Test–Retest Reliability of Single-Arm Closed Kinetic Chain Upper Extremity Stability Test

<b>Background:</b> The original Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) is a simple assessment tool but does not account for individual differences in hand starting position and fails to provide information on limb asymmetries. The purpose of the study is to evaluate the test-retest reliability of a new single-arm CKCUEST as well as the reliability of the limb symmetry index (LSI). This version normalizes the test based on the participant's arm length and allows for the assessment of limb symmetry since it is performed one arm at a time. <b>Methods:</b> Twelve healthy young adults provided both verbal and written consent to participate. Participants were excluded if they had sustained an injury in the past three months requiring medical attention and/or resulting in decreased activity for more than three days. Testing was conducted in the push-up position with participants' thumbs placed parallel and at a distance equal to the length of their dominant arm (measured from the acromion to the tip of the middle finger), and feet positioned shoulder-width apart. Participants were instructed to keep the testing hand stable on the floor while the opposite hand reached across the body to touch the stationary hand and then return to the starting position marked with athletic tape. The goal was to complete as many touches as possible in 15 s, with each touch counted only if the participant touched the stationary hand, returned to the starting position, and maintained the shoulder-width stance. The average number of touches from the three trials was used for analysis. Intraclass Correlation Coefficients (ICC<sub>(3,1)</sub>) were computed to determine test-retest reliability. <b>Results:</b> Test-retest reliability of the single-arm CKCUEST individual tests was good to excellent. The ICC<sub>(3,1)</sub> was 0.88 (95% CI: 0.74-0.95) for all tests, 0.89 (95% CI: 0.66-0.96) for the dominant arm, and 0.93 (95% CI: 0.78-0.98) for the non-dominant arm. In contrast, the reliability of the Limb Symmetry Index (LSI) was questionable, showing substantial variability with an ICC<sub>(3,1)</sub> of 0.53 (95% CI: -0.03-0.83) between Day 1 and Day 2, despite similar mean values (Day 1: 93.6 ± 8.46; Day 2: 94.8 ± 5.77). The Kappa coefficient suggested a substantial level of agreement for the direction of the asymmetry (preferred limb) (Kappa coefficient = 0.62). <b>Conclusions</b>: The new single-arm CKCUEST, which personalizes the hand starting position and measures limb symmetry, demonstrates high reliability among healthy young adults.

Authors

Institutions

Publication Details

Journal
Journal of Functional Morphology and Kinesiology
Published
2026-01-21
DOI
https://doi.org/10.3390/jfmk11010046
Primary Topic
Stroke Rehabilitation and Recovery
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Test–Retest Reliability of Single-Arm Closed Kinetic Chain Upper Extremity Stability Test

Andy Waldhelm, Matthew Gonzalez, Mareli Klopper, Edward F. Austin et al.
Journal of Functional Morphology and Kinesiology
Stroke Rehabilitation and Recovery
article

Test–Retest Reliability of Single-Arm Closed Kinetic Chain Upper Extremity Stability Test

Andy Waldhelm, Matthew Gonzalez, Mareli Klopper, Edward F. Austin, Stephanie Flynn, Ron Masri
article en

Abstract

<b>Background:</b> The original Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) is a simple assessment tool but does not account for individual differences in hand starting position and fails to provide information on limb asymmetries. The purpose of the study is to evaluate the test-retest reliability of a new single-arm CKCUEST as well as the reliability of the limb symmetry index (LSI). This version normalizes the test based on the participant's arm length and allows for the assessment of limb symmetry since it is performed one arm at a time. <b>Methods:</b> Twelve healthy young adults provided both verbal and written consent to participate. Participants were excluded if they had sustained an injury in the past three months requiring medical attention and/or resulting in decreased activity for more than three days. Testing was conducted in the push-up position with participants' thumbs placed parallel and at a distance equal to the length of their dominant arm (measured from the acromion to the tip of the middle finger), and feet positioned shoulder-width apart. Participants were instructed to keep the testing hand stable on the floor while the opposite hand reached across the body to touch the stationary hand and then return to the starting position marked with athletic tape. The goal was to complete as many touches as possible in 15 s, with each touch counted only if the participant touched the stationary hand, returned to the starting position, and maintained the shoulder-width stance. The average number of touches from the three trials was used for analysis. Intraclass Correlation Coefficients (ICC<sub>(3,1)</sub>) were computed to determine test-retest reliability. <b>Results:</b> Test-retest reliability of the single-arm CKCUEST individual tests was good to excellent. The ICC<sub>(3,1)</sub> was 0.88 (95% CI: 0.74-0.95) for all tests, 0.89 (95% CI: 0.66-0.96) for the dominant arm, and 0.93 (95% CI: 0.78-0.98) for the non-dominant arm. In contrast, the reliability of the Limb Symmetry Index (LSI) was questionable, showing substantial variability with an ICC<sub>(3,1)</sub> of 0.53 (95% CI: -0.03-0.83) between Day 1 and Day 2, despite similar mean values (Day 1: 93.6 ± 8.46; Day 2: 94.8 ± 5.77). The Kappa coefficient suggested a substantial level of agreement for the direction of the asymmetry (preferred limb) (Kappa coefficient = 0.62). <b>Conclusions</b>: The new single-arm CKCUEST, which personalizes the hand starting position and measures limb symmetry, demonstrates high reliability among healthy young adults.

Journal of Functional Morphology and KinesiologyVol. 11(1)
Graceland University (US), Blackberry (United States) (US), Ochsner Health System (US), Spectrum Health (US), South College (US), The University of Texas at San Antonio (US), University of South Alabama (US)
University of South Alabama
Openalex Percentile: Top 83%
Stroke Rehabilitation and Recovery
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.