Development and Preliminary Evaluation of the Sensory Integration in Walking Test: A Novel Tool to Assess Dynamic Sensory Integration and Fall-Risk Mechanisms

Introduction: Falls in older adults mostly occur during walking under sensory challenges, such as walking in the dark, suggesting inefficient integration of sensory inputs. We developed a novel test titled “Sensory Integration in Walking (SensIWalk)”, which allows for the elucidation of the sensory integration in ecologically valid scenarios. The aim of this study was to evaluate the validity and reliability of the SensIWalk Test in healthy young and older adults.

Methods: Data were collected in the GRAIL System (Motek Medical BV, The Netherlands). The SensIWalk Test comprised six walking conditions on: (C1)firm surface with eyes open, (C2)firm surface in the dark (1.3 lux), (C3)firm surface with visual sway, (C4)foam insoles with eyes open, (C5)foam insoles in the dark, and (C6)foam insoles with visual sway. The validity of SensIWalk was assessed against the Clinical Test of Sensory Interaction on Balance (CTSIB). For test–retest reliability, the SensIWalk Test was repeated two to 10 days later.

Results: Fifteen healthy young (mean age: 25.1±5.1 years, 60% female) and 15 healthy older adults (mean age: 69.8±3.6 years, 60% female) were included. Linear mixed-effects models revealed a significant main effect of condition on center of mass path length during the SensIWalk Test (F(5, 28.5) = 18.52, p < .001), much like in CTSIB (F(5, 29.0) = 64.86, p < .001). Bonferroni-corrected post-hoc analyses showed that during SensIWalk, no difference was observed between C1 and C2, and significant increases were displayed in conditions C3 to C6, whereas C2–C6 in CTSIB resulted in greater path length compared with C1. Test-retest reliability ranged from moderate to good across conditions (ICC(3,1) ≈ 0.618–0.899).

Conclusion: This study demonstrated that the SensIWalk is a valid and reliable assessment of sensory integration during walking for a mixture of young and older adults, further supporting its use in fall research.