Ko KR, Yoon JP, Yoo JI. Why muscle strengthening exercises should target the quadriceps and gluteus maximus in patients with knee osteoarthritis?: effects of knee pain on muscle volume and fatty degeneration based on AI-assisted cross-sectional analysis. J Orthop Translat 2025; 53: 221\u2013230.","DOI":"10.1016\/j.jot.2025.06.013"},{"key":"164676","doi-asserted-by":"crossref","unstructured":"Alnahdi AH, Zeni JA, Snyder-Mackler L. Muscle impairments in patients with knee osteoarthritis. Sports Health 2012; 4: 284\u2013292.","DOI":"10.1177\/1941738112445726"},{"key":"164677","doi-asserted-by":"crossref","unstructured":"Kuntze G, von Tscharner V, Hutchison C, Ronsky JL. Alterations in lower limb multimuscle activation patterns during stair climbing in female total knee arthroplasty patients. J Neurophysiol 2015; 114: 2718\u20132725.","DOI":"10.1152\/jn.00370.2015"},{"key":"164678","doi-asserted-by":"crossref","unstructured":"Khuna L, Soison T, Plukwongchuen T, Tangadulrat N. Reliability and concurrent validity of 30-s and 5-time sit-to-stand tests in older adults with knee osteoarthritis. Clin Rheumatol 2024; 43: 2035\u20132045.","DOI":"10.1007\/s10067-024-06969-6"},{"key":"164679","doi-asserted-by":"crossref","unstructured":"Lopponen A, Karavirta L, Koivunen K, Portegijs E, Rantanen T, Finni T, et al. Association between free-living sit-to-stand transition characteristics, and lower-extremity performance, fear of falling, and stair negotiation difficulties among community-dwelling 75 to 85-year-old adults. J Gerontol A Biol Sci Med Sci 2022; 77: 1644\u20131653.","DOI":"10.1093\/gerona\/glac071"},{"key":"164680","doi-asserted-by":"crossref","unstructured":"Song J, Chang AH, Chang RW, Lee J, Pinto D, Hawker G, et al. Relationship of knee pain to time in moderate and light physical activities: data from Osteoarthritis Initiative. Semin Arthritis Rheum 2018; 47: 683\u2013688.","DOI":"10.1016\/j.semarthrit.2017.10.005"},{"key":"164681","doi-asserted-by":"crossref","unstructured":"Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR. Stair negotiation in older people: a review. J Am Geriatr Soc 2000; 48: 567\u2013580.","DOI":"10.1111\/j.1532-5415.2000.tb05006.x"},{"key":"164682","doi-asserted-by":"crossref","unstructured":"McColl MA, Davies D, Carlson P, Johnston J, Minnes P. The community integration measure: development and preliminary validation. Arch Phys Med Rehabil 2001; 82: 429\u2013434.","DOI":"10.1053\/apmr.2001.22195"},{"key":"164683","doi-asserted-by":"crossref","unstructured":"\u00c7orbac\u0131o\u011flu \u015eK, Aksel G. Receiver operating characteristic curve analysis in diagnostic accuracy studies: a guide to interpreting the area under the curve value. Turk J Emerg Med 2023; 23: 195\u2013198.","DOI":"10.4103\/tjem.tjem_182_23"}],"container-title":["Journal of Rehabilitation Medicine"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/46246\/55004","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/46246\/55004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:56:46Z","timestamp":1785769006000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/view\/46246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":44,"URL":"https:\/\/doi.org\/10.2340\/jrm.v58.46246","relation":{},"ISSN":["1651-2081"],"issn-type":[{"value":"1651-2081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}