School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.
Physical Medicine and Rehabilitation, Physical Therapy Division, The Ohio State University, Columbus, Ohio.
J Geriatr Phys Ther. 2024;47(4):214-221. doi: 10.1519/JPT.0000000000000415. Epub 2024 Sep 18.
Stair negotiation is crucial for functional independence and is a leading cause of fall-related injuries in older adults. The Step Test Evaluation of Performance on Stairs (STEPS) is a quick and easily administered outcome measure for assessing stair negotiation. This study investigated the reliability and concurrent content validity of the STEPS test to determine its usefulness in older adults.
Eighty-two community-dwelling older adults (mean age 81.2 years, 51 females) were assessed on the STEPS test, Timed Up and Go (TUG), 5-times sit to stand (5XSTS), stair self-efficacy (SSE) questionnaire, and time to ascend and descend stairs. Participants repeated the STEPS test 7 to 14 days later for intrarater reliability by the same rater. Spearman rank and intraclass correlations were used to determine the association of measures and intrarater reliability.
The mean STEPS score was 15.6 (SD = 3.7) out of 20. The STEPS total score demonstrated excellent intra- and interrater reliability. It had moderate to good and significant correlations with TUG, 5XSTS, SSE, and time to ascend and descend measures. Faster performance on the 5XSTS, TUG, and time to ascend and descend correlated with better performance on the STEPS test, indicating validity for assessing balance and mobility during stair negotiation in older adults. Lower SSE correlated with lower observer ratings of performance on stairs (STEPS scores), indicating agreement between participant reports of self-efficacy and observer ratings of performance. Step Test Evaluation of Performance on Stairs items that demonstrated the most frequent loss of points were balance (use of handrail), step continuity, foot placement, and self-propulsion (ascent only).
Assessment of older adults' safety and performance on stairs is vital given the increased difficulty of stair navigation and the high risk for injurious falls in this population. This study demonstrates that the STEPS test is a reliable and valid outcome measure for assessing stair performance in older adults.
上下楼梯是实现功能独立的关键，也是老年人跌倒相关伤害的主要原因。台阶测试评估楼梯表现（STEPS）是一种快速且易于实施的评估上下楼梯能力的结果测量方法。本研究旨在调查 STEPS 测试的可靠性和同时效内容效度，以确定其在老年人中的有用性。
对 82 名居住在社区的老年人（平均年龄 81.2 岁，51 名女性）进行 STEPS 测试、计时起立行走测试（TUG）、5 次坐站测试（5XSTS）、楼梯自我效能感（SSE）问卷以及上下楼梯时间的评估。参与者在 7 至 14 天后由同一位评估者进行复测，以评估内部信度。采用 Spearman 秩相关和组内相关系数来确定测量指标之间的相关性和内部信度。
STEPs 得分为 20 分中的 15.6（SD=3.7）。STEPs 总分表现出极好的内部和内部信度。它与 TUG、5XSTS、SSE 和上下楼梯时间测量指标具有中度至高度显著相关性。5XSTS、TUG 和上下楼梯时间的较快表现与 STEPS 测试表现较好相关，表明其在评估老年人上下楼梯时的平衡和移动能力方面具有有效性。较低的 SSE 与观察者对楼梯表现（STEPs 得分）的评分较低相关，表明参与者自我效能感报告与观察者表现评分之间存在一致性。在 STEPs 测试中，表现出最频繁扣分的项目是平衡（使用扶手）、步幅连续性、脚步位置和自我推进（仅上升）。
鉴于老年人上下楼梯的难度增加以及该人群受伤跌倒的风险较高，对老年人楼梯安全性和表现的评估至关重要。本研究表明，STEPs 测试是评估老年人楼梯表现的可靠和有效的结果测量方法。
