Feasibility, stability and validity of the four square step test in typically developed children and children with brain damage.

PURPOSE

To assess feasibility, test-retest reliability and validity of the Four Square Step Test (FSST) in typically developed children (TD), and children with cerebral palsy (CP) and acquired brain injury (ABI).

METHODS

30 TD children, 20 with CP and 12 with ABI participated in the study. The FSST while sitting and standing, the Timed Up and Go (TUG) and the balance subtest of the Bruininks-Oseretsky Test (BOT-2) were assessed. Each child attempted the FSST twice within 1 week. The scores for the FSST were assigned according to the original test: two successes in four trials, and according to a more lenient test, one success in four trials.

RESULTS

The original form of the FSST is not feasible for children with CP or ABI. In TD children the lenient version is feasible (93%) and has moderate stability (Interclass correlation, ICC = 0.723), with a significant, positive correlation with the TUG (r = 0.56). In children with CP the lenient test is feasible (80%), stable (r = 0.83) and negatively correlates with the BOT-2 (r=-0.69). In children with ABI the test is less feasible (67%) and neither stable nor valid.

CONCLUSIONS

The lenient form of the FSST is feasible, reliable and valid in TD children and children with CP.