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An Instrumented Pull Test to Characterize Postural Responses

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The Spring Scale Test: a reliable and valid tool for explaining fall history.

Louis DePasquale¹, Lisa Toscano

¹Visiting Nurse Service of New York, NY, USA. depasqualept@aol.com

Journal of Geriatric Physical Therapy (2001)

|May 18, 2010

Summary

The new Spring Scale Test (SST) reliably measures standing balance in older adults. This perturbation-based test effectively identifies individuals with a history of falls, aiding in fall prevention strategies.

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Area of Science:

Gerontology
Biomechanics
Clinical Assessment

Background:

Falls are a significant concern for older adults, often resulting from balance impairments.
Objective, practical balance tests incorporating perturbations are less common than other balance measures.

Purpose of the Study:

To introduce and describe the Spring Scale Test (SST), a novel clinical protocol for assessing balance using waist-pull perturbations.
To evaluate the test-retest reliability of the SST.
To examine the convergent and known groups validity of the SST against established balance and gait assessments.

Main Methods:

Fifty-eight community-dwelling older adults, including fallers and non-fallers, participated in same-day test-retest assessments of the SST.
The SST involved predictable, incremental, horizontal manual waist pulls, measuring the force required to perturb balance.
Participants were categorized into fallers (at least one fall in 2 years) and non-fallers.

Main Results:

The SST demonstrated high test-retest reliability (ICC = 0.94).
Significant differences in SST performance were observed between fallers (7.5% Total Body Weight) and non-fallers (12.3% Total Body Weight).
The SST showed moderate to good convergent validity with gait speed, single limb stance, tandem stance, and Timed Up and Go tests. The SST 10% Total Body Weight cutoff demonstrated high known groups validity for predicting fall history (AUC = 0.99, sensitivity = 0.93, specificity = 0.97).

Conclusions:

The Spring Scale Test (SST) is a reliable and valid quantitative measure for assessing standing balance in a clinical setting.
The SST, particularly the 10% Total Body Weight cutoff score, is a highly effective indicator of an individual's fall history.