Whitney Susan L, Marchetti Gregory F, Morris Laura O, Sparto Patrick J
Department of Physical Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA, USA.
Arch Phys Med Rehabil. 2007 Jan;88(1):99-104. doi: 10.1016/j.apmr.2006.10.027.
To determine the reliability and validity of the Four Square Step Test (FSST) for use in people with balance deficits secondary to vestibular disorders, who frequently report falling and have difficulty with changes of direction.
Cross-sectional descriptive study.
Outpatient clinic.
Thirty-two people with balance deficits secondary to vestibular disorders (mean age, 63.7+/-17.8y) who were currently enrolled in a vestibular physical therapy program agreed to participate.
Participants performed the FSST, the Timed Up & Go (TUG) test, an 11-m walk test during which walking speed was recorded, and the Dynamic Gait Index (DGI) and completed the Dizziness Handicap Inventory (DHI) and the Activities-Specific Balance Confidence (ABC) Scale.
The main outcome measures were the FSST time, TUG results, DGI score, gait velocity, and DHI and ABC scores. Number of fall risk factors, as determined by published scores for people at risk for falling on the TUG test and gait speed, and number of falls were compared with FSST scores.
The FSST has good reliability (intraclass correlation coefficient, model 3,1: .93; 95% confidence interval, .86-.96) and had good correlations with the other gait measures (correlation coefficients for the TUG, .69; gait speed, .65; DGI, -.51) and poor correlations with the DHI and the ABC (DHI, -.13; ABC, -.12). Multivariate linear regression showed that 51.5% of FSST performance was explained by TUG score and gait speed. The mean FSST time differed significantly between groups with 0 (n=12), 1 (n=12), or 2 to 3 (n=8) risk factors for falls (analysis of variance, F=10.02; P<.01). A cutoff score of greater than 12 seconds on the FSST was associated with a sensitivity of 80% and specificity of 92% for the identification of subjects with 1 or more risk factors for falls.
The FSST is a reliable and valid tool for measuring the ability to perform multidirectional movements in people with balance deficits secondary to vestibular disorders.
确定四方步试验（FSST）在因前庭疾病导致平衡功能障碍的人群中的可靠性和有效性，这类人群经常报告有跌倒情况且在方向改变方面存在困难。
横断面描述性研究。
门诊诊所。
32名因前庭疾病导致平衡功能障碍的患者（平均年龄63.7±17.8岁），他们当时正在参加前庭物理治疗项目，同意参与研究。
参与者进行四方步试验、定时起立行走试验（TUG）、记录行走速度的11米步行试验、动态步态指数（DGI），并完成头晕残障量表（DHI）和特定活动平衡信心量表（ABC）。
主要观察指标为四方步试验时间、定时起立行走试验结果、动态步态指数评分、步态速度以及头晕残障量表和特定活动平衡信心量表评分。将根据定时起立行走试验和步态速度的已发表评分确定的跌倒风险因素数量以及跌倒次数与四方步试验评分进行比较。
四方步试验具有良好的可靠性（组内相关系数，模型3,1：0.93；95%置信区间，0.86 - 0.96），并且与其他步态测量指标具有良好的相关性（与定时起立行走试验的相关系数为0.69；与步态速度的相关系数为0.65；与动态步态指数的相关系数为 - 0.51），与头晕残障量表和特定活动平衡信心量表的相关性较差（与头晕残障量表的相关系数为 - 0.13；与特定活动平衡信心量表的相关系数为 - 0.12）。多元线性回归显示，定时起立行走试验评分和步态速度可解释四方步试验表现的51.5%。在跌倒风险因素为0（n = 12）、1（n = 12）或2至3（n = 8）的组之间，四方步试验的平均时间存在显著差异（方差分析，F = 10.02；P < 0.01）。四方步试验得分大于12秒的临界值对于识别有1个或更多跌倒风险因素的受试者的敏感性为80%，特异性为92%。
四方步试验是一种可靠且有效的工具，可用于测量因前庭疾病导致平衡功能障碍的人群进行多方向运动的能力。
