Article

The purpose of this study was to evaluate the test-retest, intra-rater
reliability and agreement of compensatory stepping thresholds. A protocol was
developed to establish anteroposterior single-stepping thresholds,
anteroposterior multiple-stepping thresholds, and lateral single-stepping
thresholds. Healthy, young subjects stood on a microprocessor-controlled
treadmill, and responded to three series of progressively challenging surface
translations. Subjects were instructed to "try not to step" when establishing
single-stepping thresholds or "try to take only one step" when establishing
multiple-stepping thresholds. Stepping thresholds were defined as the minimum
disturbance magnitude that consistently elicited a single or second compensatory
step. Thresholds were expressed as the ankle torque necessary to maintain upright
posture. Thresholds studied included anterior single-stepping thresholds (tau =
273.0 +/- 82.3 N m), posterior single-stepping, thresholds (tau = 235.5 +/- 98.0
N m), anterior multiple-stepping thresholds (tau = 977.0 +/- 416.3 N m),
posterior multiple-stepping thresholds (tau = 701.9 +/- 237.5 N m),
stability-side lateral single-stepping thresholds (tau = 225.7 +/- 77.7 Nm), and
mobility-side lateral single-stepping thresholds (tau = 236.8 +/- 85.4 N m).
Based on intraclass correlation coefficients (ICC) and Bland-Altman plots, all
thresholds demonstrated excellent reliability (ICC(2,1) = 0.87-0.97) and
agreement. These results suggest that compensatory stepping thresholds have
sufficient repeatability to be used in clinical and research-related assessments
of fall-risk. Additional study is needed to determine the intra- and inter-rater
reliabilities and validity of thresholds specific to the patient populations of
interest.
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