The Reliability and Validity of the Modified Four Square Step Test in Individuals with Anterior Cruciate Ligament Reconstruction

Hikmet Kocaman; Mehmet Canlı; Halil Alkan; Hasan Yıldırım; Nazım Tolgahan Yıldız

doi:10.1007/s43465-023-00993-5

The Reliability and Validity of the Modified Four Square Step Test in Individuals with Anterior Cruciate Ligament Reconstruction

Indian J Orthop. 2023 Sep 13;57(11):1819-1825. doi: 10.1007/s43465-023-00993-5. eCollection 2023 Nov.

Authors

Hikmet Kocaman¹, Mehmet Canlı², Halil Alkan³, Hasan Yıldırım⁴, Nazım Tolgahan Yıldız¹

Affiliations

¹ Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Karamanoglu Mehmetbey University, Karaman, Turkey.
² School of Physical Therapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey.
³ Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Muş Alparslan University, Muş, Turkey.
⁴ Faculty of Kamil Özdağ Science, Department of Mathematics, Karamanoğlu Mehmetbey University, Karaman, Turkey.

PMID: 37881277
PMCID: PMC10593669 (available on 2024-09-13)
DOI: 10.1007/s43465-023-00993-5

Abstract

Background: The modified four square step test (mFSST) is frequently used in the evaluation of dynamic balance in individuals with balance problems. However, the reliability of the mFSST has not been examined in individuals undergoing anterior cruciate ligament reconstruction (ACLR) surgery.

Purpose: The aim of this study was to examine the test-retest reliability of the mFSST in individuals undergoing ACLR surgery.

Methods: Forty-eight patients who had ACLR surgery were included in this study. Patients performed a total of four mFSSTs, two times each, by two different raters over seven days.

Results: In the current study, the mFSST demonstrated excellent test-retest and inter-rater reliability. The intraclass correlation coefficient for mFSST was 0.92. The standard error of measurement and minimal detectable change for mFSST were 0.15 and 0.41, respectively.

Conclusion: The mFSST has excellent test-retest and inter-rater reliability in patients with ACLR. It is a valid and reliable tool for evaluating dynamic balance in patients with ACLR. We think that mFSST, which is a clinical evaluation test, can be preferred because it is easy to score and does not require special equipment.

Keywords: Dynamic balance; Reliability; Validity; mFSST.

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