Reliability and validity of the Four Square Step Test in children with cerebral palsy and Down syndrome

Bandong, Aila Nica; Madriaga, Gilbert; Gorgon, Edward James R.

doi:10.1016/j.ridd.2015.08.012

Cited by 16 publications

(7 citation statements)

References 30 publications

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“…Our between-days, test–retest reliability findings for performance-based tests are generally similar to reports among other patient populations [ 23 , 24 , 28 , 29 , 34 – 37 , 39 , 40 , 51 , 52 ]. For example, among adolescents and young adults with hip dysplasia and controls ( n = 34), Scott et al reported self-selected gait speed test–retest reliability over 10 timed meters of a 14-m course (ICC 2,1 = 0.93; 95%CI: 0.87-0.96), [ 23 ] similar to our 10mWT reliability results (ICC 3,k = 0.95; 95%CI: 0.90-0.97).…”

Section: Discussionsupporting

confidence: 88%

“…Our participants with AMC had better FSST performance (median: 10.52–12.01 s) than children, aged 5–12 years, with Down syndrome and cerebral palsy, (i.e., mean: 18.7 ± 5.7 s), [ 40 ] which might be due to use of the mFSST without canes in our study and/or impaired cognition or inattention in the aforementioned pediatric study. Conversely, our participants had worse dynamic balance performance as compared to adults with unilateral lower-limb amputation [ 51 ] despite being younger and our use of the mFSST; [ 39 ] differences might be attributed to multi-region, lower-limb involvement with AMC.…”

Section: Discussionmentioning

confidence: 93%

“…While many studies report FSST or mFSST within-day test–retest reliability, only a few report between-days test–retest reliability, [ 23 , 39 , 40 , 51 ] which better parallels ‘evaluations’ and ‘re-evaluations’ in clinical practice, upon which patient improvements are determined. Among children with neurological conditions ( n = 30), FSST between-days, test–retest reliability (ICC 1,1 = 0.54-0.89; 95%CI: 0.24-0.95) is reported [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…In various pediatric and adult populations, Four Square Step Test (FSST) test–retest reliability has been reported, as has concurrent, construct, and predictive validity for falls among adults [ 23 , 38 – 40 ]. With the FSST, individuals complete multi-directional stepping (i.e., forwards, lateral, and backwards) over canes arranged in a ‘ + ’ in a specified sequence [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

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Test–retest reliability for performance-based outcome measures among individuals with arthrogryposis multiplex congenita

Sions

Donohoe

Beisheim‐Ryan

et al. 2022

BMC Musculoskelet Disord

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Background Most individuals with arthrogryposis multiplex congenita, a rare condition characterized by joint contractures in ≥ 2 body regions, have foot and ankle involvement leading to compromised gait and balance. The purpose of this study was to establish between-days, test–retest reliability for performance-based outcome measures evaluating gait and balance, i.e., the 10-m Walk Test, Figure-of-8 Walk Test, 360-degree Turn Test, and modified Four Square Step Test, among adolescents and adults with arthrogryposis multiplex congenita. Methods This reliability study included ambulatory participants, aged 10 to 50 years, with a medical diagnosis of arthrogryposis multiplex congenita. Participants completed performance-based measures, in a randomized order, on two separate occasions. Intraclass correlation coefficients with 95% confidence intervals and minimal detectable changes at the 90% and 95% confidence level were calculated. Results Participants included 38 community-ambulators with a median of 13 out of 14 upper and lower joint regions affected. Intraclass correlation coefficient point estimates and 95% confidence intervals ranged from .85-.97 and .70-.98, respectively. Minimal detectable changes were 10 to 39% of sample means and were largest for the modified Four Square Step Test. Conclusions Among individuals with arthrogryposis, gait speed per the 10-m Walk Test, as well as non-linear walking and dynamic balance assessment per the Figure-of-8 Walk and 360 Degree Turn Tests, have adequate test–retest reliability enabling evaluation of individual patient changes. Changes in groups of ambulatory individuals with arthrogryposis multiplex congenita may be reliably evaluated with all of the studied outcome measures.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Test–retest reliability for performance-based outcome measures among individuals with arthrogryposis multiplex congenita

Sions

Donohoe

Beisheim‐Ryan

et al. 2022

BMC Musculoskelet Disord

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“…In recent years, in addition to these dynamic balance tests, the four square step test (FSST), which was originally designed for the elders (7), has been the subject of research for dynamic balance assessment of pediatric populations. It was shown that FSST was a valid and reliable measure for assessing the dynamic balance in children with cerebral palsy and Down syndrome (8,9). In a pilot study conducted in 15 typically developed children, Salis and Samuel have found that the FSST had good inter-and intra-rater reliability.…”

Section: Introductionmentioning

confidence: 99%

Ti̇pi̇k Geli̇şi̇m Gösteren Çocuklarda Dört Kare Adim Testi̇ni̇n Geçerli̇k Ve Güveni̇rli̇ği̇

Tüzün¹,

Eker²,

Uzuner

et al. 2020

Türk Fizyoterapi Ve Rehabilitasyon Dergisi

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The purpose of this study was to evaluate the reliability and the validity of the four square step test (FSST), and level of agreement between the FSST and the timed up and go test (TUG) in typically developed children. Methods:Two raters assessed 150 children aged 5 to 10 years in two consecutive days. Concurrent and discriminative validities were determined. To evaluate the intra-and inter-rater reliability, the intra-class correlation coefficient (ICC) was used. The Bland-Altman plot and analysis were performed to evaluate the agreement between the measurements obtained by two raters and by the FSST and TUG. Results:The FSST and TUG scores were strongly correlated (r=0.685, p=0.001). The FSST was able to distinguish between children by age groups (p=0.001). The ICC2.1 and ICC2.2 estimates were 0.86 and 0.81, respectively. For the assessments of two raters, the Bland-Altman plot showed that all values fell within 95% limits of agreement. Bias was calculated as -0.12±0.50. The 96% of the data points were within the ±1.96 SD of the mean difference for the FSST and TUG scores. Bias was calculated as 0.47±0.80. Conclusion:The FSST is a valid and reliable test to assess the dynamic balance of typically developed children. However, the FSST cannot be substituted for the TUG.

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Validity and reliability of the 3-meter backward walk test in children with cerebral palsy

et al. 2023

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Reliability and validity of the Four Square Step Test in children with cerebral palsy and Down syndrome

Cited by 16 publications

References 30 publications

Test–retest reliability for performance-based outcome measures among individuals with arthrogryposis multiplex congenita

Test–retest reliability for performance-based outcome measures among individuals with arthrogryposis multiplex congenita

Ti̇pi̇k Geli̇şi̇m Gösteren Çocuklarda Dört Kare Adim Testi̇ni̇n Geçerli̇k Ve Güveni̇rli̇ği̇

Validity and reliability of the 3-meter backward walk test in children with cerebral palsy

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