A Systematic Review of Stair Fall Risk Assessment Instruments in Older Adults.
Taychapat Makkong, David Brienza
PMID 42769374WHAT IT FOUND
Stair-specific tests can add useful information to fall-risk assessment in older adults, but none is complete enough to stand alone.
Timed stair tests and STEPS have the best evidence; self-report stair confidence tools are less established.
Key findings
0110 studies with 1778 participants evaluated stair-specific assessment instruments for older adults.
02The strongest evidence was for selected performance-based stair tests and the STEPS observational assessment, while self-report stair confidence measures had less complete evidence.
03No instrument had evidence across all important qualities; reliability and links with other mobility or strength measures were studied most, while prediction, responsiveness, and measurement error were less consistent.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 10 studies were included, and they used different stair tests, step numbers, stair geometry, pace instructions, handrail rules, and outcome definitions, so results could not be pooled. The review did not search Scopus, and it did not search terms for specialized stair designs such as spiral staircases, so some relevant studies may have been missed. Many studies used condition-specific groups, such as people after knee replacement, with knee osteoarthritis, or after stroke, so findings may not apply to all older adults. Studies often reported error statistics without a clear standard for judging whether the error was acceptable, so change scores are hard to interpret. No instrument was evaluated across all important qualities, and self-report stair confidence tools were not well supported for whether their items form one clear scale.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that stair tests are proven predictors of falls or change over time. Only the 3-step stair-negotiation time test had evidence that slower stair time predicted later functional decline, and no instrument was complete enough to stand alone.