Objective: Determine the reliability and validity of the modified Four Square Step Test in individuals with Parkinson’s disease.

Background: Parkinson’s disease (PD) is a complex disorder marked with non-motor and motor impairments, including gait abnormalities and postural instability. As a result of balance dysfunction and postural instability, falls and injuries are common composite symptoms of PD. The modified Four Square Step Test (mFSST) replaces the canes utilized in the traditional Four Square Step Test (FSST) with tape to evaluate dynamic standing balance while stepping in multiple directions.

Method: 27 participants diagnosed with PD on medication H&Y I-III mean age 73.07 ± 6.4 completed the FSST and mFSST. Participants performed both assessments two times for an average time for interrater reliability and concurrent validity.  To determine the test-retest reliability, participants performed the mFSST again 20-60 minutes following initial assessment.

Results: The interrater and test-retest reliability was excellent (r = 0.916-0.999, ICC 2,2 = 0.96-0.99). The mFSST and FSST were highly correlated for concurrent validity (r = 0.805).

Conclusion: The mFSST demonstrates excellent reliability and validity while assessing dynamic standing balance.  The mFSST can be completed by a large number of individuals diagnosed with PD while requiring little equipment, space, and time in multiple rehabilitation settings.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/reliability-and-validity-of-modified-four-square-step-test-mfsst-performance-in-individuals-with-parkinsons-disease/