Abstract
Introduction: The Six Spot Step Test (SSST) is a complex measure of gait function developed to test people with multiple sclerosis (MS). In addition to fast walking, it also encompasses acceleration, balance and coordination. Despite increasing use in clinical practice and research, no studies have so far investigated the within-day and day-to-day variability.
Purpose: This study investigated the reliability in repeated measures of the SSST test within and between days in persons with MS.
Method: 38 MS-inpatients (EDSS 1-6, age 34-76, female: 68%) underwent a SSST and 5 min. later a re-test. This procedure was repeated two days later under the same conditions. Time was measured on a handheld stopwatch. Bland-Altman analyses were used to estimate relative and absolute 95% Limits of Agreement (LOA). Sub-analyzes with stratification for gait speed and assistive devices were conducted.
Results: Day-to-day and between-day agreements relative to the test time were ±15% and ±19% respectively (n=38). Variation in repeated measures tended to increase as test time increased. For tests performed in less than 20 sec. (n=32), absolute LOA within days and between days were ±1.5 sec. and ±2.2 sec. respectively. In tests performed without assistive devices LOA were for both outcomes ±1.7 sec. A tendency towards a learning effect from repeated measures was observed with an estimated effect of < 0.4 sec.
Conclusion: The SSST test has an acceptable within- and day-to-day reliability, despite a potential minor learning effect. For interventional purposes a change of >19% can generally be regarded as a real change. Absolute reliability tends to depend on disability level and cautious use is recommended when assistive devices is required or when the test is performed at a very slow speed.
Purpose: This study investigated the reliability in repeated measures of the SSST test within and between days in persons with MS.
Method: 38 MS-inpatients (EDSS 1-6, age 34-76, female: 68%) underwent a SSST and 5 min. later a re-test. This procedure was repeated two days later under the same conditions. Time was measured on a handheld stopwatch. Bland-Altman analyses were used to estimate relative and absolute 95% Limits of Agreement (LOA). Sub-analyzes with stratification for gait speed and assistive devices were conducted.
Results: Day-to-day and between-day agreements relative to the test time were ±15% and ±19% respectively (n=38). Variation in repeated measures tended to increase as test time increased. For tests performed in less than 20 sec. (n=32), absolute LOA within days and between days were ±1.5 sec. and ±2.2 sec. respectively. In tests performed without assistive devices LOA were for both outcomes ±1.7 sec. A tendency towards a learning effect from repeated measures was observed with an estimated effect of < 0.4 sec.
Conclusion: The SSST test has an acceptable within- and day-to-day reliability, despite a potential minor learning effect. For interventional purposes a change of >19% can generally be regarded as a real change. Absolute reliability tends to depend on disability level and cautious use is recommended when assistive devices is required or when the test is performed at a very slow speed.
| Original language | Danish |
|---|---|
| Publication date | 2018 |
| Publication status | Published - 2018 |
| Externally published | Yes |
| Event | Danske Fysioterapeuters Fagkongress 2018 - Odense Congress Center, Odense, Denmark Duration: 12. Apr 2018 → 14. Apr 2018 |
Conference
| Conference | Danske Fysioterapeuters Fagkongress 2018 |
|---|---|
| Location | Odense Congress Center |
| Country/Territory | Denmark |
| City | Odense |
| Period | 12/04/2018 → 14/04/2018 |