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

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.