Dataset Information

The Step Test Evaluation of Performance on Stairs (STEPS): Validation and reliability in a neurological disorder.

ABSTRACT:

Background

Individuals with neurological disorders often have difficulty negotiating stairs that can lead to injurious falls. Clinicians lack a clinical tool to identify impairments in stair negotiation and to assist their decision making regarding treatment plans to improve stair performance and safety. We developed a new tool called the Step Test Evaluation of Performance on Stairs (STEPS) that is designed to assess stair performance and safety in neurological populations.

Objectives

This study aimed to determine interrater and intrarater reliability of STEPS and its concurrent content validity to various clinical balance and mobility measures using individuals with Huntington's disease (HD) as the first test population.

Methods

Forty individuals with HD (mean age 50.35) participated. Three observers rated live performances of the STEPS (interrater reliability) and seven observers rated videotaped performances twice (intrarater reliability). STEPS scores correlated with clinical mobility and balance test scores.

Results

Excellent inter- and intrarater reliability (ICCs = 0.91 and 0.89 respectively) and good internal consistency (? = 0.83) were found. Better STEPS performance correlated with better performance on co-administered motor and mobility measures and Stair Self-Efficacy scores. Per multivariable regression analysis, the Unified Huntington's Disease Rating Scale modified motor score and descent time were significant predictors of STEPS performance.

Conclusions

The STEPS tool is easy to administer, requires no special devices and can be completed in less than five minutes. In the HD test population, it shows high reliability and validity making it a potentially useful tool for assessing maneuverability and safety on stairs in HD. The results suggest that the STEPS tool warrants further study to determine STEPS cut-off values for fall prediction in HD and may prove useful as an assessment tool for other neurological disorders.

SUBMITTER: Kloos AD

PROVIDER: S-EPMC6428278 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Step Test Evaluation of Performance on Stairs (STEPS): Validation and reliability in a neurological disorder.

Kloos Anne D AD Kegelmeyer Deb A DA Ambrogi Katherine K Kline David D McCormack-Mager Meredith M Schroeder Brittany B Kostyk Sandra K SK

PloS one 20190321 3

<h4>Background</h4>Individuals with neurological disorders often have difficulty negotiating stairs that can lead to injurious falls. Clinicians lack a clinical tool to identify impairments in stair negotiation and to assist their decision making regarding treatment plans to improve stair performance and safety. We developed a new tool called the Step Test Evaluation of Performance on Stairs (STEPS) that is designed to assess stair performance and safety in neurological populations.<h4>Objective ...[more]

PMID: 30897107

Similar Datasets

Project description:BACKGROUND:To assess whether commercial-grade activity monitors are appropriate for measuring step counts in older adults, it is essential to evaluate their measurement properties in this population. OBJECTIVE:This study aimed to evaluate test-retest reliability and criterion validity of step counting in older adults with self-reported intact and limited mobility from 6 commercial-grade activity monitors: Fitbit Charge, Fitbit One, Garmin vívofit 2, Jawbone UP2, Misfit Shine, and New-Lifestyles NL-1000. METHODS:For test-retest reliability, participants completed two 100-step overground walks at a usual pace while wearing all monitors. We tested the effects of the activity monitor and mobility status on the absolute difference in step count error (%) and computed the standard error of measurement (SEM) between repeat trials. To assess criterion validity, participants completed two 400-meter overground walks at a usual pace while wearing all monitors. The first walk was continuous; the second walk incorporated interruptions to mimic the conditions of daily walking. Criterion step counts were from the researcher tally count. We estimated the effects of the activity monitor, mobility status, and walk interruptions on step count error (%). We also generated Bland-Altman plots and conducted equivalence tests. RESULTS:A total of 36 individuals participated (n=20 intact mobility and n=16 limited mobility; 19/36, 53% female) with a mean age of 71.4 (SD 4.7) years and BMI of 29.4 (SD 5.9) kg/m2. Considering test-retest reliability, there was an effect of the activity monitor (P<.001). The Fitbit One (1.0%, 95% CI 0.6% to 1.3%), the New-Lifestyles NL-1000 (2.6%, 95% CI 1.3% to 3.9%), and the Garmin vívofit 2 (6.0%, 95 CI 3.2% to 8.8%) had the smallest mean absolute differences in step count errors. The SEM values ranged from 1.0% (Fitbit One) to 23.5% (Jawbone UP2). Regarding criterion validity, all monitors undercounted the steps. Step count error was affected by the activity monitor (P<.001) and walk interruptions (P=.02). Three monitors had small mean step count errors: Misfit Shine (-1.3%, 95% CI -19.5% to 16.8%), Fitbit One (-2.1%, 95% CI -6.1% to 2.0%), and New-Lifestyles NL-1000 (-4.3%, 95 CI -18.9% to 10.3%). Mean step count error was larger during interrupted walking than continuous walking (-5.5% vs -3.6%; P=.02). Bland-Altman plots illustrated nonsystematic bias and small limits of agreement for Fitbit One and Jawbone UP2. Mean step count error lay within an equivalence bound of ±5% for Fitbit One (P<.001) and Misfit Shine (P=.001). CONCLUSIONS:Test-retest reliability and criterion validity of step counting varied across 6 consumer-grade activity monitors worn by older adults with self-reported intact and limited mobility. Walk interruptions increased the step count error for all monitors, whereas mobility status did not affect the step count error. The hip-worn Fitbit One was the only monitor with high test-retest reliability and criterion validity.

