Development and Validation of the Square Excursion Step Test (SEST) for Evaluating Postural Control in Older Adults: An Examination of Stepping Agility

Document Type : Original research papers

Authors

1 1. Department of Physical Education and Sports Sciences, Raja University,Qazvin, Iran

2 Department of Sport Injuries and Corrective Exercises, Sports Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran

3 Department of Physical Education and Sports Sciences, Amirkabir University of Technology, Tehran, Iran

Abstract

Postural control during multidirectional stepping is a fundamental component of functional independence and a critical factor in fall prevention among older adults. Despite the availability of various balance assessment tools, the need remains for a practical, cost-effective, and reliable instrument tailored to this population. The primary objective of this research was to develop and validate the Square Excursion Step Test (SEST) by assessing its reliability, validity, and usability in clinical and community-based settings. A total of 88 older adults voluntarily participated in the study. The SEST involves stepping in four cardinal directions (forward, backward, left, and right) within a defined square, requiring precision, balance, and coordination. Face validity was confirmed by 10 sports science experts, yielding a Content Validity Ratio (CVR) of 0.80, surpassing the required threshold of 0.62, indicating strong consensus on its relevance. The Content Validity Index (CVI) averaged 0.90, reflecting high clarity and appropriateness of the test components. Concurrent validity was established through a significant correlation with the Timed Up and Go (TUG) test (r = 0.81; p < 0.001). Reliability assessments demonstrated an interrater reliability intraclass correlation coefficient (ICC) of 0.99 and an intrarater ICC of 0.90 across two assessments conducted ten days apart, confirming that SEST is a valid and reliable measure for evaluating balance in individuals with reduced physical fitness capabilities. These findings validate SEST as a robust tool for measuring postural stability during multidirectional stepping in older adults. The SEST’s simplicity, affordability, and strong psychometric properties make it a valuable addition to the repertoire of balance assessment tools for clinicians, researchers, and practitioners working with older populations. Further studies are recommended to explore its applicability in diverse contexts and its potential for integration into intervention programs targeting fall prevention and postural control.

Keywords

Main Subjects

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Journal of Advanced Sport Technology
Volume 9, Issue 3
September 2025
Pages 28-38

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History

  • Receive Date: 06 January 2025
  • Revise Date: 12 February 2025
  • Accept Date: 10 March 2025

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