Reliability and Validity of the Supine-to-Stand Test in Patients with Multiple Sclerosis

BackgroundThe Supine-to-Stand Test (SST) evaluates muscle strength, flexibility, and dynamic balance. It may serve as a global measure of functional movement ability in patients with Multiple Sclerosis (pwMS).ObjectiveTo investigate the validity and reliability of the SST in pwMS.MethodsThirty-four pwMS (mean EDSS score: 4.80 ± 1.13) participated in this cross-sectional observational study. Ankle plantar and dorsiflexor muscle strength was measured using a digital hand dynamometer. Manual dexterity, balance, endurance, and functional mobility were assessed using the 9-Hole Peg Test (9HPT), the Berg Balance Scale (BBS), the Six-Minute Walk Test (6MWT), and the Timed Up and Go test (TUG), respectively. The Activity-specific Balance Confidence (ABC) scale was used to identify fear of falling. Quality of life was evaluated using the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Test-retest reliability was determined using the intraclass correlation coefficient (ICC).ResultsThe SST demonstrated excellent test-retest reliability (ICC = 0.984, 95% CI 0.801-0.995). SST performance was moderately correlated with BBS (r = -0.547, p = 0.001), TUG (r = 0.619, p < 0.001), and 6MWT (r = -0.642, p < 0.001). A moderate correlation was found between plantar flexor strength on the dominant side and SST (r = 0.349, p = 0.043), whereas no significant correlation was observed for the non-dominant side or dorsiflexor strength bilaterally (p > 0.05). SST was not correlated with 9HPT bilaterally or MSQOL-54 (p > 0.05).ConclusionsThe SST is a reliable and valid tool for assessing functional movement ability in pwMS. Its significant correlations with established balance and mobility measures suggest that it may contribute to clinical decision-making, particularly in evaluating fall risk and predicting walking independence in patients with moderate disability (EDSS scores 4-6).