Factors Contributing to Single and Dual Task Performance of Four Square Step Tests in the Healthy Middle Age Group

There are many tests that evaluate fall and balance. As a clinical test, the Four Square Step Test (FSST)Test is reliable, valid, easy to score, quick to administer, requires little space, and needs no special equipment. It is unique in that it involves stepping over low objects (2.5cm) and movement in 4 directions. FSST was developed in 2002 to measure the rapid stepping that is often required when changing direction and avoiding obstacles while walking. The FSST requires a stopwatch and four single point sticks. Using the sticks resting flat on the floor to form a cross, the subject starts in one square and steps in one direction into each of the four squares and then reverses direction back to the start. The FSST is unique in that it challenges motor planning, sequencing and recall, whilst simultaneously providing clinicians with the opportunity to measure and observe a person's clearance of low obstacles at speed. The ability to clear the trail leg when stepping over an obstacle has been shown to be reduced in healthy populations. Dual task is simultaneous performance of two tasks that can be performed independently, measured separately and with different goals. Individuals have difficulties in performing two tasks together. When two tasks are performed at the same time, deterioration in performance of one or both is called dual task interference. This occurs when task requirements exceed the capacity. Age, walking speed, lower extremity muscle strength and cognitive status are factors that contribute to the dual task. In addition, prioritizing the motor or cognitive task in a dual task affects the dual task performance. Knowing these factors and improving some of them can help to create training programs designed to improve the dual task performance of individuals. There are several studies investigating factors contributing to dual task performance that focus on balance in the elderly. However, the studies including middle age group are limited. There are no studies evaluating the factors contributing to the single and dual task performance of FSST in the literature. In this study, it is aimed to explain the factors related to motor and cognitive functions to the single and dual task performance of FSST.