Step Test Evaluation of Performance on Stairs (STEPS): Assessing Stair Function in Older Adults.


Journal

Journal of geriatric physical therapy (2001)
ISSN: 2152-0895
Titre abrégé: J Geriatr Phys Ther
Pays: United States
ID NLM: 101142169

Informations de publication

Date de publication:
14 May 2024
Historique:
medline: 15 5 2024
pubmed: 15 5 2024
entrez: 14 5 2024
Statut: aheadofprint

Résumé

Stair negotiation is crucial for functional independence and is a leading cause of fall-related injuries in older adults. The Step Test Evaluation of Performance on Stairs (STEPS) is a quick and easily administered outcome measure for assessing stair negotiation. This study investigated the reliability and concurrent content validity of the STEPS test to determine its usefulness in older adults. Eighty-two community-dwelling older adults (mean age 81.2 years, 51 females) were assessed on the STEPS test, Timed Up and Go (TUG), 5-times sit to stand (5XSTS), stair self-efficacy (SSE) questionnaire, and time to ascend and descend stairs. Participants repeated the STEPS test 7 to 14 days later for intrarater reliability by the same rater. Spearman rank and intraclass correlations were used to determine the association of measures and intrarater reliability. The mean STEPS score was 15.6 (SD = 3.7) out of 20. The STEPS total score demonstrated excellent intra- and interrater reliability. It had moderate to good and significant correlations with TUG, 5XSTS, SSE, and time to ascend and descend measures. Faster performance on the 5XSTS, TUG, and time to ascend and descend correlated with better performance on the STEPS test, indicating validity for assessing balance and mobility during stair negotiation in older adults. Lower SSE correlated with lower observer ratings of performance on stairs (STEPS scores), indicating agreement between participant reports of self-efficacy and observer ratings of performance. Step Test Evaluation of Performance on Stairs items that demonstrated the most frequent loss of points were balance (use of handrail), step continuity, foot placement, and self-propulsion (ascent only). Assessment of older adults' safety and performance on stairs is vital given the increased difficulty of stair navigation and the high risk for injurious falls in this population. This study demonstrates that the STEPS test is a reliable and valid outcome measure for assessing stair performance in older adults.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
Stair negotiation is crucial for functional independence and is a leading cause of fall-related injuries in older adults. The Step Test Evaluation of Performance on Stairs (STEPS) is a quick and easily administered outcome measure for assessing stair negotiation. This study investigated the reliability and concurrent content validity of the STEPS test to determine its usefulness in older adults.
METHODS METHODS
Eighty-two community-dwelling older adults (mean age 81.2 years, 51 females) were assessed on the STEPS test, Timed Up and Go (TUG), 5-times sit to stand (5XSTS), stair self-efficacy (SSE) questionnaire, and time to ascend and descend stairs. Participants repeated the STEPS test 7 to 14 days later for intrarater reliability by the same rater. Spearman rank and intraclass correlations were used to determine the association of measures and intrarater reliability.
RESULTS AND DISCUSSION CONCLUSIONS
The mean STEPS score was 15.6 (SD = 3.7) out of 20. The STEPS total score demonstrated excellent intra- and interrater reliability. It had moderate to good and significant correlations with TUG, 5XSTS, SSE, and time to ascend and descend measures. Faster performance on the 5XSTS, TUG, and time to ascend and descend correlated with better performance on the STEPS test, indicating validity for assessing balance and mobility during stair negotiation in older adults. Lower SSE correlated with lower observer ratings of performance on stairs (STEPS scores), indicating agreement between participant reports of self-efficacy and observer ratings of performance. Step Test Evaluation of Performance on Stairs items that demonstrated the most frequent loss of points were balance (use of handrail), step continuity, foot placement, and self-propulsion (ascent only).
CONCLUSIONS CONCLUSIONS
Assessment of older adults' safety and performance on stairs is vital given the increased difficulty of stair navigation and the high risk for injurious falls in this population. This study demonstrates that the STEPS test is a reliable and valid outcome measure for assessing stair performance in older adults.

