Dite Wayne, Temple Viviene A
Royal Talbot Rehabilitation Centre, Physiotherapy Department, RMIT University, Faculty of Life Sciences, School of Medical Sciences, Melbourne, Australia.
Arch Phys Med Rehabil. 2002 Nov;83(11):1566-71. doi: 10.1053/apmr.2002.35469.
To establish the reliability and validity of a new clinical test of dynamic standing balance, the Four Square Step Test (FSST), to evaluate its sensitivity, specificity, and predictive value in identifying subjects who fall, and to compare it with 3 established balance and mobility tests.
A 3-group comparison performed by using 3 validated tests and 1 new test.
A rehabilitation center and university medical school in Australia.
Eighty-one community-dwelling adults over the age of 65 years. Subjects were age- and gender-matched to form 3 groups: multiple fallers, nonmultiple fallers, and healthy comparisons.
Not applicable.
Time to complete the FSST and Timed Up and Go test and the number of steps to complete the Step Test and Functional Reach Test distance.
High reliability was found for interrater (n=30, intraclass correlation coefficient [ICC]=.99) and retest reliability (n=20, ICC=.98). Evidence for validity was found through correlation with other existing balance tests. Validity was supported, with the FSST showing significantly better performance scores (P<.01) for each of the healthier and less impaired groups. The FSST also revealed a sensitivity of 85%, a specificity of 88% to 100%, and a positive predictive value of 86%.
As a clinical test, the FSST is reliable, valid, easy to score, quick to administer, requires little space, and needs no special equipment. It is unique in that it involves stepping over low objects (2.5cm) and movement in 4 directions. The FSST had higher combined sensitivity and specificity for identifying differences between groups in the selected sample population of older adults than the 3 tests with which it was compared.
建立一种新的动态站立平衡临床测试方法——四方步测试（FSST）的可靠性和有效性，评估其在识别跌倒受试者方面的敏感性、特异性和预测价值，并将其与3种已确立的平衡和移动性测试进行比较。
采用3种经过验证的测试和1种新测试进行三组比较。
澳大利亚的一个康复中心和大学医学院。
81名65岁以上的社区居住成年人。根据年龄和性别匹配受试者，形成3组：多次跌倒者、非多次跌倒者和健康对照组。
不适用。
完成FSST和定时起立行走测试的时间，以及完成台阶测试的步数和功能性伸展测试距离。
组间评分者间（n = 30，组内相关系数[ICC]=0.99）和重测信度（n = 20，ICC = 0.98）具有高可靠性。通过与其他现有平衡测试的相关性发现了有效性证据。有效性得到支持，FSST在每个更健康和损伤较轻的组中显示出显著更好的表现评分（P<0.01）。FSST还显示出85%的敏感性、88%至100%的特异性和86%的阳性预测值。
作为一种临床测试，FSST可靠、有效、易于评分、实施快速、所需空间小且无需特殊设备。其独特之处在于它涉及跨过低物体（2.5厘米）并向4个方向移动。在选定的老年成年人样本群体中，FSST在识别组间差异方面的综合敏感性和特异性高于与之比较的3种测试。
