A novel video game-based device for measuring stepping performance and fall risk in older people

Abstract

Objective: To determine whether a dance mat test of choice stepping reaction time (CSRT) is reliable and can detect differences in fall risk in older adults. Design: Randomized order, crossover comparison. Setting: Balance laboratory, medical research institute, and retirement village. Participants: Older (mean age, 78.87±5.90y; range, 65-90y) independent-living people (N=47) able to walk in place without assistance. Interventions: Not applicable. Main Outcome Measures: Reaction (RT), movement, and response times of dance pad-based stepping tests, Physiological Profile Assessment (PPA) score, Digit Symbol Substitution Test (DSST) score, time to complete the Trail Making Test (TMT) A+B, Fall Efficacy Scale International (FES-I) score, Activities-specific Balance Confidence (ABC) Scale score, and Incidental and Planned Exercise Questionnaire (IPEQ) incidental IPEQ activity subscore. Results: Test-retest reliability of the dance mat CSRT response time was high (intraclass correlation coefficient model 3,k=.90; 95% confidence interval [CI], .82-.94; P 1) had significantly slower response times than people with low/mild fall-risk scores (PPA score <1) at 1146±182 and 1010±132ms, respectively (P=.005), and multiple fallers and single/nonfallers showed significant differences in RT (883±137 vs 770±100ms; P=.009) and response time (1180±195 vs 1031±145ms; P=0.017). Conclusions: The new dance mat device is a valid and reliable tool for assessing stepping ability and fall risk in older community-dwelling people. Because it is highly portable, it can be used in clinic settings and the homes of older people as both an assessment and training device. © 2011 by the American Congress of Rehabilitation Medicine.