Validity and reliability of a simple 'low-tech' test for measuring choice stepping reaction time in older people.
OBJECTIVE
To establish the psychometric properties of a simple 'low-tech' choice stepping reaction time test (CSRT-M) by investigating its validity and test-retest reliability.


METHODS
Cross-sectional.


METHODS
Community.


METHODS
A total of 169 older people from the control arm of a clinical trial and a convenience sample of 30 older people.


METHODS
Demographic, physical, cognitive and prospective falls data were collected in addition to CSRT-M. The CSRT-M time was taken as the total time to complete 20 steps onto four targets printed on a portable rubber mat. Assessment of the original electronic version (CSRT-E) and re-administration of the CSRT-M the next day was done in 30 participants.


RESULTS
Multivariate regression analysis showed that the CSRT-M time was best explained by leaning balance control, quadriceps strength and cognitive functioning (R2= 0.44). Performance on the CSRT-M was worse in older participants and participants with a presence of fall risk factors, supporting good discriminant validity. The odds of suffering multiple future falls increased by 74% (odds ratio (OR) = 1.74, 95% CI (confidence interval) = 1.14-2.65, p = 0.010) for each standard deviation increase in CSRT-M, supporting good predictive validity. Criterion validity was confirmed by a strong bivariate correlation between CSRT-M and CSRT-E (0.81, p < 0.001). Test-retest reliability for the CSRT-M was good (intraclass correlation coefficient = 0.74, 95% CI = 0.45-0.88, p < 0.001).


CONCLUSIONS
A simple test of unplanned volitional stepping (CSRT-M) has excellent predictive validity for future falls, good inter-day test-retest reliability and excellent criterion validity with respect to the well-validated CSRT-E. The CSRT-M, therefore, may be a useful fall risk screening tool for older people.
1 NeuRA, University of New South Wales, Sydney, New South Wales, Australia.
K
K
Delbaere
1 NeuRA, University of New South Wales, Sydney, New South Wales, Australia.
Y J
YJ
Gschwind
1 NeuRA, University of New South Wales, Sydney, New South Wales, Australia.|2 The George Institute for Global Health, The University of Sydney, Sydney, Australia.
C
C
Sherrington
2 The George Institute for Global Health, The University of Sydney, Sydney, Australia.
E
E
Barraclough
1 NeuRA, University of New South Wales, Sydney, New South Wales, Australia.|3 Physiology Department, University of the Basque Country, Leioa, Spain.
M A
MA
Garrués-Irisarri
1 NeuRA, University of New South Wales, Sydney, New South Wales, Australia.
S R
SR
Lord
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D004856:Postural Balance; D011237:Predictive Value of Tests; D011930:Reaction Time; D012678:Sensation Disorders / Q000175:diagnosis*
Choice stepping reaction time; accidental falls; aged; assessment; portable test