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Published on: September 1, 2023
Examining the test-retest reliability and construct validity of the Six-Spot Step Test in older adults with
John Brincks1, Jacob Callesen1
1Faculty of Health Science, VIA University College, Research Centre for Health and Welfare Technology - Programme for Rehabilitation, Aarhus, Denmark.
Objective:
To evaluate the test-retest reliability and construct validity of the Six-Spot Step Test in older adults.
Design:
Cross-sectional study.
Setting:
Outpatient clinics.
Subjects:
Sixty-six adults aged ⩾65 years with self-reported balance problems.
Main Measure:
The Six-Spot Step Test was completed twice on day 1. Three days later, the Six-Spot Step Test, the Timed "Up and Go" test, Dynamic Gait Index, the Mini-BESTest, and standing balance test were conducted. Reliability and validity were estimated using Bland-Altman statistics, minimal detectable change, Intraclass Correlation Coefficient (ICC), and Spearman's rank correlation coefficient (ρ).
Results:
Participants had a mean (SD) age of 75.5 (6.6) years, a median (Q1-Q3) Montreal Cognitive Assessment test score of 26 (24-27), and a median (Q1-Q3) Falls Efficacy Scale International score of 22 (20-26). The study found within-day and between-day limits of agreements of ±15.7% and ±18.1%, respectively. The minimal detectable changes at the 95% level of confidence for within-day and between-day were 17.5% and 21.6%, and the ICCs were 0.96 (CI: 0.92-0.98) and 0.94 (CI: 0.86-0.97), respectively. A learning effect was observed between the first and second Six-Spot Step Test. Moderate to strong correlations were found between the Six-Spot Step Test and Mini-BESTest (ρ = -0.62), Dynamic Gait Index (ρ = -0.55), and the Timed "Up and Go" test (ρ = 0.79). Weak correlations were identified between the Six-Spot Step Test and static standing balance test (ρ < 0.38).
Conclusion:
The Six-Spot Step Test shows excellent relative consistency and moderate to high construct validity in older adults. A change of 21.6% is a true change in outcome.
