Reliability and Validity of the Six-Spot Step Test After Total Hip Arthroplasty (SSST)

Assessment of the Reliability and Validity of the Six-Spot Step Test in Patients Following Total Hip Arthroplasty

This study aims to assess the SSST's validity, reliability, and ability to differentiate between high and low fall risk individuals in THA patients. Establishing the SSST as a valid and reliable tool will help manage rehabilitation and apply timely interventions for THA patients.

Study Overview

• Status: Completed
• Conditions: Rehabilitation; Total Hip Replacement; Reproducibility of Results
• Intervention / Treatment: Diagnostic test: Six Spot Step Test; Diagnostic test: Oxford Hip Score; Diagnostic test: Berg Balance Scale

Detailed Description

Total hip arthroplasty (THA) is a common surgery for patients with advanced hip osteoarthritis, aiming to reduce pain and improve function. However, THA patients often experience difficulties in mobility tasks, such as walking, stair climbing, and standing up, even years after surgery. These functional impairments increase the risk of falls, highlighting the need for effective clinical tests to assess balance and mobility. Identifying factors contributing to balance dysfunction and implementing appropriate rehabilitation are crucial for improving quality of life.

The Six-Spot Step Test (SSST), developed by Nieuwenhuis et al., is a quick and easy test that evaluates balance and mobility in daily life activities. However, its validity and reliability in THA patients have not been studied. This research aims to assess the SSST's validity, reliability, and ability to differentiate between high and low fall risk individuals in THA patients. Establishing the SSST as a valid and reliable tool will help manage rehabilitation and apply timely interventions for THA patients.

• Study Type: Interventional
• Enrollment (Actual): 61
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ordu, Turkey
    • Ordu University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Underwent primary unilateral Total Hip Arthroplasty (THA)
• Surgery performed using the posterolateral approach
• At least six months of postoperative follow-up

Exclusion Criteria:

• Patients who underwent bilateral or revision THA
• History of additional lower limb surgery
• Body mass index (BMI) greater than 40 kg/m²
• Neurological, orthopedic, or systemic disorders that could impair gait or balance

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Other; Patients with total hip arthroplasty (THA)

Diagnostic test: Six Spot Step Test; The Six-Spot Step Test (SSST), which evaluates balance and functional ambulation, will be performed in an area 5 meters long and 1 meter wide. Five wooden cylinders will be arranged in a zig-zag pattern within this space, with the last cylinder positioned at the centerline. The participant will be asked to strike the wooden cylinders with the medial or lateral side of the same foot and push them outward. The test will be repeated twice with the dominant foot and twice with the non-dominant foot. A trial will be conducted before the test to familiarize participants with the procedure. A two-minute rest period between the test and trials will be provided to minimize fatigue effects. The test's inter-rater reliability will be assessed by two physiotherapists with more than 5 years of clinical experience, who will administer the test twice at 5-minute intervals.; Diagnostic test: Oxford Hip Score; The Oxford Hip Score will be used for functional level assessment.; Diagnostic test: Berg Balance Scale; The Berg Balance Scale (BBS) will be used to assess dynamic balance, which is reliable and commonly used within the orthopedic setting.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Six Spot Step Test-3	The SSST wil be measured by the first investigator	7-10 days after
Six Spot Step Test-4	The SSST wil be measured by the second investigator	7-10 days after
Six Spot Step Test-1	The SSST wil be measured by the first investigator	Day 1
Six Spot Step Test-2	The SSST wil be measured by the second investigator	Day 1
Timed Up and Go test	A timed up and go test test will be measured for validity analysis.	Day 1
Four Square Step Test	A four square step test will be measured for validity analysis.	Day 1

Collaborators and Investigators

• Sponsor: T.C. ORDU ÜNİVERSİTESİ
• Investigators: Study Director: Elif AYGUN POLAT, PhD, T.C. ORDU ÜNİVERSİTESİ; Principal Investigator: Yusuf POLAT, Assoc. Prof., T.C. ORDU ÜNİVERSİTESİ; Principal Investigator: Sevim ACAROZ, Assoc. Prof., T.C. ORDU ÜNİVERSİTESİ; Principal Investigator: Yunus Emre OZBILEN, MD, T.C. ORDU ÜNİVERSİTESİ; Study Chair: Alper ÇIRAKLI, Prof., T.C. ORDU ÜNİVERSİTESİ

Study record dates

Study Major Dates

• Study Start (Actual): November 30, 2024
• Primary Completion (Actual): December 30, 2024
• Study Completion (Actual): January 12, 2025

Study Registration Dates

• First Submitted: November 21, 2024
• First Submitted That Met QC Criteria: November 22, 2024
• First Posted (Actual): November 26, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 12, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: ODU-SBFTR-AYGUNPOLAT-003; 2024/20 (Other Identifier: Ordu University Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: There is not a plan to make IPD available.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No