Description of novel instrumented analysis of the Four Square Step Test with clinical application: A pilot study

Staci M. Shearin, Karen J. McCain, Ross Querry

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Falls are a common problem for adults in the United States raising concerns about injuries and the resulting economic burden. As a result, it is critical to develop objective measures to assess dynamic balance and the track progress related to interventions or disease progression over time. Research Question: Are there differences in balance between individuals in the community, individuals post-stroke, persons with Multiple Sclerosis (MS), and individuals living with Parkinson's Disease (PD) as measured with a new instrumented Four Square Step Test (i-FSST)? Methods: The i-FSST was utilized to assess dynamic balance in 41 individuals (11 community dwelling adults and 10 individuals in each group of persons post stroke, with PD, and with MS). Outcome data including the overall duration of the FSST as well unique temporal-spatial stepping patterns through the test, timing of transitions between each quadrant, and the time in each quadrant prior to transitioning. Results: One-way ANOVAs were conducted to determine whether i-FSST duration, Over Double Support (ODS), and Changes in Main Support (CMS) differed by participants’ groups. There was a significant difference between groups in test Duration (F = 9.56, P =. 000), ODS (F = 15.71, P =. 001), and CMS (F = 7.03, P =. 001). Further differences in these variables were found between various groups using Bonferroni post-hoc testing. Significance: The i-FSST is an innovative and potentially beneficial tool for quantitatively measuring the dynamics that occur in the traditional FSST including a general measure of dynamic balance as well as transition times and stability during the test. This technology can provide objective data on stability, weight shifting, and weight acceptance that may guide interventions and further assessment.

Original languageEnglish (US)
Pages (from-to)14-19
Number of pages6
JournalGait and Posture
StatePublished - Oct 2020


  • Balance
  • Four square step test
  • Instrumentation
  • Neurologic rehabilitation

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


Dive into the research topics of 'Description of novel instrumented analysis of the Four Square Step Test with clinical application: A pilot study'. Together they form a unique fingerprint.

Cite this