Reliability and fall experience discrimination of Cross Step Moving on Four Spots Test in the elderly.

OBJECTIVES

To examine the reliability and fall experience discrimination of the Cross Step Moving on Four Spots Test (CSFT) and the relationship between CSFT and fall-related physical function.

DESIGN

The reliability of the CSFT was examined in a test-retest format with the same tester. Fall history, fall risk, fear of falling, activities of daily living (ADL), and various physical parameters were measured for all participants.

SETTING

A community center and university medical school.

PARTICIPANTS

Elderly community-dwelling subjects (N=533; 62 men, 471 women) aged 65 to 94 years living independently.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Time to complete all the CSFT steps required, fall risk score, ADL score, and fall-related physical function (isometric muscle strength: toe grip, plantar flexion, knee extension, hip flexion, hand grip; balance: 1-leg standing time with eyes open, functional reach test using an elastic stick; and gait: 10-m maximal walking speed).

RESULTS

The trial-to-trial reliability test indicated good reliability of the CSFT in both sexes (intraclass correlation coefficient =.833 in men, .825 in women). However, trial-to-trial errors increased with an increase in the CSFT values in both sexes. Significant correlations were observed between the CSFT values and scores for most fall-related physical function tests in both sexes. However, the correlation coefficient for all significant correlations was <0.5. Two-way analysis of variance (sex × fall experience) revealed that the fall experience is a significant factor affecting CSFT values; values in fallers were significantly lower than those in nonfallers. The odds ratios in logistic regression analysis were significant in both sexes (men, 1.35; women, 1.48). As determined by the Youden index, the optimal cutoff value for identifying fall experience was 7.32 seconds, with an area under the curve of .676.

CONCLUSIONS

The CSFT can detect fall experience and is useful in the evaluation of different fall-related physical functions including muscle strength, balance, and mobility.