Comparison of the accuracy to predict falls of the figure of 8 walk test with and without dual-task in older adults

Abstract

Background: The figure of eight walk test (F8W) is a measurement tool that examines the ability to walk on a curved path. Adding secondary tasks to the F8W test may increase its ability to predict falls in older adults. This research aimed 1.) to examine the accuracy of the F8W test and the F8W test with dual-tasking for predicting future falls in older adults; 2.) to investigate the reliability and the concurrent validity of the F8W test with and without dual-task in older adults. Methods: Eighty older adults between the ages of 60 and 80 were recruited. At the beginning of the study, participants completed the standard F8W test, F8W+cog (walking while doing serial subtractions by threes) and F8W+motor (walking while carrying a glass of water on the tray with one hand). The number of falls was documented during a six-month follow-up. The area under the receiver operating characteristic curve (AUC) was used to compare the accuracy for predicting falls. The cut-off points and the psychometric properties of the tests were computed. Sixteen older adults were recruited for reliability and the concurrent validity of the F8W test with and without dual-task in older adults. Results: The F8W+motor time was the most accurate for predicting falls in older adults, with an AUC of 0.74, whereas the standard F8W and the F8W+cog time both had AUCs of 0.69. The F8W+motor’s optimal cut-off score was > 12 s, with a sensitivity of 76.5% and a specificity of 65.1%. The time and step counts of F8W, F8W+cog, and F8W+motor demonstrated excellent intra-rater and inter-rater reliability (ICC3,3 = 0.95–0.99 and ICC2,3 = 0.92–0.99, respectively). The F8W, F8W+cog, and F8W+motor time were all considerably well correlated to excellently correlated with TUG (r = 0.89, 0.80, and 0.88, respectively). The F8W, F8W+cog, and F8W+motor steps were moderately correlated with TUG (r = 0.62, rs = 0.63, and r = 0.52, respectively). Conclusion: The F8W with a motor task time was a more potent tool for detecting fall risk than the standard F8W or the F8W+cog. Clinicians may utilize the F8W+motor time as preliminary guidelines when making clinical judgments concerning older adults who are at risk of falling.