UULEX Reliability in Individuals With Stroke

NCT07885774 — Not yet recruiting, 30 participants, Karabuk University

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Test-Retest Reliability of the Unsupported Upper Limb Exercise Test (UULEX) in Individuals With Stroke

Registry	NCT07885774
Status	Not yet recruiting
Study type	Observational
Enrollment	30 (Estimated)
Sponsor	Karabuk University (Other)
Conditions	Stroke, UULEX, Test-Retest Reliability
Interventions	Unsupported Upper Limb Exercise Test [UULEX] (Diagnostic test)
Dates	start 2026-10-26 (estimated), primary completion 2026-12-01 (estimated), completion 2026-12-26 (estimated), first posted 2026-10-21, last updated 2026-10-21

-Summary

This study was designed to determine the test-retest reliability of the Unsupported Upper Limb Exercise Test (UULEX) in individuals with stroke. Motor impairments following stroke, particularly reductions in upper limb muscle strength, motor control, and functional performance, may adversely affect individuals' activities of daily living and functional independence. Therefore, the assessment of upper limb performance using reliable and feasible methods is important for planning and monitoring the rehabilitation process.

The UULEX is an incremental, performance-based, easy-to-administer, and low-cost field test developed to assess upper limb exercise capacity. Although the UULEX has been used in different clinical populations, evidence regarding its test-retest reliability in individuals with stroke is limited. In this study, the UULEX will be administered twice to individuals with stroke at a predetermined interval, and the consistency between the two measurements will be evaluated to determine its test-retest reliability. It is hypothesized that the UULEX will demonstrate high test-retest reliability in individuals with stroke. The findings of this study are expected to provide evidence regarding the reliability of the UULEX as a clinical assessment tool for evaluating upper limb exercise capacity in individuals with stroke.

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+Arms and interventions

Arm	Type	Interventions	Description
Hemiplegia group		Diagnostic Test: Unsupported Upper Limb Exercise Test [UULEX]	Individuals diagnosed with hemiplegia, aged 18-78 years, and willing to participate were included in the study, whereas those with upper extremity or neck pain, cognitive impairment, comorbidities affecting upper extremity and hand function (carpal tunnel syndrome, trigger finger, impingement syndrome, thoracic outlet syndrome, or lateral or medial epicondylitis), or a history of upper extremity surgery were excluded.

Unsupported Upper Limb Exercise Test [UULEX] (Diagnostic test): The UULEX consists of eight horizontal levels positioned 15 cm apart. Participants are seated facing the chart and raise a 0.2-kg bar from hip level to progressively higher levels at a rate of 30 movements per minute using a metronome. After a 2-min warm-up, the level is increased every minute. Once the highest level is reached, the load is increased by 0.5 kg each minute up to 2 kg. The test continues until symptom limitation or a maximum of 12 min. For reliability assessment, the UULEX will be performed three times using the same standardized protocol. The first two assessments will be conducted on the same day with a 1-h rest interval, and the third will be performed one week later.

+Outcome measures

Primary outcomes

Test-Retest Reliability of the Unsupported Upper Limb Exercise Test (UULEX) [The UULEX will be administered three times to each participant: the first and second assessments will be performed with a 1-hour rest interval, and the third assessment will be conducted one week later.]: Upper limb exercise capacity will be assessed using the Unsupported Upper Limb Exercise Test (UULEX). Participants will perform progressive unsupported upper limb exercise until symptom limitation or the maximum test duration is reached. UULEX performance will be recorded as total test duration (seconds). The test will be performed three times: twice on the same day with a 1-hour interval and once one week later. Test-retest reliability will be determined by comparing UULEX performance across assessments.

+Eligibility

Sex: All, ages: 18 Years to 78 Years, accepts healthy volunteers

Inclusion Criteria:

* Diagnosis of hemiplegia
* Age between 18 and 78 years
* Willingness to participate in the study

Exclusion Criteria:

* Presence of upper extremity or neck pain
* Cognitive impairment
* Presence of comorbidities affecting upper extremity and hand function (carpal tunnel syndrome, trigger finger, impingement syndrome, thoracic outlet syndrome, lateral or medial epicondylitis)
* History of upper extremity surgery

+Publications

Takahashi T, Jenkins SC, Strauss GR, Watson CP, Lake FR. A new unsupported upper limb exercise test for patients with chronic obstructive pulmonary disease. J Cardpulm Rehabil. 2003;23:430-437. Lima VP, Velloso M, Almeida FD, Carmona B, Ribeiro-Samora GA, Janaudis-Ferreira T. Test-retest reliability of the unsupported upper-limb exercise test (UULEX) and 6-min peg board ring test (6PBRT) in healthy adult individuals. Physiother Theory Pract. 2018;34(10):806-812. Fulton I, McEvoy M, Pieterse J, Williams M, Thoirs K, Petkov J. Transversus abdominis: changes in thickness during the unsupported upper limb exercise test in older adults. Physiother Theory Pract. 2009;25(8):523-532. Cetin SY, Basakci Calik B, Ayan A, Cavlak U. Validity and reliability of the unsupported upper-limb exercise test in individuals with rheumatoid arthritis. Int J Rheum Dis. 2019 Nov;22(11):2025-2030. doi: 10.1111/1756-185X.13720. Epub 2019 Oct 9. PMID: 31595690. Karazeybek, Z. B., & Naz, İ. (2022). Convergent Validity and Test-Retest Reliability of the Unsupported Upper Limb Exercise Test in Patients with Chronic Neck Pain. Perceptual and Motor Skills, 129(4), 1177-1192.