Validity and reliability of a simple 'low-tech' test for measuring choice stepping reaction time in older people

Clin Rehabil. 2016 Nov;30(11):1128-1135. doi: 10.1177/0269215515613422. Epub 2016 Jul 11.

Abstract

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.

Design: Cross-sectional.

Setting: Community.

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

Main measures: 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.

Keywords: Choice stepping reaction time; accidental falls; aged; assessment; portable test.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Choice Behavior
  • Cross-Sectional Studies
  • Exercise Test / methods*
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Independent Living
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Postural Balance
  • Predictive Value of Tests
  • Reaction Time*
  • Sensation Disorders / diagnosis*