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ObjectivesThe Biodex SD Stability System has been shown to be a reliable assessment tool for postural stability. However, its ability to provide an accurate representation of balance has not been compared with functional performance measures such as the four‐square step test (FSST) and timed‐up‐and‐go test (TUG). The purpose of this study was to investigate reliability, internal consistency, and construct validity of FSST, TUG, and Biodex SD (limits of stability [LOS] and modified Clinical Test of Sensory Organization and Balance [m‐CTSIB]).MethodsAn observational reliability and validity study was conducted. A convenience sample of 105 healthy adults, 77 females and 28 males, mean age 24.5 years old (± 4.66 SD) performed balance assessments including the FSST, TUG, Biodex SD LOS, and m‐CTSIB. For LOS, the overall percentage and test duration were recorded. For m‐CTSIB, the overall Sway Index was recorded. Condition 1 of the m‐CTSIB represented simple postural stability.ResultsThe Biodex SD LOS overall percentage, TUG, and FSST showed strong to excellent test‐retest reliability (ICC [3, 1] = .83 [mean 1: 58.14, mean 2: 60.54], .88 [mean 1: 6.98 seconds, mean 2: 6.91 seconds], .92 [mean 1: 6.29 seconds, mean 2: 6.14 seconds], respectively), while the Biodex SD m‐CTSIB overall percentage demonstrated strong test‐retest reliability (ICC [3, 1] = .75 [mean 1: 1.18, mean 2: 1.18]). The LOS test duration showed moderate test‐retest reliability (ICC [3, 1] = .58 [mean 1: 38.55 seconds, mean 2: 37.10 seconds]), while the m‐CTSIB condition 1 showed poor test‐retest reliability (ICC [3, 1] = .24 [mean 1: 0.63, mean 2: 0.66]). Weak construct validity was found between TUG, FSST, and Biodex SD measures of LOS and m‐CTSIB (r values = −0.15‐0.22).ConclusionIt is suggested that clinicians use more than one measure to assess different aspects of a patient's balance deficits to better guide treatment and intervention.

This study provided valuable insight into the illness experience from the perspective of the IWD and identified key areas amenable to interventions, such as managing embarrassment about memory problems as well as improving self-efficacy and inner strength. Moreover, this study provided additional support for the inclusion of IWDs in the research process and highlighted the need for further research regarding clinical application of findings, testing of hypotheses, and analyzing efficacy of interventions.

An Otago-based strengthening, balance, and walking home exercise program can potentially be used to decrease the number of falls and the risk of falling among older adults residing in an assisted living facility.

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Discussion highlights how these findings can be used to expand our understanding of individuals with dementia's illness experience and to develop efficacious interventions for addressing negative aspects of living with memory loss while supporting positive aspects.

Background/Purpose: To identify the unique predictors of comfortable and fast gait speed in community-dwelling older adults using measures of physical performance (eg, lower extremity strength and balance), self-reported balance confidence, and global cognitive function. Methods: Demographic information was collected from 60 healthy, community-dwelling older adults older than 60 years. Participants completed the following assessments: Mini-Mental State Examination; Activities-Specific Balance Confidence Scale; 30-second Chair Stand (30-SCS); Functional Reach (FR); and gait speed (comfortable and fast) using the GAITRite system. Hierarchical linear regression was used to examine the relationship of both fast and comfortable gait speeds with functional performance (CST and FR), cognition (Mini-Mental State Examination), Activities-Specific Balance Confidence Scale, and demographic information (age, gender, and body mass index). Results and Discussion: Functional performance measures (30-SCS and FR) explained 55.4% and 64.7%, respectively, of the variance in comfortable and fast gait speed. Unique predictors for comfortable gait speed included 30-SCS, FR, and body mass index. Unique predictors of fast gait speed included 30-SCS, FR, gender, body mass index, and Activities-Specific Balance Confidence Scale score. These predictors explained 68.5% and 80.4% of the total variance in comfortable and fast gait speed, respectively. Global cognition was not a unique predictor of gait speed when performance measures were statistically controlled. However, the current study measured global cognitive status rather than the specific cognitive constructs, such as processing speed or executive function. Further research is needed to determine the role of cognition in the composition of gait speed. Conclusions: Gait speed is an important indicator for many outcomes such as fall risk, mortality, and functional status. Understanding that key variables of strength and balance comprise a large portion of gait speed allows clinicians to better direct their care and optimize rehabilitation outcomes. This study specifically used functional measures of strength and balance that can be easily implemented in the clinical setting.

The current intervention used a Strength-Based Approach to facilitate implementation of exercise activities that could be completed by the sample. Therefore, integration of these techniques into mainstream clinical practice and research should be feasible with this patient population. Future research directions and implications of these findings also are discussed.