Identifiants

pubmed: 38744442
doi: 10.1519/JPT.0000000000000415
pii: 00139143-990000000-00049
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 APTA Geriatrics, An Academy of the American Physical Therapy Association.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

Références

Hinman MR, O’Connell JK, Dorr M, Hardin R, Tumlinson AB, Varner B. Functional predictors of stair-climbing speed in older adults. J Geriatr Phys Ther. 2014;37(1):1-6. doi:10.1519/JPT.0b013e318298969f
doi: 10.1519/JPT.0b013e318298969f
Stessman J, Rottenberg Y, Jacobs JM. Climbing stairs, handrail use, and survival. J Nutr Health Aging. 2017;21(2):195-201. doi:10.1007/s12603-016-0763-5
doi: 10.1007/s12603-016-0763-5
Jacobs JV. A review of stairway falls and stair negotiation: lessons learned and future needs to reduce injury. Gait Posture. 2016;49:159-167. doi:10.1016/j.gaitpost.2016.06.030
doi: 10.1016/j.gaitpost.2016.06.030
Tiedemann AC, Sherrington C, Lord SR. Physical and psychological factors associated with stair negotiation performance in older people. J Gerontol A Biol Sci Med Sci. 2007;62(11):1259-1265. doi:10.1093/gerona/62.11.1259
doi: 10.1093/gerona/62.11.1259
Blanchet R, Edwards N. A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review. BMC Geriatr. 2018;18(1):272. doi:10.1186/s12877-018-0958-1
doi: 10.1186/s12877-018-0958-1
Elliott DB, Foster RJ, Whitaker D, Scally AJ, Buckley JG. Analysis of Lower Limb Movement to Determine the Effect of Manipulating the Appearance of Stairs to Improve Safety: A Linked Series of Laboratory-Based, Repeated Measures Studies. Southampton (UK); 2015.
Sharma S, Wilson R, Pryymachenko Y, et al. Reliability, validity, responsiveness, and minimum important change of the Stair Climb Test in adults with hip and knee osteoarthritis. Arthritis Care Res (Hoboken). 2023;75(5):1147-1157. doi:10.1002/acr.24821
doi: 10.1002/acr.24821
Stratford PW, Kennedy D, Pagura SM, Gollish JD. The relationship between self-report and performance-related measures: questioning the content validity of timed tests. Arthritis Rheum. 2003;49(4):535-540. doi:10.1002/art.11196
doi: 10.1002/art.11196
Nightingale EJ, Pourkazemi F, Hiller CE. Systematic review of timed stair tests. J Rehabil Res Dev. 2014;51(3):335-350. doi:10.1682/jrrd.2013.06.0148
doi: 10.1682/jrrd.2013.06.0148
Conway ZJ, Blackmore T, Silburn PA, Cole MH. Dynamic balance control during stair negotiation for older adults and people with Parkinson disease. Hum Mov Sci. 2018;59:30-36. doi:10.1016/j.humov.2018.03.012
doi: 10.1016/j.humov.2018.03.012
Kloos AD, Kegelmeyer DA, Ambrogi K, et al. The step test evaluation of performance on stairs (STEPS): validation and reliability in a neurological disorder. PLoS One. 2019;14(3):e0213698. doi:10.1371/journal.pone.0213698
doi: 10.1371/journal.pone.0213698
Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903. doi:10.1093/ptj/80.9.896
doi: 10.1093/ptj/80.9.896
Lusardi MM, Fritz S, Middleton A, et al. Determining risk of falls in community dwelling older adults: a systematic review and meta-analysis using posttest probability. J Geriatr Phys Ther. 2017;40(1):1-36. doi:10.1519/JPT.0000000000000099
doi: 10.1519/JPT.0000000000000099
Nordin E, Rosendahl E, Lundin-Olsson L. Timed “Up & Go” test: reliability in older people dependent in activities of daily living – focus on cognitive state. Phys Ther. 2006;86(5):646-655. doi:10.1093/ptj/86.5.646
doi: 10.1093/ptj/86.5.646
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148. doi:10.1111/j.1532-5415.1991.tb01616.x
doi: 10.1111/j.1532-5415.1991.tb01616.x
Lin M, Hwang H, Hu M, Wu H, Wang Y, Huang F. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc. 2004;52(8):1343-1348. doi:10.1111/j.1532-5415.2004.52366.x
doi: 10.1111/j.1532-5415.2004.52366.x
Wrisley DM, Kumar NA. Functional gait assessment: concurrent, discriminative, and predictive validity in community-dwelling older adults. Phys Ther. 2010;90(5):761-773. doi:10.2522/ptj.20090069
doi: 10.2522/ptj.20090069
Tiedemann A, Shimada H, Sherrington C, Murray S, Lord S. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing. 2008;37(4):430-435. doi:10.1093/ageing/afn100
doi: 10.1093/ageing/afn100
