Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7HE, UK.
Syst Rev. 2017 Sep 11;6(1):187. doi: 10.1186/s13643-017-0577-5.
The four square step test (FSST) was first validated in healthy older adults to provide a measure of dynamic standing balance and mobility. The FSST has since been used in a variety of patient populations. The purpose of this systematic review is to determine the validity and reliability of the FSST in these different adult patient populations.
The literature search was conducted to highlight all the studies that measured validity and reliability of the FSST. Six electronic databases were searched including AMED, CINAHL, MEDLINE, PEDro, Web of Science and Google Scholar. Grey literature was also searched for any documents relevant to the review. Two independent reviewers carried out study selection and quality assessment. The methodological quality was assessed using the QUADAS-2 tool, which is a validated tool for the quality assessment of diagnostic accuracy studies, and the COSMIN four-point checklist, which contains standards for evaluating reliability studies on the measurement properties of health instruments.
Fifteen studies were reviewed studying community-dwelling older adults, Parkinson's disease, Huntington's disease, multiple sclerosis, vestibular disorders, post stroke, post unilateral transtibial amputation, knee pain and hip osteoarthritis. Three of the studies were of moderate methodological quality scoring low in risk of bias and applicability for all domains in the QUADAS-2 tool. Three studies scored "fair" on the COSMIN four-point checklist for the reliability components. The concurrent validity of the FSST was measured in nine of the studies with moderate to strong correlations being found. Excellent Intraclass Correlation Coefficients were found between physiotherapists carrying out the tests (ICC = .99) with good to excellent test-retest reliability shown in nine of the studies (ICC = .73-.98).
The FSST may be an effective and valid tool for measuring dynamic balance and a participants' falls risk. It has been shown to have strong correlations with other measures of balance and mobility with good reliability shown in a number of populations. However, the quality of the papers reviewed was variable with key factors, such as sample size and test set up, needing to be addressed before the tool can be confidently used in these specified populations.
四步踏格测试（FSST）最初在健康老年人中进行了验证，以提供动态站立平衡和移动能力的衡量标准。此后，FSST 已在各种患者群体中使用。本系统评价的目的是确定 FSST 在这些不同成年患者群体中的有效性和可靠性。
进行文献检索，以突出所有测量 FSST 有效性和可靠性的研究。检索了六个电子数据库，包括 AMED、CINAHL、MEDLINE、PEDro、Web of Science 和 Google Scholar。还搜索了灰色文献，以获取与审查相关的任何文件。两名独立审查员进行了研究选择和质量评估。使用 QUADAS-2 工具评估方法学质量，QUADAS-2 是一种用于评估诊断准确性研究质量的经过验证的工具，以及 COSMIN 四点清单，其中包含评估健康仪器测量特性的可靠性研究的标准。
共审查了 15 项研究，涉及社区居住的老年人、帕金森病、亨廷顿病、多发性硬化症、前庭障碍、中风后、单侧胫骨截肢后、膝痛和髋骨关节炎。其中三项研究的方法学质量为中等，在 QUADAS-2 工具的所有领域中都存在低风险和适用性。三项研究在 COSMIN 四点清单的可靠性部分中得分为“公平”。FSST 的同时效度在其中 9 项研究中进行了测量，发现了中度至强相关性。在 9 项研究中发现了物理治疗师进行测试的极好的组内相关系数（ICC=0.99），具有良好至极好的测试-重测可靠性（ICC=0.73-0.98）。
FSST 可能是一种测量动态平衡和参与者跌倒风险的有效且有效的工具。它已被证明与其他平衡和移动能力测量方法具有很强的相关性，并且在许多人群中表现出良好的可靠性。然而，所审查的论文质量参差不齐，需要解决诸如样本量和测试设置等关键因素，然后才能在这些指定人群中自信地使用该工具。
Zotero 插件