Objective: Determine the relationship between the modified Four Square Step Test and outcome measures related to fall risk and quality of life in individuals with Parkinson’s disease.
Background: Parkinson’s diseases (PD) is a progressive disease that is a one of the most prevalent diseases involving the CNS, estimated to be affecting more than one million people in the United States.1-4 Parkinson’s disease is characterized by four cardinal motor features: bradykinesia, resting tremor, rigidity of muscles, and impaired posture.1-5 These motor impairments progressively compromise balance, mobility, and participation in functional activities. As a result of balance dysfunction and postural instability, falls and injuries are common composite symptoms of PD.6 As a result, there is an inherent increased risk of fall that is associated with the diagnosis of PD.
Method: 27 participants diagnosed with PD on medication H&Y I-III mean age 73.07 ± 6.4 completed the FSST and mFSST. Participants attended one testing session, in which they completed the mFSST, FSST, TUG, and QOL measures (PFS-16, FOGQ, PDQ-39, and ABC).
Results: To determine the predictability of the mFSST hierarchical multiple regression was performed using the enter method. after entry of the seven significant variables, the total variance explained by the model as a whole was 55%, F(7,19) = 3.271, p = 0.02. The overall model 1 regression equation for mFSST = 4.66 + (0.93 TUG) + (-6.39 SS gait speed) + (2.03 FC gait speed) + (1.46 step length SS) + (-1.55 step length FC) + (-0.63 stride length SS) + (-0.63 stride length FC).
Conclusion: The mFSST significantly correlates (p < 0.01) with other balance assessments (FSST and TUG). In individuals with PD, it also correlates (p < 0.05) with the spatial-temporal parameters of gait. However; the mFSST does not correlate with QOL measures in individuals with PD. The mFSST is a feasible fall risk assessment tool that can help predict fall risk when utilized with additional fall risk assessments. To capture changes in all domains of the ICF as PD progresses, the addition of QOL measures (FOGQ, PFS-16, PDQ-39, ABC) provide clinicians with a comprehensive fall risk assessment.
References: 1. Umphred DA. Umphred’s neurological rehabilitation. 6th ed. St. Louis, Mo: Elsevier, Mosby; 2013. 2. O’Sullivan S, Schmitz T, Fulk G. Physical rehabilitation. 6th ed. Philadelphia: F. A. Davis Company; 2013. 3. Drake DF, Harkins S, Qutubuddin A. Pain in parkinson’s disease: Pathology to treatment, medication to deep brain stimulation. NeuroRehabilitation. 2005;20(4):335. 4. Macphee GJ, Stewart DA. Parkinson’s disease – pathology, aetiology and diagnosis. Rev Clin Gerontol. 2012;22(3):165-178. 5. Weaver TB, Robinovitch SN, Laing AC, Yang Y. Falls and parkinson’s disease: Evidence from video recordings of actual fall events. J Am Geriatr Soc. 2016;64(1):96-101. 6. Bryant MS, Rintala DH, Hou JG, Lai EC, Protas EJ. Effects of Levodopa on forward and backward gait patterns in persons with parkinson’s disease. NeuroRehabilitation. 2011;29(3):247.
To cite this abstract in AMA style:
A. Boddy, K. Mitchell, W. Brewer, J. Ellison. The Relationship Between Modified Four Square Step Test (mFSST) and Outcome Measures Related to Fall Risk and Quality of Life in Individuals with Parkinson’s Disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/the-relationship-between-modified-four-square-step-test-mfsst-and-outcome-measures-related-to-fall-risk-and-quality-of-life-in-individuals-with-parkinsons-disease/. Accessed May 16, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-relationship-between-modified-four-square-step-test-mfsst-and-outcome-measures-related-to-fall-risk-and-quality-of-life-in-individuals-with-parkinsons-disease/