Using the Four Square Step Test to measure balance in people with rheumatoid arthritis

Validity And Reliability Of The Four Square Step Test In Individuals With Rheumatoid Arthritis

Observational Inonu University · NCT07264101

This project will test whether the Four Square Step Test reliably measures balance and links to disease activity, pain, strength, and quality of life in adults with rheumatoid arthritis.

Quick facts

Study typeObservational
Enrollment50 (estimated)
Ages18 Years to 65 Years
SexAll
SponsorInonu University Academic / other
Locations1 site (Malatya)
Trial IDNCT07264101 on ClinicalTrials.gov

What this trial studies

This cross-sectional observational project will apply a standardized protocol to measure Four Square Step Test (FSST) performance in adults with rheumatoid arthritis and compare results to clinical measures including disease activity scores, pain scales, muscle strength tests, and quality-of-life questionnaires. Measurement tools will be administered in randomized order with rest intervals to reduce fatigue and minimize bias, and inter- and intra-rater reliability of the FSST will be examined. Participants are ambulatory adults aged 18–65 with RA, no recent major treatment changes, and sufficient cognition and language ability to follow instructions. The analysis will determine correlations between FSST performance and clinical parameters and quantify the test's reliability in this patient group.

Who should consider this trial

Good fit: Ideal candidates are adults 18–65 with rheumatoid arthritis per ACR/EULAR 2010 criteria, followed for at least six months, able to walk 10 meters unaided, with no major treatment changes in the past four weeks, MMSE ≥24, and able to understand Turkish.

Not a fit: Patients with significant neurological, vestibular, or serious orthopedic disease, recent lower-extremity surgery or serious injury within six months, acute systemic illness, inability to walk 10 meters, or inability to follow instructions in Turkish are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, clinicians could use a quick, standardized FSST to identify balance problems and guide fall-prevention or rehabilitation strategies for people with RA.

How similar studies have performed: The FSST has shown validity and reliability in older adults and various neurological and musculoskeletal populations, but specific validation work in rheumatoid arthritis is limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age between 18 and 65 years
* Diagnosis of rheumatoid arthritis according to ACR/EULAR 2010 criteria
* No major changes in treatment regimen (e.g., initiation or modification of DMARDs/biologics, high-dose steroid increase) within the last 4 weeks
* Ability to walk at least 10 meters without assistance
* Mini-Mental State Examination (MMSE) score ≥ 24
* Ability to understand and follow instructions in Turkish

Exclusion Criteria:

* Participants who cannot understand or follow verbal instructions in Turkish
* Participants with a history of neurological, vestibular, or serious orthopedic disease
* Participants whose physical participation is limited due to acute infection or systemic disease
* Participants who have had lower extremity surgery or a history of serious injury within the last 6 months

Where this trial is running

Malatya

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Rheumatoid ArthritisFour Square Step TestBalance
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.