The four square step test in children with Down syndrome: Reliability and concurrent validity.

Area of Science:

• Pediatric physical therapy
• Neurology
• Developmental disorders

Background:

• Assessing balance is crucial for children with Down syndrome (DS) to understand their functional mobility.
• The Four Square Step Test (FSST) is a potential tool for measuring dynamic balance, but its reliability and validity in children with DS require investigation.

Purpose of the Study:

• To determine the test-retest and inter-rater reliability of the FSST in children with Down syndrome.
• To validate the FSST against a criterion measure of dynamic balance (Functional Reach Test - FRT) in this population.

Main Methods:

• A cross-sectional study involving 13 children with DS who performed the FSST.
• Test-retest reliability was assessed by the principal investigator performing the FSST twice.
• Inter-rater reliability was evaluated by two investigators, and concurrent validity was determined using the FRT.

Main Results:

• The FSST exhibited good test-retest reliability (ICC(1,1) = 0.70) and inter-rater reliability (ICC(2,1) = 0.78).
• Bland-Altman limits of agreement supported the reliability findings.
• Concurrent validity between the FRT and FSST was moderate (Spearman's ρ = -0.58).

Conclusions:

• The FSST is a reliable tool for measuring balance in children with Down syndrome.
• The FSST demonstrates moderate to good concurrent validity, suggesting its utility in assessing dynamic balance in this population.