Relationships Between Instrumented Four Square Step Test and Gait for a Mixed Neurologic and Community‐Dwelling Population

Background and Purpose Outcome measures are designed to identify functional mobility issues, safety concerns, and areas for intervention. While gait and balance are often evaluated separately, they interact significantly. Understanding how various outcome measures relate to gait performance may allow for more targeted interventions. The purpose of this study was to examine the relationship between dynamic balance, as assessed by the instrumented Four Square Step Test (i‐FSST), and gait parameters among community‐dwelling adults and individuals with neurological conditions (stroke, multiple sclerosis [MS], or Parkinson's disease [PD]). Methods This cross‐sectional study used the i‐FSST to assess dynamic balance in 40 individuals typical of a neurologic clinic (11 community dwelling adults, 10 individuals with Parkinson's disease, 10 with multiple sclerosis, and 9 individuals post stroke). Outcome measures included FSST duration, stepping patterns, quadrant transition timing, and time spent in the quadrants. Gait was assessed using temporal‐spatial parameters (gait velocity, step length, gait variability index [GVI], double limb support [DLS], single limb support [SLS]). Results The i‐FSST duration had a significant negative relationship with gait velocity ( r = −0.754) and step length ( r = −0.651). Additionally, i‐FSST duration had a significant relationship with single limb support (SLS) ( r = −0.593), double limb support (DLS) ( r = 0.588) and gait variability index (GVI) ( r = 0.594). ODS (defined as the number of double support periods) had a relationship with gait velocity ( r = −0.559), step length ( r = −0.562), GVI ( r = 0.573), SLS ( r = −0.538), DLS ( r = 0.539). CMS (indicates number of times weight is transfers between legs) correlated with gait speed ( r = −0.656), step length ( r = −0.663), and GVI ( r = 0.515). Discussion The i‐FSST demonstrates multiple significant associations with key gait metrics, suggesting its clinical utility in assessing balance‐related factors that affect gait. Clinically, the test may aid in identifying impairments in weight shifting, directional movement, and dynamic balance.