Reliability of the TUDS test for children with cerebral palsy

Abstract

BackgroundThe timed up and down stairs (TUDS) test is widely used to assess the time required by a patient to climb up and down stairs as a measure of functional mobility.AimThis cross-sectional study was conducted to examine test-retest, intra-rater, and inter-rater reliability of TUDS test in children with cerebral palsy (CP).SubjectsForty children (22 boys and 18 girls) with unilateral and bilateral spastic CP were selected from the Cairo University Hospitals to participate in this study. The age range was 3–9 years. Subjects classified according to Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) in categories 1 or 2 only were included. All subjects with muscle tone above normal (spasticity) were included.MethodsThe TUDS test was performed at two testing sessions on the same day to determine test-retest reliability; the main investigator scored all children at real time using a stopwatch and then rescored them later from video recording to determine intra-rater reliability. Another research team member scored all children from video recording to determine inter-rater reliability. Scoring was carried out at real time and from video recordings of the trials. Reliability was estimated using intra-class correlation coefficients (ICC).ResultsThe TUDS test showed excellent reliability for all measured types of reliability. ICC score for test-retest reliability was 0.978, ICC score for intra-rater reliability was 0.999, while ICC score for inter-rater reliability was 0.998 and 0.999.ConclusionThe TUDS test is a reliable outcome measure for children with spastic CP. It can be measured at real time or later from video recording of the performance trials. The TUDS test is an important tool in the re-evaluation process of children with CP.