The Use of the Four Square Step Test and the 10‐m Walk/Run Test to Determine Fall Risk in Children With Duchenne Muscular Dystrophy

INTRODUCTION/AIMS: The identification of the risk of falling in Duchenne muscular dystrophy (DMD) is essential for the implementation of timely preventive approaches. This study aimed to examine the ability of the four square step test (FSST) and the 10-m walk/run test (10MWRT) to discriminate between fallers and non-fallers in children with DMD. METHODS: Ninety-five children with DMD were included in this study. Functional level was determined with the Vignos Scale. Children who had fallen at least once in the previous month were categorized as "fallers" (n = 50), while those who had not fallen were categorized as "non-fallers" (n = 45). The FSST and 10MWRT were performed. The Mann-Whitney U test was performed to examine group differences in the FSST and 10MWRT scores. The predictive values of the FSST and 10MWRT were determined with receiver operating characteristic curves. RESULTS: ) and non-fallers (median age: 9.00 years; median BMI: 17.95) were similar (p > 0.05). Fallers demonstrated lower functional levels compared with non-fallers (p < 0.001). The FSST for fallers was 20.04 ± 12.57 s while that for non-fallers was 11.44 ± 2.94 s with a cut-off point of 13.10 s (p < 0.05). The 10MWRT for fallers and non-fallers were 9.42 ± 4.77 and 5.36 ± 2.10 s, respectively, with a cut-off point of 5.60 s (p < 0.05). DISCUSSION: The two outcome measures were shown to be sensitive and specific in determining the risk of falls in children with DMD. The cut-off points may guide professionals in planning a proactive rehabilitation program to reduce fall risk or minimize subsequent injuries.