Reliability and validity of Six-Spot Step Test (SSST) in stroke survivors

Area of Science:

• Neurorehabilitation
• Clinical Biomechanics
• Motor Control

Background:

• The Six-Spot Step Test (SSST) was developed to evaluate walking ability and balance in multiple sclerosis patients.
• It offers more comprehensive ambulatory assessment than existing tests like the Timed Up and Go (TUG) test.
• The SSST was modified to assess advanced balance control in stroke survivors.

Purpose of the Study:

• To evaluate the psychometric properties of the modified SSST.
• To assess its reliability and validity in healthy older adults and stroke survivors.

Main Methods:

• An experimental design was employed in a university-affiliated neurorehabilitation laboratory.
• Fifty participants (25 chronic stroke survivors, 25 healthy older adults) were recruited.
• Stroke survivors underwent SSST twice, along with Fugl-Meyer assessment for lower extremities (FMA-LE), Berg Balance Scale (BBS), limit of stability (LOS) test, TUG test, and Community Integration Measures (CIM-C). Healthy controls only performed the SSST.

Main Results:

• The SSST demonstrated excellent reliability (inter-rater, intra-rater, test-retest; ICC >0.95).
• Significant correlations were observed between SSST performance and FMA-LE (r=0.517), BBS (r=-0.531), and TUG test (r=0.828) scores.
• Minimal detectable change (MDC) for SSST time was 6.05s; cutoff times for affected/unaffected leg kicking obstacles were 10.11s/10.18s, respectively (80% sensitivity, 92% specificity).

Conclusions:

• The SSST is a reliable measure for stroke survivors.
• It shows significant correlations with established clinical assessments (FMA-LE, BBS, TUG).
• The SSST is suitable for evaluating advanced balance control in stroke survivors, aiding clinical rehabilitation.