Psychometric properties of the sit-to-stand test for patients with pulmonary hypertension: A systematic review

Background

Pulmonary hypertension (PH) is defined as an increase in mean pulmonary arterial pressure, often accompanied by indicators such as dyspnea on exertion, exercise intolerance, and systemic muscle dysfunction. Various protocols exist that can indirectly assess these indicators through the sit-to-stand test (STST).

Objective

Assess the psychometric properties of different STST protocols in patients with PH.

Methods

This study is a systematic review. We searched the PubMed, EMBASE, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases. The risk of bias was assessed using the COSMIN tool and the certainty of evidence using the modified Recommendations, Assessment, Development, and Evaluation (GRADE) classification. Two investigators evaluated independently, and a third evaluator was consulted as needed.

Results

Out of a total of 7933 articles identified, only 5 articles met the criteria for inclusion in the analysis. Four psychometric properties were assessed across the five protocols used. The 1-STST protocol provided high-quality evidence for both convergent validity and responsiveness. The 30-STST protocol showed moderate-quality evidence for convergent validity and responsiveness, while the 5-STST also demonstrated moderate-quality evidence for responsiveness. The between-groups validity and reliability of the 30-STST protocol were considered to be low and very low, respectively.

Conclusion

Despite the limited number of studies, we can infer that the most commonly used protocol is the 1-STST, which has a high degree of convergent validity and responsiveness when compared to other assessment tools.