Dataset Information

Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults.

ABSTRACT: Thus far, few studies have examined the estimation and actual performance of locomotor ability in older adults. To our knowledge, there are no studies examining the relationship between stepping-forward estimation versus ability and fall occurrence. The aim of this study was to develop and assess the reliability and validity of a new test for fall risk assessment in community-dwelling older adults. In total, 347 participants (73.1 ± 6.2 years; 266 women) were assessed for their perception of maximum distance for the stepping-forward and action boundary. The test was developed following the existing literature and expert opinions. The task showed strong internal consistency. Intraclass correlation ranged from 0.99 to 1 for intrarater agreement and from 0.83 to 0.97 for interrater agreement. Multivariate binary regression analysis models revealed an area under the curve (AUC) of 0.665 (95% CI: 0.608-0.723) for fallers and 0.728 (95% CI: 0.655-0.797) for recurrent fallers. The stepping-forward affordance perception test (SF-APT) was demonstrated to be accurate, reliable and valid for fall risk assessment. The results showed that a large estimated stepping-forward associated with an underestimated absolute error works as a protective mechanism for fallers and recurrent fallers in community-dwelling older adults. SF-APT is safe, quick, easy to administer, well accepted and reproducible for application in community or clinical settings by either clinical or nonclinical care professionals.

SUBMITTER: Almeida G

PROVIDER: S-EPMC6867623 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults.

Almeida Gabriela G Bravo Jorge J Folgado Hugo H Rosado Hugo H Mendes Felismina F Pereira Catarina C

PloS one 20191120 11

Thus far, few studies have examined the estimation and actual performance of locomotor ability in older adults. To our knowledge, there are no studies examining the relationship between stepping-forward estimation versus ability and fall occurrence. The aim of this study was to develop and assess the reliability and validity of a new test for fall risk assessment in community-dwelling older adults. In total, 347 participants (73.1 ± 6.2 years; 266 women) were assessed for their perception of max ...[more]

PMID: 31747394

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Project description:Low back pain is associated with changes in trunk muscle structure and function and motor control impairments. Voluntary force modulation (FM) of trunk muscles is a unique and under-investigated motor control characteristic. One of the reasons for this paucity of evidence is the lack of exploration and publication on the reliability and validity of trunk FM protocols. The purpose of this study was to determine the within- and between-day test-retest reliability and construct validity for trunk extensor muscle FM. Twenty-nine healthy participants were tested under three FM conditions with different modulation rates. Testing was performed on a custom-built apparatus designed for trunk isometric force testing. FM accuracy relative to a fluctuating target force (20-50%MVF) was quantified using the root mean square error of the participant's generated force relative to the target force. Reliability and precision of measurement were assessed using the Intraclass Correlation Coefficient (ICC), standard error of measurement (SEM), minimal detectable difference (MDD95), and Bland-Altman plots. In a subset of participants, we collected surface electromyography of trunk and hip muscles. We used non-negative matrix factorization (NNMF) to identify the underlying motor control strategies. Within- and between-day test-retest reliability was excellent for FM accuracy across the three conditions (ICC range: 0.865 to 0.979). SEM values ranged 0.9-1.8 Newtons(N) and MDD95 ranged from 2.4-4.9N. Conditions with faster rates of FM had higher ICCs. NNMF analysis revealed two muscle synergies that were consistent across participants and conditions. These synergies demonstrate that the muscles primarily involved in this FM task were indeed the trunk extensor muscles. This protocol can consistently measure FM accuracy within and between testing sessions. Trunk extensor FM, as measured by this protocol, is not specific to any trunk muscle group but is the result of modulation by all the trunk extensor muscles.

Project description:BackgroundThe Fukuda-stepping-test (FST), i.e., repetitive walking on the spot while blindfolded, has been proposed as a means to assess the integrity of the vestibular pathways. While its sensitivity to detect abnormalities in patients is limited, it may be useful in studying the physiology of the subjective-straight-ahead (SSA). Considering reported systematic shifts in SSA in humans, we hypothesize that such asymmetries arise from individual differences in the orientation/configuration of the macular organs and in central processing of vestibular input. We hypothesize that such asymmetries are stable over time in individual subjects. Alternatively, such asymmetries may arise from random noise in the sensory/motor systems involved, demonstrating low reproducibility over time.Materials and methodsTwenty-four subjects walked on the spot over 60 s while blindfolded (n = 6 trials per subject). Using an inertial measurement unit (IMU) placed at the chest, angular deviations were recorded and compared to manually-measured final positions. Both static (direction, magnitude) and dynamic (time-to-onset of deviation, pattern of deviations) parameters were retrieved from the yaw slopes.ResultsSignificant deviations were found in 15/24 participants for the manual measurements (leftwards = 8; rightwards = 7), whereas when using the IMU-sensor 13/24 participants showed significant shifts (leftwards = 9; rightwards = 4). There was a high correlation (0.98) between manually measured rotation angles (average absolute deviations = 58.0 deg ± 48.6 deg; intra-individual variability = 39 deg ± 24 deg) and sensor-based yaw slopes (1.00 deg/s ± 0.88 deg/s; 0.67 deg/s ± 0.41 deg/s). Relevant yaw deviation was detected 22.1 s ± 12.3 s (range = 5.6 s-59.2 s) after the onset of marching (no relevant yaw-deviation in 15/139 measurements), showing a mostly linear behavior over time.ConclusionWe observed significant inter-individual variability in task performance in the FST, reproducing findings from previous studies. With test-re-test reliability being moderate only, but at the same time observing a preference in the side of shifts in most trials and subjects, we conclude that likely both individually varying estimates of straight-ahead and random noise contribute to the pattern of angular deviations observed. Using an IMU-sensory based approach, additional dynamic parameters could be retrieved, emphasizing the value of such a quantitative approach over manual measurements. Such an approach may provide useful additional information to distinguish patients from healthy controls.

Dataset Information

Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults.

Publications

Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults.

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