Mobility is a fundamental element of healthy aging. Balance is a necessary function during mobility for all movements throughout life in elderly individuals. Falls due to balance disorders in elderly individuals cause a decrease in the quality of life. Studies in the literature indicate that 13% of individuals aged 65-69 experience falls, and this rate rises to 46% in individuals over 85. Lower extremity muscle volume and strength gradually decrease with aging. This decreased muscle strength directly impacts individuals' activities of daily living.Normal walking speed for elderly individuals is related to balance and overall health performance. However, walking assessments generally focus on walking activities in a forward direction and in a straight line. However, in daily life, we may need to sit on a chair, walk backward to navigate a narrow space, or change direction suddenly due to obstacles or environmental cues. Walking backward requires more complex motor control, and these gait training programs are known to be effective in improving balance and walking skills.Clinically, balance assessments in the elderly persons are commonly measured by using the TUG, 10-meter walk test, functional reach test, 4-square step test, and Berg balance scale. The methods used to assess balance are still not fully standardized. The best test for assessing dynamic balance and fall risk is still up for debate, especially when it comes to elderly individuals who live freely in the community. Further research is needed to determine whether lateral walking tests can identify those at high risk of falling in elderly adults. The purpose of this study was to determine the reliability, validity, and minimal detectable change (MDC) of the Figure-of-8 backward walking test in healthy elderly adults.
Study Type
OBSERVATIONAL
Enrollment
87
Kahramanmaraş Sütçü imam University, Faculty of Health Science, Department of Physiotherapy and Rehabilitation
Kahramanmaraş, Onikişubat, Turkey (Türkiye)
RECRUITINGfigure-of-eight backward walking test
In the figure-of-eight backward walking (F8BWT) test, participants begin at the midpoint of two cones 1.5 m apart. Participants walk backward, circle both cones, and record the time it takes to return to the starting point. The test is administered by both raters on the first and second days.The assessments will be conducted by two separate specialists(physiotherapists). Individuals' completion times for each activity during the tests will be recorded using a stopwatch. Assessments will be conducted over two days, in two sessions per day. On the first day, in the first session, the first assessor (PT1) will perform the F8BWT twice. In the second session, the second assessor (PT2) will perform the F8BWT twice. The average of the two recorded times will be noted. On the second day of the assessment, the PT2 will begin by performing the F8BWT. PT2 will then perform the F8BWT twice. The average of the two recorded times will be noted.
Time frame: On the day 1, in the first session, the first assessor (PT1) will perform the F8BWT twice. In the second session, the second assessor (PT2) will perform the F8BWT twice.
SOCIODEMOGRAPHIC FORM
Demographic information (age, height, weight, gender, education level, medication use, chronic diseases, medications), history and number of falls in the last year, and history of surgery on the lower extremity will be questioned.
Time frame: On the day1, in the first session, the first assessor (PT1) will record.
8-Figure Walk Test
This test is used to evaluate individuals' walking and balance performance. In the figure-of-eight backward walking test, participants start from the midpoint of two cones 1.5 m apart. Participants walk forward, circle each cone, and record the time it takes to return to the starting point.
Time frame: On the day1, in the first session, the first assessor (PT1) will record.
Timed Up and Go Test (TUG)
In the timed up and go test, the time required for the participant to rise from a chair, walk 3 m, turn, walk back, and sit back in the chair is recorded. Participants are asked to remove their shoes if they have any that might affect walking performance.
Time frame: On the first day1, in the first session, the first assessor (PT1) will record.
Modified 4-Square Step Test (mFSST)
The mFSST is a dynamic balance test that involves forward, backward, and sideways steps. A square is drawn on the floor and consists of four equal parts. These are numbered clockwise, 1-2-3-4. Subjects are asked to complete the test one step at a time, following the command "Start," 1-2-3-4, and then 4-3-2-1, without scraping their feet. The elapsed time is recorded.
Time frame: On the first day1, in the first session, the first assessor (PT1) will record.
3-Meter Backward Walk Test (3MGYT)
For this test, a 3-meter distance is marked with a tape, and participants are asked to walk backwards, with their heels on the tape. During the test, participants are asked to walk as fast as possible, but running is not allowed. Participants may look back if they wish. The time is measured and recorded.
Time frame: On the day1, in the first session, the first assessor (PT1) will record.
Tandem Test
This test, used to assess balance, is administered with eyes open and eyes closed, alternating between each foot. The participant is asked to stand with one foot in front of the other (tandem stance), first with eyes open, then with eyes closed, for 10 seconds. They are asked to place the foot they find most comfortable with either forward or backward. The times during the test are recorded in seconds using a stopwatch.
Time frame: On the day1, in the first session, the first assessor (PT1) will record.
One-Legged Standing Test
In the one-leg standing test, participants are asked to stand on one foot of their choice while lifting the other foot, keeping it away from the ground and other body parts. If the foot touches the ground or the extremity in contact with the ground changes position during the test, the test is terminated and the time is recorded. Alternatively, if participants can stand on one foot for 30 seconds, the test is terminated and the time is recorded.
Time frame: On the day1, in the first session, the first assessor (PT1) will record.
The Falls Efficacy Scale-International (FES-I)
The The Falls Efficacy Scale-International (FES-I) is a questionnaire developed to assess the tendency to fall during activities of daily living. The test has a 4-point Likert-type scale (1- not at all concerned, 2- somewhat concerned, 3- quite concerned, and 4- very concerned). The 16-item questionnaire requires a minimum score of 16 and a maximum score of 64. Increasing scores indicate deterioration of balance (23). Participants complete the FES-I questionnaire in a quiet environment, and the score is then calculated.
Time frame: On the day1, in the first session, the first assessor (PT1) will record.
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