Buatois S, Miljkovic D, Manckoundia P, et al. Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. J Am Geriatr Soc. 2008;56(8):1575-1577. doi:10.1111/j.1532-5415.2008.01777.x
doi: 10.1111/j.1532-5415.2008.01777.x
Bohannon RW, Shove ME, Barreca SR, Masters LM, Sigouin CS. Five-repetition sit-to-stand test performance by community-dwelling adults: a preliminary investigation of times, determinants, and relationship with self-reported physical performance. Isokinet Exerc Sci. 2007;15:77-81. doi:10.3233/IES-2007-0253
doi: 10.3233/IES-2007-0253
Schaubert KL, Bohannon RW. Reliability and validity of three strength measures obtained from community-dwelling elderly persons. J Strength Cond Res. 2005;19(3):717-720. doi:10.1519/R-15954.1
doi: 10.1519/R-15954.1
Brown M, Sinacore DR, Binder EF, Kohrt WM. Physical and performance measures for the identification of mild to moderate frailty. J Gerontol A Biol Sci Med Sci. 2000;55(6):M350-M355. doi:10.1093/gerona/55.6.m350
doi: 10.1093/gerona/55.6.m350
Romero S, Bishop MD, Velozo CA, Light K. Minimum detectable change of the Berg Balance Scale and Dynamic Gait Index in older persons at risk for falling. J Geriatr Phys Ther. 2011;34(3):131-137. doi:10.1519/JPT.0b013e3182048006
doi: 10.1519/JPT.0b013e3182048006
Beninato M, Fernandes A, Plummer LS. Minimal clinically important difference of the functional gait assessment in older adults. Phys Ther. 2014;94(11):1594-1603. doi:10.2522/ptj.20130596
doi: 10.2522/ptj.20130596
Bennell K, Dobson F, Hinman R. Measures of physical performance assessments: self-paced walk test (SPWT), stair climb test (SCT), six-minute walk test (6MWT), chair stand test (CST), timed up and go (TUG), sock test, lift and carry test (LCT), and car task. Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S350-S370. doi:10.1002/acr.20538
doi: 10.1002/acr.20538
Hamel KA, Cavanagh PR. Stair performance in people aged 75 and older. J Am Geriatr Soc. 2004;52(4):563-567. doi:10.1111/j.1532-5415.2004.52162.x
doi: 10.1111/j.1532-5415.2004.52162.x
Altmeier D, Kempe M, Memmert D. Stair self-efficacy questionnaire to test the ability of stair negotiation for older people. Ger J Exerc Sport Res. 2018;48(1):40-47. doi:10.1007/s12662-017-0483-y
doi: 10.1007/s12662-017-0483-y
Bujang MA, Baharum N. A simplified guide to determination of sample size requirements for estimating the value of intraclass correlation coefficient: a review. Arch Orofac Sci. 2017;12(1):1-11. doi:10.21315/mjms2021.28.2.2
doi: 10.21315/mjms2021.28.2.2
Portney L, Watkins M. Foundations of Clinical Research: Applications to Practice. 3rd ed. Pearson; 2008.
Bohannon RW. Knee extension strength and body weight determine sit-to-stand independence after stroke. Physiother Theory Pract. 2007;23(5):291-297. doi:10.1080/09593980701209428
doi: 10.1080/09593980701209428
Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR. Stair negotiation in older people: a review. J Am Geriatr Soc. 2000;48(5):567-580. doi:10.1111/j.1532-5415.2000.tb05006.x
doi: 10.1111/j.1532-5415.2000.tb05006.x
Edwards N, Dulai J, Rahman A. A scoping review of epidemiological, ergonomic, and longitudinal cohort studies examining the links between stair and bathroom falls and the built environment. Int J Environ Res Public Health. 2019;16(9):1598. doi:10.3390/ijerph16091598
doi: 10.3390/ijerph16091598
Steffen TM, Hacker T, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther. 2002;82(2):128-137. doi:10.1093/ptj/82.2.128
doi: 10.1093/ptj/82.2.128

Auteurs

Deb Kegelmeyer (D)

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Raquel S Minarsch (RS)

Physical Medicine and Rehabilitation, Physical Therapy Division, The Ohio State University, Columbus, Ohio.

Katherine Marita (K)

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Audrey Hoffmeister (A)

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Gabrielle Schnaterbeck (G)

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Timothy R Wohl (TR)

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Yevgeniya Gokun (Y)

Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, Columbus, Ohio.

Anne Kloos (A)

School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Classifications MeSH