# Test–Retest Reliability of Single-Arm Closed Kinetic Chain Upper Extremity Stability Test

## TL;DR

Researchers tested a new version of a physical stability test for the upper body and found it to be reliable for measuring performance consistency and limb symmetry.

## Contribution

The study introduces a personalized single-arm upper extremity stability test that accounts for individual differences and assesses limb symmetry.

## Key findings

- The new single-arm CKCUEST showed good to excellent test–retest reliability with ICC values ranging from 0.88 to 0.93.
- The Limb Symmetry Index (LSI) had questionable reliability with an ICC of 0.53 and high variability between test days.
- There was substantial agreement on the direction of limb asymmetry between test sessions.

## Abstract

Background: The original Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) is a simple assessment tool but does not account for individual differences in hand starting position and fails to provide information on limb asymmetries. The purpose of the study is to evaluate the test–retest reliability of a new single-arm CKCUEST as well as the reliability of the limb symmetry index (LSI). This version normalizes the test based on the participant’s arm length and allows for the assessment of limb symmetry since it is performed one arm at a time. Methods: Twelve healthy young adults provided both verbal and written consent to participate. Participants were excluded if they had sustained an injury in the past three months requiring medical attention and/or resulting in decreased activity for more than three days. Testing was conducted in the push-up position with participants’ thumbs placed parallel and at a distance equal to the length of their dominant arm (measured from the acromion to the tip of the middle finger), and feet positioned shoulder-width apart. Participants were instructed to keep the testing hand stable on the floor while the opposite hand reached across the body to touch the stationary hand and then return to the starting position marked with athletic tape. The goal was to complete as many touches as possible in 15 s, with each touch counted only if the participant touched the stationary hand, returned to the starting position, and maintained the shoulder-width stance. The average number of touches from the three trials was used for analysis. Intraclass Correlation Coefficients (ICC(3,1)) were computed to determine test–retest reliability. Results: Test–retest reliability of the single-arm CKCUEST individual tests was good to excellent. The ICC(3,1) was 0.88 (95% CI: 0.74–0.95) for all tests, 0.89 (95% CI: 0.66–0.96) for the dominant arm, and 0.93 (95% CI: 0.78–0.98) for the non-dominant arm. In contrast, the reliability of the Limb Symmetry Index (LSI) was questionable, showing substantial variability with an ICC(3,1) of 0.53 (95% CI: −0.03–0.83) between Day 1 and Day 2, despite similar mean values (Day 1: 93.6 ± 8.46; Day 2: 94.8 ± 5.77). The Kappa coefficient suggested a substantial level of agreement for the direction of the asymmetry (preferred limb) (Kappa coefficient = 0.62). Conclusions: The new single-arm CKCUEST, which personalizes the hand starting position and measures limb symmetry, demonstrates high reliability among healthy young adults.