The SCT assesses the ability to ascend and descend a flight of stairs, as well as lower extremity strength, power, and balance.
A number of test variations have been developed for different populations (osteoarthritis [OA], rheumatoid arthritis, elderly, cardiopulmonary, cerebrovascular accident, and children). Test variations in people with lower extremity OA include the number of steps, the task requirement (ascent only or ascent/decent combined), or whether the test is timed over a set number of steps or the step count is recorded for a set period of time: 9-step ascend/descend (11, 25, 42–46), 4-step ascend/descend (6), 3-step ascent cycle duration (47), 30-second test (12 steps) (48, 49), 3-step measured on 0–6 scale of level of assistance (26), and 6-step fast and self-paced (21).
Cibulka MT, White DM, Woehrle J, Harris-Hayes M, Enseki K, Fagerson TL, et al. Hip pain and mobility deficits. Hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther 2009;39:A1–25 (14).
Logerstedt DS, Snyder-Mackler L, Ritter RC, Axe MJ. Knee pain and mobility impairments: meniscal and articular cartilage lesions. J Orthop Sports Phys Ther 2010;40:A1–35 (50).
Examples of use.
Outcome measure following hip/knee arthroplasty: Madsen OR, Brot C. Assessment of extensor and flexor strength in the individual gonarthrotic patient: interpretation of performance changes. Clin Rheumatol 1996;15:154–60 (49).
Farquhar S, Snyder-Mackler L. The Chitranjan Ranawat Award: the nonoperated knee predicts function 3 years after unilateral total knee arthroplasty. Clin Orthop Relat Res 2010;468:37–44 (51).
Floren M, Reichel H, Davis J, Laskin RS. The mini-incision mid-vastus approach for total knee arthroplasty. Oper Orthop Traumatol 2008;20:534–43 (52).
Zeni JA Jr, Snyder-Mackler L. Clinical outcomes after simultaneous bilateral total knee arthroplasty: comparison to unilateral total knee arthroplasty and healthy controls. J Arthroplasty 2010;25:541–6 (53).
Zeni JA Jr, Snyder-Mackler L. Early postoperative measures predict 1- and 2-year outcomes after unilateral total knee arthroplasty: importance of contralateral limb strength. Phys Ther 2010;90:43–54 (54).
Outcome measure following physical rehabilitation (exercise programs) in hip and knee OA: Galea MP, Levinger P, Lythgo N, Cimoli C, Weller R, Tully E, et al. A targeted home- and center-based exercise program for people after total hip replacement: a randomized clinical trial. Arch Phys Med Rehabil 2008;89:1442–7 (15).
Fisher NM, Gresham GE, Abrams M, Hicks J, Horrigan D, Pendergast DR. Quantitative effects of physical therapy on muscular and functional performance in subjects with osteoarthritis of the knees. Arch Phys Med Rehabil 1993;74:840–7 (17).
Ettinger WH Jr, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis: the Fitness Arthritis and Seniors Trial (FAST). JAMA 1997;277:25–31 (55).
Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum 2007;57:407–14 (56).
Bennell KL, Hunt MA, Wrigley TV, Hunter DJ, McManus FJ, Hodges PW, et al. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthritis Cartilage 2010;18:621–8 (57).
McKnight PE, Kasle S, Going S, Villanueva I, Cornett M, Farr J, et al. A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee. Arthritis Care Res (Hoboken) 2010;62:45–53 (58).
Talbot LA, Gaines JM, Huynh TN, Metter EJ. A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study. J Am Geriatr Soc 2003;51:387–92 (59).
Outcomes following drug therapy trials: Clarke AK. A double-blind comparison of naproxen against indometacin in osteoarthrosis. Arzneimittelforschung 1975;25:302–4 (60).
Predictive studies (risk/prevention) in hip and knee OA: Pua YH, Clark RA, Bryant AL. Physical function in hip osteoarthritis: relationship to isometric knee extensor steadiness. Arch Phys Med Rehabil 2010;91:1110–6 (21).
Thomas SG, Pagura SM, Kennedy D. Physical activity and its relationship to physical performance in patients with end stage knee osteoarthritis. J Orthop Sports Phys Ther 2003;33:745–54 (22).
Singh JA, O'Byrne M, Harmsen S, Lewallen D. Predictors of moderate-severe functional limitation after primary total knee arthroplasty (TKA): 4701 TKAs at 2-years and 2935 TKAs at 5-years. Osteoarthritis Cartilage 2010;18:515–21 (61).
Zeni JA Jr, Axe MJ, Snyder-Mackler L. Clinical predictors of elective total joint replacement in persons with end-stage knee osteoarthritis. BMC Musculoskelet Disord 2010;11:86 (62).
Zeni JA Jr, Snyder-Mackler L. Preoperative predictors of persistent impairments during stair ascent and descent after total knee arthroplasty. J Bone Joint Surg Am 2010;92:1130–6 (63).
Cost-effectiveness: Sevick MA, Bradham DD, Muender M, Chen GJ, Enarson C, Dailey M, et al. Cost-effectiveness of aerobic and resistance exercise in seniors with knee osteoarthritis. Med Sci Sports Exerc 2000;32:1534–40 (64).
Used in a number of different performance batteries: Lin YC, Davey RC, Cochrane T. Tests for physical function of the elderly with knee and hip osteoarthritis. Scand J Med Sci Sports 2001;11:280–6 (6).
McCarthy CJ, Oldham JA. The reliability, validity and responsiveness of an aggregated locomotor function (ALF) score in patients with osteoarthritis of the knee. Rheumatology (Oxford) 2004;43:514–7 (24).
Rejeski WJ, Ettinger WH Jr, Schumaker S, James P, Burns R, Elam JT. Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthritis Cartilage 1995;3:157–67 (25).
Shields RK, Enloe LJ, Evans RE, Smith KB, Steckel SD. Reliability, validity, and responsiveness of functional tests in patients with total joint replacement. Phys Ther 1995;75:169–79 (26).
Stratford PW, Kennedy DM, Woodhouse LJ. Performance measures provide assessments of pain and function in people with advanced osteoarthritis of the hip or knee. Phys Ther 2006;86:1489–96 (27) (Table 1).