TY - JOUR
T1 - The intra-rater reliability and agreement of compensatory stepping thresholds of healthy subjects
AU - Crenshaw, Jeremy R.
AU - Kaufman, Kenton R.
N1 - Funding Information:
Funding for JRC provided by NIH T32 HD0744 . The information or content and conclusions do not necessarily represent the official position of, nor should any official endorsement be inferred by the National Institutes of Health.
PY - 2014/2
Y1 - 2014/2
N2 - The purpose of this study was to evaluate the test-retest, intra-rater reliability and agreement of compensatory stepping thresholds. A protocol was developed to establish anteroposterior single-stepping thresholds, anteroposterior multiple-stepping thresholds, and lateral single-stepping thresholds. Healthy, young subjects stood on a microprocessor-controlled treadmill, and responded to three series of progressively challenging surface translations. Subjects were instructed to "try not to step" when establishing single-stepping thresholds or "try to take only one step" when establishing multiple-stepping thresholds. Stepping thresholds were defined as the minimum disturbance magnitude that consistently elicited a single or second compensatory step. Thresholds were expressed as the ankle torque necessary to maintain upright posture. Thresholds studied included anterior single-stepping thresholds (τ=273.0. ±. 82.3. N. m), posterior single-stepping, thresholds (τ=235.5. ±. 98.0. N. m), anterior multiple-stepping thresholds (τ=977.0. ±. 416.3. N. m), posterior multiple-stepping thresholds (τ=701.9. ±. 237.5. N. m), stability-side lateral single-stepping thresholds (τ=225.7. ±. 77.7. N. m), and mobility-side lateral single-stepping thresholds (τ=236.8. ±. 85.4. N. m). Based on intraclass correlation coefficients (ICC) and Bland-Altman plots, all thresholds demonstrated excellent reliability (ICC(2,1)=0.87-0.97) and agreement. These results suggest that compensatory stepping thresholds have sufficient repeatability to be used in clinical and research-related assessments of fall-risk. Additional study is needed to determine the intra- and inter-rater reliabilities and validity of thresholds specific to the patient populations of interest.
AB - The purpose of this study was to evaluate the test-retest, intra-rater reliability and agreement of compensatory stepping thresholds. A protocol was developed to establish anteroposterior single-stepping thresholds, anteroposterior multiple-stepping thresholds, and lateral single-stepping thresholds. Healthy, young subjects stood on a microprocessor-controlled treadmill, and responded to three series of progressively challenging surface translations. Subjects were instructed to "try not to step" when establishing single-stepping thresholds or "try to take only one step" when establishing multiple-stepping thresholds. Stepping thresholds were defined as the minimum disturbance magnitude that consistently elicited a single or second compensatory step. Thresholds were expressed as the ankle torque necessary to maintain upright posture. Thresholds studied included anterior single-stepping thresholds (τ=273.0. ±. 82.3. N. m), posterior single-stepping, thresholds (τ=235.5. ±. 98.0. N. m), anterior multiple-stepping thresholds (τ=977.0. ±. 416.3. N. m), posterior multiple-stepping thresholds (τ=701.9. ±. 237.5. N. m), stability-side lateral single-stepping thresholds (τ=225.7. ±. 77.7. N. m), and mobility-side lateral single-stepping thresholds (τ=236.8. ±. 85.4. N. m). Based on intraclass correlation coefficients (ICC) and Bland-Altman plots, all thresholds demonstrated excellent reliability (ICC(2,1)=0.87-0.97) and agreement. These results suggest that compensatory stepping thresholds have sufficient repeatability to be used in clinical and research-related assessments of fall-risk. Additional study is needed to determine the intra- and inter-rater reliabilities and validity of thresholds specific to the patient populations of interest.
KW - Balance
KW - Clinical assessments
KW - Falls
KW - Older adults
KW - Stability
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U2 - 10.1016/j.gaitpost.2013.11.006
DO - 10.1016/j.gaitpost.2013.11.006
M3 - Article
C2 - 24300837
AN - SCOPUS:84892786056
SN - 0966-6362
VL - 39
SP - 810
EP - 815
JO - Gait and Posture
JF - Gait and Posture
IS - 2
ER -