Interdisciplinary expert agreement on group and definitions for compensatory protective step strategies to prevent falls: A e-Delphi method study

Abstract

Background: Older adults have a high probability of experiencing falls during activities of daily living, which can lead to fear of falling, alterations in gait patterns, decreased mobility, reduced social interactions, and limited ability to perform various tasks. Previous studies examining gait in the presence of perturbations have identified and analyzed several protective gait strategies aimed at preventing falls. However, there is a lack of standardized terminology and definitions for these strategies, hindering comparison and collaborative progress among researchers and professionals. Objective: To unify definitions of compensatory protective step strategies and establish a standardized terminology. Methods: This study adapted the Conducting and Reporting of Delphi Studies (CREDES) guidelines and followed a chronological sequence: 1) Preliminary phase: A literature review and both quantitative (three dimensions: relevance, wording, and identification, assessed using a Likert-type scale (1 to 5) and qualitative (an open-ended question) assessment were conducted; 2) Exploratory phase: Expert panel selection (n = 14) and the e-Delphi study were conducted; and 3) Final phase: Expert opinions were collected and analyzed. Content validity was assessed using Aiken’s V coefficient. Results: The results demonstrated high levels of validity (V ≥ 0.68) for all definitions, with none being eliminated based on Aiken’s V critical value. Conclusion: A precise definition was developed for each of the 14 compensatory protective step strategies (13 identified in the scoping review and one added by the expert panel). In total, the number of definitions was reduced from 61 to 14, with one definition for each of the compensatory protective step strategies identified.