The push-off test: Development of a simple, reliable test of upper extremity weight-bearing capability

作者：Vincent Joshua I^*; MacDermid Joy C; Michlovitz Susan L; Rafuse Richard; Wells Rowsell Christina; Wong Owen; Bi**ee Leslie

来源：Journal of Hand Therapy, 2014, 27(3): 185-191.

DOI：10.1016/j.jht.2014.03.002

• Upper limb
• Weight-bearing
• Push-off test
• Reliability
• Construct validity
• Impairment measures
• Self-report measures

Study design: Longitudinal clinical measurement study. Introduction: The push-off test (POT) is a novel and simple measure of upper extremity weight-bearing that can be measured with a grip dynamometer. There are no published studies on the validity and reliability of the POT. The relationship between upper extremity self-report activity/participation and impairment measures remain an unexplored realm.
Purpose: The primary purpose of this study is to estimate the intra and inter-rater reliability and construct validity of the POT. The secondary purpose is to estimate the relationship between upper extremity self-report activity/participation questionnaires and impairment measures.
Methods: A convenience sample of 22 patients with wrist or elbow injuries were tested for POT, wrist/elbow range of motion (ROM), isometric wrist extension strength (WES) and grip strength; and completed two self-report activity/participation questionnaires: Disability of the Arm. Shoulder and the Hand (DASH) and Work Limitations Questionnaire (WLQ-26). POT's inter and intra-rater reliability and construct validity was tested. Pearson's correlations were run between the impairment measures and self-report questionnaires to look into the relationship amongst them.
Results: The POT demonstrated high inter-rater reliability (ICC affected = 0.97; 95% Cl. 0.93-0.99; ICC unaffected = 0.85; 95% Cl. 0.68-0.94) and intra-rater reliability (ICC affected = 0.96; 95% C.I. 0.92-0.97; ICC unaffected = 0.92; 95% C.I. 0.85-0.97). The POT was correlated moderately with the DASH (r = -0.47; p = 0.03). While examining the relationship between upper extremity self-reported activity/participation questionnaires and impairment measures the strongest correlation was between the DASH and the POT (r = -0.47; p = 0.03) and none of the correlations with the other physical impairment measures reached significance. At-work disability demonstrated insignificant correlations with physical impairments.
Conclusion: The POT test provides a reliable and easily administered quantitative measure of ability to bear the load through an injured arm. Preliminary evidence supports a moderate relationship between loading bearing measured by the POT and upper extremity function measured by the DASH.

• 出版日期2014-9