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Year : 2014  |  Volume : 9  |  Issue : 3  |  Page : 221-226

The four square step test in children with Down syndrome: Reliability and concurrent validity

1 Department of Pediatric Physiotherapy, Alva's College of Physiotherapy, Moodabidri, Karnataka, India
2 Department of Pediatric Physiotherapy, Maharishi Markandeswar Institute of Physiotherapy and Rehabilitation (MMIPR), Maharishi Markandeswar University, Mullana, Haryana, India

Correspondence Address:
Asir John Samuel
Assistant Professor, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar University, Mullana - 133 207, Haryana
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Source of Support: Transportation to the special school was provided by Alva’s College of Physiotherapy, Moodabidri, Karnataka, India and authors were extremely grateful for the support provided. The cost for making four sticks, which were used in the study were sponsored by the first author, Dr. Ajai Verma, Conflict of Interest: None

DOI: 10.4103/1817-1745.147573

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Purpose: To estimate test-retest reliability, inter-rater reliability and validation of a method for measuring balance by stepping over four squares, four square step test (FSST) in children with Down syndrome (DS). Methods: A sample of 13 children with DS was recruited for the cross-sectional study. They were asked to perform FSST and the time taken was noted. For estimating test-retest reliability, FSST was done by principal investigator twice and Inter-rater reliability was assessed by principal investigator and second investigator with an interval of 7 days. FRT was used as the criterion dynamic balance measure to validate FSST. The data was tabulated and analysed statistically. Results: The test-retest reliability and inter-rater reliability of FSST are ICC (1,1) = 0.70 (0.64-0.90) and ICC (2,1) = 0.78 (0.62-0.91) respectively. The Bland-Altman limits of agreement were also satisfied. Concurrent validity between FRT and FSST with Spearman's ρ = −0.58 (−0.86 to −0.13). Conclusion: FSST has moderate to good concurrent validity and good reliability among the children with Down syndrome.


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