Mobility assessment: sensitivity and specificity of measurement sets in older adults.
Identifieur interne : 000C37 ( Main/Corpus ); précédent : 000C36; suivant : 000C38Mobility assessment: sensitivity and specificity of measurement sets in older adults.
Auteurs : Victoria P. Panzer ; Dorothy B. Wakefield ; Charles B. Hall ; Leslie I. WolfsonSource :
- Archives of physical medicine and rehabilitation [ 1532-821X ] ; 2011.
English descriptors
- KwdEn :
- MESH :
Abstract
OBJECTIVE
To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall risk, and predict future falls.
DESIGN
Observational study with 1-year weekly falls follow-up.
SETTING
Mobility laboratory.
PARTICIPANTS
Community-dwelling volunteers (N=74; age, 65-94y) categorized at entry as 27 nonfallers or 47 fallers by using Medicare criteria (1 injury fall or >1 noninjury fall in the previous year).
INTERVENTIONS
None.
MAIN OUTCOME MEASURES
Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (falls status), Tinetti Performance Oriented Mobility Assessment (POMA), computerized dynamic posturography Sensory Organization Test (SOT), and subsequent falls reported weekly.
RESULTS
Measurement variables were selected that met reliability (intraclass coefficient of correlation >.6) and/or discrimination (P<.01) criteria (clinical variables: turn steps and time, gait velocity, step-in-tub time, downstairs time; forceplate variables: quiet standing Romberg ratio sway area, maximal lean anterior-posterior excursion, sit-to-stand medial-lateral excursion, sway area). Sets were created (3 clinical, 2 forceplate) using combinations of variables appropriate for older adults with different functional activity levels, and composite scores were calculated. Scores identified entry falls status and concurred with POMA and SOT scores. The full clinical set (5 measurement variables) produced sensitivity of 80% and specificity of 74% to falls status. Composite scores were more sensitive and specific overall in predicting subsequent injury falls and multiple falls compared with falls status and POMA or SOT score.
CONCLUSIONS
Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls by using tasks that should be appropriate to diverse participants.
DOI: 10.1016/j.apmr.2011.01.004
PubMed: 21621667
PubMed Central: PMC3146767
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pubmed:21621667Le document en format XML
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<author><name sortKey="Panzer, Victoria P" sort="Panzer, Victoria P" uniqKey="Panzer V" first="Victoria P" last="Panzer">Victoria P. Panzer</name>
<affiliation><nlm:affiliation>Department of Neurology, University of Connecticut Health Center, Farmington, CT 06030-1840, USA. panzer@nso1.uchc.edu</nlm:affiliation>
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<author><name sortKey="Wakefield, Dorothy B" sort="Wakefield, Dorothy B" uniqKey="Wakefield D" first="Dorothy B" last="Wakefield">Dorothy B. Wakefield</name>
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<author><name sortKey="Hall, Charles B" sort="Hall, Charles B" uniqKey="Hall C" first="Charles B" last="Hall">Charles B. Hall</name>
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<author><name sortKey="Wolfson, Leslie I" sort="Wolfson, Leslie I" uniqKey="Wolfson L" first="Leslie I" last="Wolfson">Leslie I. Wolfson</name>
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<author><name sortKey="Hall, Charles B" sort="Hall, Charles B" uniqKey="Hall C" first="Charles B" last="Hall">Charles B. Hall</name>
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<author><name sortKey="Wolfson, Leslie I" sort="Wolfson, Leslie I" uniqKey="Wolfson L" first="Leslie I" last="Wolfson">Leslie I. Wolfson</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (MeSH)</term>
<term>Activities of Daily Living (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Biomechanical Phenomena (MeSH)</term>
<term>Female (MeSH)</term>
<term>Geriatric Assessment (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Movement (MeSH)</term>
<term>Sensitivity and Specificity (MeSH)</term>
<term>Task Performance and Analysis (MeSH)</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Accidental Falls</term>
<term>Activities of Daily Living</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Biomechanical Phenomena</term>
<term>Female</term>
<term>Geriatric Assessment</term>
<term>Humans</term>
<term>Male</term>
<term>Movement</term>
<term>Sensitivity and Specificity</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall risk, and predict future falls.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN</b>
</p>
<p>Observational study with 1-year weekly falls follow-up.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SETTING</b>
</p>
<p>Mobility laboratory.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b>
</p>
<p>Community-dwelling volunteers (N=74; age, 65-94y) categorized at entry as 27 nonfallers or 47 fallers by using Medicare criteria (1 injury fall or >1 noninjury fall in the previous year).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b>
</p>
<p>None.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURES</b>
</p>
<p>Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (falls status), Tinetti Performance Oriented Mobility Assessment (POMA), computerized dynamic posturography Sensory Organization Test (SOT), and subsequent falls reported weekly.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Measurement variables were selected that met reliability (intraclass coefficient of correlation >.6) and/or discrimination (P<.01) criteria (clinical variables: turn steps and time, gait velocity, step-in-tub time, downstairs time; forceplate variables: quiet standing Romberg ratio sway area, maximal lean anterior-posterior excursion, sit-to-stand medial-lateral excursion, sway area). Sets were created (3 clinical, 2 forceplate) using combinations of variables appropriate for older adults with different functional activity levels, and composite scores were calculated. Scores identified entry falls status and concurred with POMA and SOT scores. The full clinical set (5 measurement variables) produced sensitivity of 80% and specificity of 74% to falls status. Composite scores were more sensitive and specific overall in predicting subsequent injury falls and multiple falls compared with falls status and POMA or SOT score.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls by using tasks that should be appropriate to diverse participants.</p>
</div>
</front>
</TEI>
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<AbstractText Label="DESIGN" NlmCategory="METHODS">Observational study with 1-year weekly falls follow-up.</AbstractText>
<AbstractText Label="SETTING" NlmCategory="METHODS">Mobility laboratory.</AbstractText>
<AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">Community-dwelling volunteers (N=74; age, 65-94y) categorized at entry as 27 nonfallers or 47 fallers by using Medicare criteria (1 injury fall or >1 noninjury fall in the previous year).</AbstractText>
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<AbstractText Label="MAIN OUTCOME MEASURES" NlmCategory="METHODS">Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (falls status), Tinetti Performance Oriented Mobility Assessment (POMA), computerized dynamic posturography Sensory Organization Test (SOT), and subsequent falls reported weekly.</AbstractText>
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<CopyrightInformation>Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
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