Modified marching-in-place test for interlimb coordination as a screening tool for fall risk in older adults

Background. Interlimb coordination is an essential component of postural stability. The marching-in-place (MIP) test is a practical tool that requires little space and time and no equipment. However, its usefulness to assess fall risk in older adults is unknown. The present study aimed to determine the association of the MIP test results with fall risk and to establish its psychometric properties as a screening tool for fall risk in older adults. Methods: The study involved two phases. Phase I was a pilot in 15 older adults. The MIP test was evaluated and modified to improve its feasibility as a screening tool. Phase II was a cross-sectional study involving 288 community-dwelling older adults. Participants were assessed for fall history and balance-related fall risk (using the timed up and go test and the four square step test) and the modified MIP test. Results: Impaired interlimb coordination in the modified MIP test was associated with fall risk (p<0.001) and a history of fall (p=0.001). The modified MIP test had a sensitivity of 96.83%, specificity of 46.22%, positive predictive value of 33.52%, and negative predictive value of 98.11%. Conclusion: The modified MIP test results are associated with fall risk and fall history. Its psychometric properties support its use as an inexpensive and feasible screening tool for fall risk in older adults.