1. Pre-Program Screening and Assessment Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California State University, Fullerton

2. Modified Test of Sensory Interaction in Balance (M-CTSIB)  Test of sensory impairment  Original test developed by Horak & Shumway-Cook in 1986  6 conditions in original test; 4 conditions in modified version

3. Modified Test of Sensory Interaction in Balance  Standardized position: Feet shoulder width apart, arms folded across chest  Test Items include: Standing with eyes open, firm surface (3/3) Standing with eyes closed, firm surface Standing with eyes open, foam surface Standing with eyes closed, foam surface

4. Interpretation of Item Scores  Possible underlying Impairments? Condition 1- Standing with eyes open, firm surface Poor gaze stabilization Poor use of somatosensory cues Lower body weakness

5. Interpretation of Item Scores  Possible underlying Impairments? Condition 2- Standing with eyes closed, firm surface Poor use of somatosensory cues Lower body weakness Fear of falling

6. Interpretation of Item Scores  Possible underlying Impairments? Condition 3- Standing with eyes open, foam surface Poor use of visual cues Lower body weakness Poor COG control

7. Interpretation of Item Scores  Possible underlying Impairments? Condition 4- Standing with eyes closed, foam surface Poor use of vestibular cues Fear of falling in high sway condition Lower body weakness

8. Multidirectional Reach Test (MDRT)  Developed by Newton in 1997  Test of motor impairment  Provides information about limits of stability and type of strategy  Test comprised of reaching in 4 directions without moving feet

9. Multidirectional Reach Test  Yardstick at shoulder height  Standardized test position: Feet shoulder width apart, arm extended, palm facing in (“handshake”) with hand extended, heels remain in contact with floor  Subtract end number from starting number  Practice trial, 3 test trials  Score is the average

10. Multidirectional Reach Test  Mean values: Forward = 8.9 in Backward = 4.6 in Left = 6.6 in Right = 6.8 in  Individual is either above or below average  Movement provides information about postural strategy

11. Interpretation of Scores Possible impairments associated with below Average Scores: Reduced limits of stability Lower body muscle weakness Reduced ankle ROM Fear of falling Poor dynamic COG control

12. Fifty Foot Walk Test Used to identify functional limitations in gait Specifically measures overall gait speed and ability to alter gait speed to meet changing task demands Performed at a “preferred” and fast speed. Slow gait speeds associated with increased risk for falls

13. Test Procedures Measure a total distance of 70 feet. Place line at start and end on floor. Place mark up wall at 10 foot and 60 foot mark. Start stopwatch as foot crosses line at 10 foot mark. Stop watch as foot crosses 60 foot mark. Gait speed is determined by dividing 50 by time elapsed. (Provides ft/sec value) Stride length can be determined by counting number of steps taken over 50 feet.

14. Administration of Test Verbally instruct participant to walk at “their preferred speed” or “as quickly but safely as possible.” Walk slightly behind and to the side of the participant during each walking trial. DO NOT SET THE PACE for them.

15. “Walkie-Talkie” Test Test is designed to measure participant’s ability to divide attention between two tasks - “walking and talking” in this case A “positive” response indicates an inability to divide attention between talking and walking. A “negative” response indicates that the participant is able to continue to divide attention successfully in this task.

16. Test Administration As you walk towards the fifty foot walk station, ask the participant an open-ended question: Example: “What did you do over the weekend?’ Record a positive score if the participant stops to answer the question; a negative score if the participant continues walking while talking