Reliability and fall experience discrimination of Cross Step Moving on Four Spots Test in the elderly.

Objectives: To examine the reliability and fall experience discrimination of the Cross Step Moving on Four Spots Test (CSFT) and the relationship between CSFT and fall-related physical function.

Design: The reliability of the CSFT was examined in a test-retest format with the same tester. Fall history, fall risk, fear of falling, activities of daily living (ADL), and various physical parameters were measured for all participants.

Setting: A community center and university medical school.

Participants: Elderly community-dwelling subjects (N=533; 62 men, 471 women) aged 65 to 94 years living independently.

Interventions: Not applicable.

Main Outcome Measures: Time to complete all the CSFT steps required, fall risk score, ADL score, and fall-related physical function (isometric muscle strength: toe grip, plantar flexion, knee extension, hip flexion, hand grip; balance: 1-leg standing time with eyes open, functional reach test using an elastic stick; and gait: 10-m maximal walking speed).

Results: The trial-to-trial reliability test indicated good reliability of the CSFT in both sexes (intraclass correlation coefficient =.833 in men, .825 in women). However, trial-to-trial errors increased with an increase in the CSFT values in both sexes. Significant correlations were observed between the CSFT values and scores for most fall-related physical function tests in both sexes. However, the correlation coefficient for all significant correlations was <0.5. Two-way analysis of variance (sex × fall experience) revealed that the fall experience is a significant factor affecting CSFT values; values in fallers were significantly lower than those in nonfallers. The odds ratios in logistic regression analysis were significant in both sexes (men, 1.35; women, 1.48). As determined by the Youden index, the optimal cutoff value for identifying fall experience was 7.32 seconds, with an area under the curve of .676.

Conclusions: The CSFT can detect fall experience and is useful in the evaluation of different fall-related physical functions including muscle strength, balance, and mobility.