Riis Johannes, Wølke Steffen, Danielsen Mathias Brix, Pedersen Mette Merete, Andersen Stig, Jørgensen Martin Grønbech
Department of Geriatric Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, 9000, Aalborg, Denmark.
Eur Geriatr Med. 2025 May 30. doi: 10.1007/s41999-025-01240-w.
Integrated motor-cognitive assessments, such as the Stepping Trail Making Test (S-TMT) and Trail Walking Test (TWT), have shown promise in predicting fall risk and assessing cognitive function. However, their reliability and validity need clarification in European populations.
This intra-rater test-retest reliability study involved community-dwelling older adults aged 65+. Participants completed both the S-TMT and the TWT across two sessions, 1 week apart, to assess reliability and correlation. The S-TMT required participants to step on numbered squares in sequence on a 1 × 1 meter mat, while the TWT involved walking through a randomized sequence of 15 numbered flags within a 5 × 5 meter area. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC), and correlations were assessed using Pearson correlation.
We included 34 participants (mean age 74.9, 23 female). Both tests demonstrated good-to-excellent reliability: the S-TMT showed an ICC of 0.81 to 0.93, while the TWT showed an ICC of 0.83 to 0.97 based on number of trials. The S-TMT exhibited significant learning effects between sessions, whereas the TWT showed minimal learning effects. A moderate correlation (r = 0.48) was found between the tests, indicating they assess different aspects of motor-cognitive function.
The S-TMT and TWT are reliable and complimentary tools for assessing motor-cognitive interactions in older adults. The S-TMT is suitable for single assessment as learning effects limits short-time re-testing, whereas the TWT seems more appropriate for repeated testing. Further studies should validate these results across diverse populations and explore their predictive value for long-term outcomes.
综合运动认知评估，如阶梯连线测试（S-TMT）和步道行走测试（TWT），在预测跌倒风险和评估认知功能方面已显示出前景。然而，其在欧洲人群中的可靠性和有效性需要进一步明确。
这项评估者内重测信度研究纳入了65岁及以上的社区居住老年人。参与者在相隔1周的两个时间段内完成了S-TMT和TWT，以评估信度和相关性。S-TMT要求参与者在1×1米的垫子上按顺序踩在标有数字的方块上，而TWT则是在5×5米的区域内走过15个标有数字的旗帜的随机序列。使用组内相关系数（ICC）评估重测信度，并使用Pearson相关评估相关性。
我们纳入了34名参与者（平均年龄74.9岁，23名女性）。两项测试均显示出良好到优秀的信度：基于试验次数，S-TMT的ICC为0.81至0.93，而TWT的ICC为0.83至0.97。S-TMT在各时间段之间表现出显著的学习效应，而TWT的学习效应最小。两项测试之间发现中等相关性（r = 0.48），表明它们评估了运动认知功能的不同方面。
S-TMT和TWT是评估老年人运动认知相互作用的可靠且互补的工具。S-TMT由于学习效应限制了短时间的重新测试，适合单次评估，而TWT似乎更适合重复测试。进一步的研究应在不同人群中验证这些结果，并探索它们对长期结果的预测价值。
