Feasibility, Reliability and Validity of Sit to Stand Tests in People with Heart Failure

This prospective cohort study will be undertaken to determine feasibility, reliability and responsiveness to change of two commonly used variations of the sit to stand test (STST-5 and STST-60) in people with heart failure (HF) enrolled in an exercise training programme. The sit-to-stand test (STST) is a short-duration test, frequently used in rehabilitation settings as a measure of balance and mobility. Several variations of the test exist, all of which require individuals to repetitively move from sitting to standing for different durations. Being a functional activity and easy to administer in any setting, the STST has been proposed as a viable option for assessment of exercise capacity in people with HF. Whilst it has been used as a measure of improved performance for people with HF undergoing an exercise training programme, reliability and validity in this population is yet to be determined. The relationship of these two STSTs with other measures traditionally collected at the baseline assessment will also be assessed. Eligible participants will be identified by the Physiotherapist associated with the HF exercise programme at each of the participating sites and will be provided with written and verbal information about the study. Consenting participants will undergo their usual assessments at baseline and follow-up (week 13) which include performance of a 6MWT and Timed up and go test (TUGT), however will also complete two STSTs, adding approximately 15 minutes to the assessment duration. Participants will attend their 12 week HF exercise rehabilitation programme as planned at their respective health facility. This is a 12 week, centre-based, group exercise programme, whereby individuals attend weekly for 1 hour of exercise training, supervised by the HF Physiotherapist and nurse. Eligible participants who choose not to participate in the study will attend the exercise training programme as per usual practice, however will not have the STSTs included in their baseline and follow-up assessments. For participants, measures will be conducted by the investigator at each site. All investigators are experienced Physiotherapists very familiar with these test procedures. Due to the number of STSTs involved and consequent potential for fatigue, the order of the two STSTs tests will be randomised at baseline and follow-up for each participant. STST-5: In this test, participants will be asked to complete the test procedure five times. A stopwatch will be used to record the time elapsed until the participant is fully sitting following the fifth stand. The time required to complete the test will be recorded in seconds to two decimal places. STST-60: In this test, the participant is asked to complete the procedure for 60 seconds whilst the assessor silently counts the number of complete stands during this time. Incomplete attempts will not be counted, except on the final stand, when the attempt will be counted if the participant is greater than halfway up. Blood pressure will be measured in sitting at completion of the two performances of each STST. Because we aim to investigate feasibility of performing the STST in the home environment, participants at one site will perform the two STSTs in their homes with the Physiotherapist (based at the health facility), supervising via a Telehealth video link. These Telehealth appointments for performance of the STST (baseline and follow-up) will be scheduled at a time that is suitable for participants and assistance will be provided to those not familiar with the technology. It is anticipated that these appointments will take less than 30 minutes. All other measures for the baseline and week 13 assessments will be conducted as usual at the health facility.