Development of a rapid stepping test to challenge rapid weight-shifting function in older adults

The ability to step rapidly, shift weight from side-to-side, and maintain temporal rhythmicity are important functional elements for walking independently and preventing falls in seniors.

The purpose of this study was to develop a clinically feasible test of rapid stepping performance that challenges the ability to step rapidly, shift weight from side-to-side, and maintain temporal rhythmicity.

Participants were a volunteer sample of healthy, self-ambulating older adults aged 70-98 years. A Repeated Alternating Stair Touch Test was developed, which involved rapidly shifting weight in the medial-lateral direction by tapping each foot alternately onto a step. Performance on the test was assessed using trunk acceleration signals. Associations between the number of steps completed on the Repeated Alternating Stair Touch Test in 20 s and acceleration magnitude, variability, and stepping rhythmicity were assessed using Pearson correlations and linear regression. Repeatability was assessed during a 2-week follow-up period.

The acceleration magnitude, variability, and stepping rhythmicity variables related moderately with the number of steps on the Repeated Alternating Stair Touch Test (r = 0.534-0.572, p < 0.05) and were independent predictors of the number of steps taken (R ² adj. = 0.624, p < 0.001). Repeatability was mixed, though most acceleration variables and number of steps had moderate to high correlations between sessions (intraclass correlations: 0.486-0.828), but a learning effect was evident; performance improved between sessions.

The Repeated Alternating Stair Touch Test has potential as a simple test of rapid, rhythmic weight-shifting function, but requires modification to improve repeatability.