Effective Tempo of the Step Test for Dynamic Balance Ability in the Elderly

Abstract

This study aimed to examine the reliability and sex-and age-related differences of step tests with stipulated tempos as well as to clarify useful test parameters and tempos. One hundred forty elderly people and fifty young adults conducted tapping and stepping tests, matching the tempo provided by a metronome. Both tests involve movements where the subject touches a sheet with both the right and left hands or right and left legs at a designated spot. Evaluation parameters were the time difference between the beep sound and the time at which the sheet was touched in both tests as well as two-leg support and one-leg support times in the step test. The trial-to-trial reliability of the parameters in both tests was high. The time differences of both 40 bpm tests in the elderly were larger in males than in females. In the step test, the time difference and two-leg support times of the elderly were larger, in the order of 40, 60, and 120 bpm, and the oneleg support time was less in 40 bpm than 60 bpm or 120 bpm. The one-leg support time of the young subjects was larger, in the order of 40, 60, and 120 bpm. A significant age-related difference was found in the 40 bpm and 60 bpm test, and the time difference and two-leg support time were larger in the elderly while the one-leg support time was larger in the young subjects. The time difference at 40 bpm in the elderly was larger in the step test than in the tap test. There was no significant difference between both tests in the young subjects. In conclusion, the step test with the slow tempo, because it requires a long one-leg support phase, is effective for evaluating dynamic balance in the elderly. The time difference and two-leg and one-leg support times are effective evaluation parameters of the step test.

Reliability and Fall Experience Discrimination of Cross Step Moving on Four Spots Test in the Elderly

“…Moreover, Shin and Demura 35 reported an ICC of 0.73 for the time difference between foot contact on a preassigned spot and a stipulated tempo of 40 beats/min. The reliability values of the step parameters in the present study were similar to or slightly lower than the values in these reports.…”

Relationship between the Step Test with Stipulated Tempos and Gait Ability in the Elderly

“…Toyama and Fujiwara (1990) reported that the 120 bpm tempo used in this study is the most stable tempo during gait. Shin and Demura (2007) reported that the elderly can easily perform the step test to the 120 bpm tempo, as can young adults. Also in the present results, the 120 bpm tempo showed insignificant differences among groups with different gait times, and the time difference among the three groups was minimal as compared with the other two tempo conditions.…”

“…A 120 bpm tempo was reported to be the most efficient interval during walking (Toyama and Fujiwara, 1990). Sixty bpm and 40 bpm tempos, which correspond to 1/2 and 1/3 intervals of 120 bpm, were selected as slower tempos (Shin and Demura, 2007). ➁ The 10 m gait test…”

“…Hence, they are not effective for estimating the fall risk of the healthy elderly (O'Brien et al, 1998;Boulgarides LK et al, 2003). In addition, because any test consists of plural movements, wide spaces and sufficient measuring time are necessary (Shin and Demura, 2007). Hill et al (1996) and Nakata (2002) have devised the spot step test, which more closely resembles natural gait, to evaluate the dynamic balance ability of the elderly.…”

Examination of the Usefulness of the Obstacle-Single Leg forward Step (OSFS) Test for Evaluating Fall Risk

“…Shin and Demura (2007, 2009a, 2009b focused on this quick forward step by developing the Single leg forward step test (SFS test) which evaluates the usefulness of the elderly's fall-related physical fitness. Because, in the single-leg forward step test, participants must step forward and then return to their original position quickly, considerable strength and balance are both required in the supporting and stepping legs.…”