The Validity and Reliability of the Four Square Step Test
Condition: Only Child; Balance, Postural
Study type: Observational

Summary: 
      This study will evaluate concurrent and discriminative validity, reliability and level of
      agreement between the Timed Up & Go test and the four square step test in typically developed
      children.
    

Detailed description: 
      Participants will be assessed by two physiotherapists on two separate days. Prior to the
      trial, testing instructions to be delivered to participants will be translated and adapted
      into Turkish. In order to maximize potential agreement and to improve rating accuracy,
      reliability, and validity, assessment skills of the raters will be refreshed through
      training.

      Administration of the tests will be performed in a corridor of the school. Assessments will
      be performed in a quiet and adequately lighted environment to minimize the distraction.
      Participants will be tested with their regular footwear. The demographic information of
      participants will be recorded. The dynamic balance performances on the four square step test
      (FSST) and the Timed up & Go test (TUG) will be assessed by Rater A and B independently and
      these assessments repeated 24-h later. The participants will be allowed to rest up to five
      minutes between sessions. A stopwatch will be used to measure time to complete the FSST and
      TUG test.

      Evaluations of concurrent and discriminative validity will be based on mean scores from the
      first measurement of rater A. Pearson's correlation coefficient (r) will be used to assess
      the concurrent validity of the FSST and TUG tests. Between-groups discriminative validity of
      the FSST will be evaluated by the one-way analysis of variance (ANOVA) with Bonferroni
      post-hoc test. Both intra- and inter-rater reliability will be assessed using intraclass
      correlation coefficients (ICC). ICC2,1 and ICC2,2 estimates and their 95% confidence
      intervals will be calculated based on absolute-agreement. Bland & Altman plots will be
      constructed to demonstrate agreement between TUG and FSST, and between assessments of rater A
      and B.
    

Intervention name(s): the Four Square Step test
Intervention type(s): Diagnostic Test
Intervention description(s): A square will be formed by using four 90 cm long canes placed on the ground. The sequence will be explained and demonstrated to the participants. They will be allowed one practice trial and subsequently two trials. Instructions will be given and encouraged to complete the sequence as fast as possible without touching the canes. The sequence of trial was 1,2,3,4,1,4,3,2,1. If a participant touch the canes, or perform the test sequence inaccurately, or both feet of the participant do not make contact with the floor in each square, the trial will be considered as unsuccessful and the test will be repeated. One unsuccessful trial will be allowed. The best time will be taken as the score of FSST which are completed successfully.
Observational model: Other
Time perspective: Other
Sampling method: Probability Sample
Study population: 
        Typically developed children between the ages of 5-10 in Cihangir-Düzova Elementary School
        in Famagusta, North Cyprus.