A study of the discriminative properties of the Six-Spot Step Test in older adults at risk of falling and those not at risk

Objective To investigate the discriminative properties of the Six-Spot Step Test in older adults with self-reported balance problems. Methods Seventy-five older adults aged >= 65 years completed the Six-Spot Step Test and the Timed "Up and Go" test. A Mini-BESTest score of <= 19 was used as a cutoff for defining the risk of falling, and a receiver operating characteristics curve was generated to determine relevant cutoff scores. Results An overall accuracy of 85% for the Six-Spot Step Test and 88% for the Timed "Up and Go" test were found. The probability of ruling out people at risk of falling increased with a test score shorter than 8.0 and 7.3 seconds on the Six-Spot Step Test and the Timed "Up and Go" test, respectively. Maximizing the total true positive and true negative test results generated a cutoff score of 8.8 seconds (accuracy 79%) and 8.3 seconds (accuracy 80%) for the Six-Spot Step Test and the Timed "Up and Go" test, respectively. Conclusions The Six-Spot Step Test, which challenges the ability to adapt to more complex tasks during walking, discriminates accurately between older adults at risk of falling and those not at risk. Results as low as eight seconds qualify for fall-preventive interventions.