Project description:Background and purposePreventing subsequent falls in persons recovering from hip fracture is paramount. The Four Square Step Test (FSST) is a fast, easy measure of dynamic balance, with times more than 15 seconds previously associated with multiple fall risk in older adults. This study investigates among hip fracture patients (1) FSST performance, and how (2) unique population characteristics (such as fracture side) and (3) cognition impact FSST performance.MethodsPatients with hip fracture (n = 40) 60 years and older came from an ancillary study to a larger randomized controlled trial testing two 16-week in-home physical therapy interventions after completion of usual care rehabilitation. Baseline measurers included: FSST, demographics, fracture characteristics, Modified Mini-Mental State Examination (3MS), Hooper Visual Organization Test (HVOT), and Trails Making Tests (TMT) A and B.ResultsOf 40 patients with hip fracture, 13 did not complete the FSST at baseline and were significantly older (P = .040) and performed worse on cognitive tests (3MS, HVOT, TMT-B; P < .05). Mean FSST time was 24.3 ± 13.1 seconds for the other 27, of whom 7 finished in less than 15 seconds. A significant 3-way interaction was observed, such that those with left-side pertrochanteric fractures who performed poorly on the HVOT did significantly worse on the FSST (P < .01, R2 = 0.93).DiscussionAlmost one-third of patients with hip fracture could not perform the FSST after completing usual care rehabilitation. Inability to perform the FSST was not random, as those without the FSST were physically and cognitively worse than those who did perform the FSST. Among those who could attempt the FSST, few performed well. Cognitive ability related to spatial orientation and fracture characteristics such as fracture side and fracture type has a synergistic effect on FSST performance.ConclusionsThis is one of the first studies to assess the FSST in a population with hip fracture. At 4 months after hip fracture, most patients cannot perform the FSST in less than 15 seconds. Fracture side and fracture type appear important to FSST performance, as does cognition. More work needs to be done longitudinally to study the FSST in patients with hip fracture.

Project description:Main aim of this study was examining validity and reliability of using a new specific Parkour repeated sprint ability test (SPRSA) for assessing repeated sprint ability while facing obstacles and establishing between-day reliability and sensitivity of SPRSA related to its physiological and performance responses. Thirteen high-level traceurs (three females) performed in random order and twice eight tests for assessing a total of 23 variables: SPRSA (a typical maximal-speed shuttle run interspersed with four Parkour competition-common fundamentals) and seven established fitness tests, core stability, hand-grip, vertical-jump, long-jump, pull-up, 300-m shuttle run (as a field test for anaerobic capacity), and Leger test. Except for muscular elasticity index of vertical jump test (intra-class Correlation Coefficient model 3,1 [ICC3,1] = 0.54 [fair]), fitness tests' ICC3,1s resulted excellent (ICC3,1: 0.93-1.00). SPRSA total time and time of its fastest sprint (SPRSA peak time) were significantly correlated with the majority of core stability (r: -0.79 to 0.59; P < 0.01-0.05), jumping (r: -0.78 to 0.67; P < 0.01-0.05), pull-up tests (r: -0.86; P < 0.01), 300-m shuttle run test total time (r: 0.77-0.82; P < 0.01), and Leger test-estimated VO2 max (r: -0.78; P < 0.01). Principal component analysis (PCA) of the 23 variables led to extraction of four significant components (each due to different variables' combinations), which explained 90.2% of 23 variables' total variance. SPRSA (i.e., total and peak time) showed high reliability (ICC3,1: 0.991-0.998 and standard-error-of-measurement %: 0.07-0.32). Finally, SPRSA showed high sensitivity (smallest-worthwhile-change %: 0.29-0.68). Considering its excellent logical and strong ecological validity, SPRSA may serve as a valid specific field test for Parkour sport. In addition, thanks to its high reliability and sensitivity, this test is suitable for monitoring, evaluating, and programming training processes for Parkour practitioners in repeated sprint ability involving crossing obstacles.

Dataset Information

The Step Test Evaluation of Performance on Stairs (STEPS): Validation and reliability in a neurological disorder.

Background

Objectives

Methods

Results

Conclusions

Publications

The Step Test Evaluation of Performance on Stairs (STEPS): Validation and reliability in a neurological disorder.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets