Dataset Information

Mobility assessment: sensitivity and specificity of measurement sets in older adults.

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.

SUBMITTER: Panzer VP

PROVIDER: S-EPMC3146767 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Mobility assessment: sensitivity and specificity of measurement sets in older adults.

Panzer Victoria P VP Wakefield Dorothy B DB Hall Charles B CB Wolfson Leslie I LI

Archives of physical medicine and rehabilitation 20110601 6

<h4>Objective</h4>To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall risk, and predict future falls.<h4>Design</h4>Observational study with 1-year weekly falls follow-up.<h4>Setting</h4>Mobility laboratory.<h4>Participants</h4>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 prev ...[more]

PMID: 21621667

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Project description:BackgroundUnderstanding the factors that influence hospital mobility, especially in the context of a heightened focus on falls prevention, is needed to improve care.ObjectiveThis qualitative study uses a socioecological framework to explore factors that influence hospital mobility in older adults.DesignQualitative research PARTICIPANTS: Semi-structured interviews and focus groups were conducted with medically-ill hospitalized older adults (n = 19) and providers (hospitalists, nurses, and physical and occupational therapists (n = 48) at two hospitals associated with an academic health system.ApproachInterview and focus group guides included questions on perceived need for mobility, communication about mobility, hospital mobility culture, and awareness of patients' walking activity. Data were analyzed thematically and mapped onto the constructs of the socioecological model.Key resultsA consistent theme among patients and providers was that "mobility is medicine." Categories of factors reported to influence hospital walking activity included intrapersonal factors (patients' health status, fear of falls), interpersonal factors (patient-provider communication about mobility), organizational factors (clarity about provider roles and responsibilities, knowledge of safe patient handling, reliance on physical therapy for mobility), and environmental factors (falls as a never event, patient geographical locations on hospital units). Several of these factors were identified as potentially modifiable targets for intervention. Patients and providers offered recommendations for improving awareness of patient's ambulatory activity, assigning roles and responsibility for mobility, and enhancing education and communication between patients and providers across disciplines.ConclusionPatients and providers identified salient factors for future early mobility initiatives targeting hospitalized older adults. Consideration of these factors across all stages of intervention development and implementation will enhance impact and sustainability.

Dataset Information

Mobility assessment: sensitivity and specificity of measurement sets in older adults.

Objective

Design

Setting

Participants

Interventions

Main outcome measures

Results

Conclusions

Publications

Mobility assessment: sensitivity and specificity of measurement sets in older adults.

Similar Datasets

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