Testing the Validity of the Diamond Steps Test for Balance in Healthy Adults

Objectives: To test the validity of the Diamond Steps Test (DST), a new test to assess balance. Design: This cross-sectional study evaluated the validity of the DST, a brief new balance assessment tool. Setting: The implementation site was the rehabilitation center of a hospital. Data collection was conducted from February to June 2017. Participants: Healthy adults (N=65) between the ages of 40 and 72 years who volunteered to participate. Interventions: Not applicable. Main Outcome Measures: Two measures were used to assess DST: the time required to step around the diamond 5 times (5-DS) and the time required to step around the diamond twice, once using the dominant foot and the other using the non-dominant foot (LRDS). Results: Multiple regression analysis was performed for each of the 2 methods for measuring DST. Five variables were predictive of DST as measured by the 5-DS test: the 10-Second Open Close Stepping Test, timed Up and Go (TUG) test, Y Balance Test (YBT) posterolateral reach for the left leg, Standing on One Leg with Eyes Closed (SOLEC) test for the right leg, and sex. The coefficient of determination was 0.54. For DST measured by the LRDS, 4 variables were found to be predictive: the 30-Second Chair Stand Test, YBT posterolateral reach for the left leg, TUG, and SOLEC for the right leg. The coefficient of determination was 0.49. Conclusion: The DST was shown to assess 7 of the 9 components of balance (static stability, functional stability limits, underlying motor systems, anticipatory posture control, dynamic stability, reactive postural control, and sensory integration), suggesting that it is a valid test to use for balance assessment.