Test-retest reliability and agreement of physical fall risk assessment tools in adults with intellectual disabilities.
Timed Up-and-Go, chair stand, handgrip, and Romberg tests give steady scores with adults with ID, so you can track real balance change.
01Research in Context
What this study did
Salb et al. (2015) checked if four common fall-risk tests work the same way twice with adults who have intellectual disability. They gave 37 adults the Timed Up-and-Go, 30-second chair stand, handgrip, and Romberg balance tests on two separate days.
Each test took under five minutes and needed only a chair, stopwatch, and firm surface. The team wanted to know if scores stayed steady, so staff can trust small changes later.
What they found
All four tools showed moderate-to-excellent test-retest reliability. ICC values ranged from 0.59 to 0.97, meaning most adults scored nearly the same on both days.
Small error margins (SEM) suggest the tests can spot real improvement or decline during balance training or vitamin programs.
How this fits with other research
Blomqvist et al. (2013) showed adolescents with ID already have weaker balance and leg strength than peers. Johannes gives you the tools to measure that gap in adults.
Reyer et al. (2006) and Williams et al. (2019) studied vitamin D supplements in residential settings. They found normalizing vitamin D levels may not cut fractures, so adding reliable balance tests fills the screening gap those studies left open.
Pyo et al. (2011) warned that some ID assessments lose validity over time. Johannes counters by showing these four physical tests stay stable, giving you confidence in repeated measures.
Why it matters
You now have four quick, low-cost screens that hold up over time. Use them every six months in day programs or group homes to catch balance slips before a fall happens. Pair the results with vitamin D data from S et al. and V et al. to build a full fall-prevention plan that covers both bone health and balance.
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02At a glance
03Original abstract
BACKGROUND: Physical decline and high rates of inactivity lead to an increased risk of falling in the intellectual disability (ID) population. It is important therefore to develop interventions to prevent falls and to develop valid and reliable assessment tools, which are suitable for use with people with ID. Targeting the most important fall risk factors such as strength, balance and gait measurement is important, yet there is a paucity of previous research on testing the feasibility and reliability of strength, balance and gait assessments with people with ID. AIMS: The aims of this study are (i) to describe the test-retest reliability and agreement [standard error of measurement (SEM)] of slightly adapted fall risk assessments and (ii) to describe the test-retest reliability and SEM of these tests in younger and older age groups and mild/moderate and severe/profound ID-level groups. METHODS: Residents of a German residential facility for people with ID were asked to take part. The study has a test-retest design, whereby all participants were tested twice, with 7 days in-between the first (T1) and second (T2) testing days. The 'timed up and go', '30-second chair stand', 'handgrip' and 'Romberg balance test' were all performed. Intraclass correlation coefficient (ICC) (2,1) values and SEM were calculated for the full sample, two age groups (split at the age of 60 years) and mild/moderate and severe/profound ID-level groups. RESULTS: A total of 37 residents with a mean age of 59.3 years (standard deviation = 17.7) performed the tests on both testing days. Mainly moderate to excellent ICC values were found for all tests for the full sample and in all groups (0.59-0.97). Different SEM values were found for full sample and sub-groups. CONCLUSION: Strength, balance and gait assessment tools, which are easy to use and understand, were found to be reliable in adults with ID. The SEM is most important for interpreting the real effects of an intervention. Further analyses will be required to gain more information about the SEM in different age groups or ID-level groups.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12216