Open AccessReliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults
Author(s) -
Gabriela Almeida,
Jorge Bravo,
Hugo Folgado,
Hugo Rosado,
Felismina Rosa Parreira Mendes,
Catarina Pereira
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0225118
Subject(s) - intraclass correlation , concurrent validity , construct validity , inter rater reliability , test (biology) , predictive validity , physical medicine and rehabilitation , reliability (semiconductor) , psychology , medicine , kappa , physical therapy , developmental psychology , psychometrics , internal consistency , rating scale , mathematics , paleontology , power (physics) , physics , quantum mechanics , biology , geometry
Thus far, few studies have examined the estimation and actual performance of locomotor ability in older adults. To our knowledge, there are no studies examining the relationship between stepping-forward estimation versus ability and fall occurrence. The aim of this study was to develop and assess the reliability and validity of a new test for fall risk assessment in community-dwelling older adults. In total, 347 participants (73.1 ± 6.2 years; 266 women) were assessed for their perception of maximum distance for the stepping-forward and action boundary. The test was developed following the existing literature and expert opinions. The task showed strong internal consistency. Intraclass correlation ranged from 0.99 to 1 for intrarater agreement and from 0.83 to 0.97 for interrater agreement. Multivariate binary regression analysis models revealed an area under the curve (AUC) of 0.665 (95% CI: 0.608–0.723) for fallers and 0.728 (95% CI: 0.655–0.797) for recurrent fallers. The stepping-forward affordance perception test (SF-APT) was demonstrated to be accurate, reliable and valid for fall risk assessment. The results showed that a large estimated stepping-forward associated with an underestimated absolute error works as a protective mechanism for fallers and recurrent fallers in community-dwelling older adults. SF-APT is safe, quick, easy to administer, well accepted and reproducible for application in community or clinical settings by either clinical or nonclinical care professionals.