Sage Journals: Discover world-class research

Abstract

BACKGROUND:

Clinical tests that can discriminate between people at risk of falling and those not at risk are warranted. The discriminative properties of the Six-Spot Step Test was investigated in people with Parkinson’s disease at risk of falling.

METHODS:

Eighty-one participants with a median age of 69 years (Q1–Q3:63–74) and a median Hoehn and Yahr score of 2.5 (Q1–Q3:2–3) completed the Six-Spot Step Test and the Timed “Up and Go” test. A mini-BESTest score of 19 or below was used as a cut-off for defining risk of falling, and a receiver operating characteristics curve was generated to determine clinical relevant cut-off scores.

RESULTS:

A cut-off score of 7.0 and 6.8 seconds identified people not at risk of falling, while 11.1 and 9.4 seconds identified people at risk of falling for the Six-Spot Step Test and the Timed “Up and Go” test, respectively. When maximizing the sensitivity and specificity a cut-off score of 9.2 (accuracy of 84%) and 8.1 seconds (accuracy of 70%) was found for the Six-Spot Step Test and the Timed “Up and Go” test, respectively.

CONCLUSION:

The Six-Spot Step Test discriminates accurately between people with Parkinson’s disease at risk of falling and people not at risk.

Keywords

Walking agility risk of falling Parkinson’s disease clinical test discriminative properties

Get full access to this article

View all access options for this article.

References

Arvidsson Lindvall,

, Anderzén-Carlsson,

, Appelros,

, & Forsberg,

(2018). Validity and test–retest reliability of the six-spot step test in persons after stroke. Physiotherapy Theory and Practice, 1–8.

Bloem,

B. R.

, Marinus,

, Almeida,

, Dibble,

, Nieuwboer,

, Post,

, . . .& Schrag,

(2016). Measurement instruments to assess posture, gait, and balance in Parkinson’s disease: Critique and recommendations. Movement Disorders, 31(9), 1342–1355.

Brincks,

, Callesen,

, Dalgas,

, & Johnsen,

(2019). Test-retest reliability and limits of agreement of the Six-Spot Step Test in people with Parkinson’s disease Article. Clinical Rehabilitation, 33(2), 285–292.

Brincks,

, Callesen,

, Johnsen,

, & Dalgas,

(2019). A study of the validity of the Six-Spot Step Test in ambulatory people with Parkinson’s disease. Clinical Rehabilitation, 33(7), 1206–1213.

Callesen,

, Richter,

, Kristensen,

, Sunesen,

, Næsby,

, Dalgas,

, & Skjerbæk,

A. G.

(2019). Test–retest agreement and reliability of the Six Spot Step Test in persons with multiple sclerosis. Multiple Sclerosis Journal, 25(2), 286–294.

Dibble,

L. E.

, & Lange,

(2006). Predicting falls in individuals with Parkinson disease: A reconsideration of clinical balance measures. Journal of Neurologic Physical Therapy: JNPT, 30(2), 60–67.

Franchignoni,

, Horak,

, Godi,

, Nardone,

, & Giordano,

(2010). Using psychometric techniques to improve the Balance Evaluation Systems Test: The mini-BESTest. Journal of Rehabilitation Medicine, 42(4), 323–331.

Goetz,

C. G.

, Poewe,

, Rascol,

, Sampaio,

, Stebbins,

G. T.

, Counsell,

, . . .& Seidl,

(2004). Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations TheDisorder Society Task Force on rating scales for Parkinson’s disease. Movement Disorders, 19(9), 1020–1028.

Hoo,

Z. H.

, Candlish,

, & Teare,

(2017). What is an ROC curve? Emergency Medicine Journal: EMJ, 34(6), 357–359.

10.

Jaeschke,

, Guyatt,

G. H.

, Sackett,

D. L.

, Guyatt,

, Bass,

, Brill-Edwards,

, . . .& Wilson,

(1994). Users’ Guides to the Medical Literature. JAMA, 271(9), 703.

11.

King,

L. A.

, Priest,

K. C.

, Salarian,

, Pierce,

, & Horak,

F. B.

(2012). Comparing the Mini-BESTest with the Berg Balance Scale to Evaluate Balance Disorders in Parkinson’s Disease. Parkinson’s Disease, 2012, 1–7.

12.

King,

, & Horak,

(2013). On the Mini-BESTest: Scoring and the Reporting of Total Scores. Physical Therapy, 93(4), 571–575.

13.

Kreutzfeldt,

, Jensen,

H. B.

, Ravnborg,

, Markvardsen,

L. H.

, Andersen,

, & Sindrup,

S. H.

(2017). The six-spot-step test - a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy. Journal of the Peripheral Nervous System, 22(2), 131–138.

14.

Leddy,

A. L.

, Crowner,

B. E.

, & Earhart,

G. M.

(2011). Utility of the Mini-BESTest, BESTest, and BESTest Sections for Balance Assessments in Individuals With Parkinson Disease. Journal of Neurologic Physical Therapy, 35(2), 90–97.

15.

Mak,

, & Auyeung,

(2013). The mini-BESTest can predict Parkinsonian recurrent fallers: A 6-month prospective study. Journal of Rehabilitation Medicine, 45(6), 565–571.

16.

Nieuwenhuis,

M. M.

, Tongeren,

, Van, Sorensen,

P. S.

, & Ravnborg,

(2006). The six spot step test: A new measurement for walking ability in multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England), 12(4), 495–500.

17.

Podsiadlo,

, & Richardson,

(1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148.

18.

Sandroff,

B. M.

, Motl,

R. W.

, Sosnoff,

J. J.

, & Pula,

J. H.

(2015). Further validation of the Six-Spot Step Test as a measure of ambulation in multiple sclerosis. Gait & Posture, 41(1), 222–227.

19.

Simel,

D. L.

, Samsa,

G. P.

, & Matchar,

D. B.

(1991). Likelihood ratios with confidence: Sample size estimation for diagnostic test studies. Journal of Clinical Epidemiology, 44(8), 763–770.

20.

Yvette Am Grimbergen,

M. M. B. R. B.

(2004). Falls in Parkinson’s disease. Current Opinion in Neurology, 17(4), 405–415.

A study of the discriminative properties of the Six-Spot Step Test in people with Parkinson’s disease at risk of falling