A study of the validity of the Six-Spot Step Test in ambulatory people with Parkinson’s disease

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Objective: To evaluate the test-retest reliability and construct validity of the Six-Spot Step Test in older adults. Design: Cross-sectional study. Setting: Outpatient clinics. Subjects: Sixty-six adults aged ⩾65 years with self-reported balance problems. Main measure: The Six-Spot Step Test was completed twice on day 1. Three days later, the Six-Spot Step Test, the Timed “Up and Go” test, Dynamic Gait Index, the Mini-BESTest, and standing balance test were conducted. Reliability and validity were estimated using Bland-Altman statistics, minimal detectable change, Intraclass Correlation Coefficient (ICC), and Spearman’s rank correlation coefficient (ρ). Results: Participants had a mean (SD) age of 75.5 (6.6) years, a median ( Q1– Q3) Montreal Cognitive Assessment test score of 26 (24–27), and a median ( Q1– Q3) Falls Efficacy Scale International score of 22 (20–26). The study found within-day and between-day limits of agreements of ±15.7% and ±18.1%, respectively. The minimal detectable changes at the 95% level of confidence for within-day and between-day were 17.5% and 21.6%, and the ICCs were 0.96 (CI: 0.92–0.98) and 0.94 (CI: 0.86–0.97), respectively. A learning effect was observed between the first and second Six-Spot Step Test. Moderate to strong correlations were found between the Six-Spot Step Test and Mini-BESTest (ρ = −0.62), Dynamic Gait Index (ρ = −0.55), and the Timed “Up and Go” test (ρ = 0.79). Weak correlations were identified between the Six-Spot Step Test and static standing balance test (ρ < 0.38). Conclusion: The Six-Spot Step Test shows excellent relative consistency and moderate to high construct validity in older adults. A change of 21.6% is a true change in outcome.

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Examining the test-retest reliability and construct validity of the Six-Spot Step Test in older adults with self-reported balance problems

Brincks

Callesen

2021

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“…A total of 1319 people with a mean (1-3 quartile) age of 55.5 years (49.1-68.9) participated in 13 studies. Thirteen out of 16 (81.3%) articles focused on people affected by neurological diseases, with 8 articles including people with multiple sclerosis (n = 859), 9,12,[32][33][34][35][36][37] 3 articles from 1 study included people with Parkinson's disease (n = 81), 14,15,38 one concerned about people with stroke (n = 81), 11 and 1 article looked at people with Chronic Inflammatory Polyneuropathy (n = 123). 10 In addition to neurological diseases, three articles investigated balance-related concerns in older adults.…”

Section: Resultsmentioning

confidence: 99%

“…Within the past 5 years, more studies have validated and used the Six-Spot Step Test in clinical studies for populations with challenging balance functioning, [10][11][12][13][14][15] making it a more commonly used balance measure in scientific literature and clinical practice. Despite the fast-raising literature validating the Six-Spot Step Test, no systematic review evaluating its metric characteristics is available.…”

Section: Introductionmentioning

confidence: 99%

The psychometric properties of the Six-Spot Step Test – a systematic review using the COSMIN guidelines

Aakrann,

Brincks

2024

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Objective Accurate and reliable balance measures are important for prescribing fall prevention treatments and monitoring their effectiveness. Thus, we aimed to systematically review the psychometric properties of the Six-Spot Step Test, an increasingly used measure of dynamic balance. Data sources A literature search using the free-text term “Six-Spot Step Test” was performed on 12 February 2024, in Medline, Embase, Rehabilitation & Sports Medicine and SPORTDiscus. Eligibility criteria were adults aged 18 or more, trials evaluating the psychometric properties of the Six-Spot Step Test, and English-language articles. Conference abstracts were excluded. Review methods Two investigators screened and selected data independently and assessed the methodological quality and evidence using the COSMIN Risk of Bias checklist and modified GRADE approach. One investigator extracted study characteristics such as design, population and psychometric properties. Results Of the 159 articles identified, 16, evaluating multiple measurement properties, were included in the final analysis. A total of 1319 people participated, including people affected by Stroke, multiple sclerosis, Parkison's disease, chronic inflammatory polyneuropathy and older adults with balance problems. Eight articles assessing reliability (n = 618, intraclass correlations coefficient ≥0.7, minimal detectable change = 22%) and 12 construct validity (n = 1082, 83% true hypothesis, area under the curve >0.7) exhibited sufficient methodological quality with high-level evidence, while two studies (n = 167) examining responsiveness showed very low evidence. Conclusion Apart from responsiveness, robust evidence supports the reliability and validity of the Six-Spot Step Test for assessing dynamic balance in a specific group of individuals with neurological diseases and older adults. Further, it is considered feasible for clinical use.

“…The tests are considered valid and reliable in persons with Parkinson's disease. [15][16][17][18][19][20] Further information on the test procedures is described in the supplementary material.…”

Section: Discussionmentioning

confidence: 99%

Validity and reliability of linear encoder muscle power testing in persons with Parkinson's disease

Bonde-Jensen,

Dalgas,

Hvid

et al. 2024

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Objective To investigate the construct validity ON medication and the reliability both ON and OFF medication of linear encoder muscle power testing in persons with Parkinson's disease (pwPD). Design A study using baseline data from one randomized controlled trial (study 1) and one cohort study (study 2). Setting University exercise lab. Participants Study 1: 35 healthy controls and 70 pwPD. Study 2: 20 pwPD. Intervention Study 1: baseline data. Study 2: 4 chair rise tests (2 ON and 2 OFF medication), in a randomized order, separated by 4 to 16 days. Main measures Linear encoder data were collected from a chair rise test. Known groups validity and convergent validity (i.e., construct validity) were assessed by comparing peak power between pwPD and healthy controls and associations between peak power and functional performance (i.e., 6-Min Walk Test, Timed Up and Go Test, Six-Spot Step Test), respectively. Reliability was assessed as day-to-day variation and by intraclass correlation coefficients. Results Peak power was comparable between pwPD and healthy controls (−7.2%, p = 0.17), but lower in moderately impaired pwPD compared to mildly impaired pwPD (−27%, p < 0.01) and healthy controls (−23%, p < 0.01). Moderate to strong associations were observed between peak power and functional performance (r2 = 0.44–0.51). Day-to-day variation ON and OFF medication were 1.0 and 1.3 W/kg, respectively, while intraclass correlation coefficients were 0.95 (0.87;0.98) and 0.93 (0.82;0.97), respectively. Conclusion Linear encoder muscle power testing shows inconsistent known groups validity, acceptable convergent validity ON medication, and excellent day-to-day reliability ON and OFF medication in pwPD.