scholarly journals Functional Gait Assessment: Concurrent, Discriminative, and Predictive Validity in Community-Dwelling Older Adults

2010 ◽  
Vol 90 (5) ◽  
pp. 761-773 ◽  
Author(s):  
Diane M. Wrisley ◽  
Neeraj A. Kumar
Keyword(s):  
Older Adults ◽  
Predictive Validity ◽  
Fall Risk ◽  
Small Sample Size ◽  
Small Sample ◽  
Community Dwelling ◽  
Cutoff Score ◽  
Gait Assessment ◽  
Functional Gait ◽  
Community Dwelling Older Adults

BackgroundThe Functional Gait Assessment (FGA) is a reliable and valid measure of gait-related activities.ObjectiveThe purpose of this study was to determine the concurrent, discriminative, and predictive validity of the FGA in community-dwelling older adults.DesignThis was a prospective cohort study.MethodsThirty-five older adults aged 60 to 90 years completed the Activities-specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed “Up & Go” Test (TUG), and Functional Gait Assessment (FGA) during one session. Falls were tracked by having participants complete a monthly fall calendar for 6 months. Spearman correlation coefficients were used to determine concurrent validity among the ABC, BBS, TUG, DGI, and FGA. To determine the optimum scores to classify fall risk, sensitivity (Sn), specificity (Sp), and positive and negative likelihood ratios (LR+ and LR−) were calculated for the FGA in classifying fall risk based on the published criterion scores of the DGI and TUG and for the FGA, TUG, and DGI in identifying prospective falls. Receiver operator curves with area under the curve were used to determine the effectiveness of the FGA in classifying fall risk and of the DGI, TUG, and FGA in identifying prospective falls.ResultsThe FGA correlated with the ABC (r=.053, P<.001), BBS (r=.84, P<.001), and TUG (r=−.84, P<.001). An FGA score of ≤22/30 provides both discriminative and predictive validity. The FGA (scores ≤22/30) provided 100% Sn, 72% Sp, LR+ of 3.6, and LR− of 0 to predict prospective falls.LimitationsThe study was limited by the length of time of follow-up and the small sample size that did not allow for evaluation of criterion scores by decade.ConclusionsThe FGA with a cutoff score of 22/30 is effective in classifying fall risk in older adults and predicting unexplained falls in community-dwelling older adults.

scholarly journals Minimal Clinically Important Difference of the Functional Gait Assessment in Older Adults

2014 ◽  
Vol 94 (11) ◽  
pp. 1594-1603 ◽  
Author(s):  
Marianne Beninato ◽  
Arlene Fernandes ◽  
Laura S. Plummer
Keyword(s):  
Older Adults ◽  
Minimal Clinically Important Difference ◽  
Physical Therapists ◽  
Weighted Kappa ◽  
Small Sample ◽  
Community Dwelling ◽  
Poor Agreement ◽  
Gait Assessment ◽  
Clinically Important Difference ◽  
Functional Gait

BackgroundThe Functional Gait Assessment (FGA) is commonly used to measure walking balance. The minimal clinically important difference (MCID) has yet to be determined for the FGA.ObjectiveThe purposes of this study were to determine: (1) the MCID in the FGA for older community-dwelling adults relative to patients' and physical therapists' estimates of change and (2) the extent of agreement between patients' and physical therapists' estimates of change.DesignThis study was a prospective case series.MethodsPatients and physical therapists rated the amount of change in balance while walking after an episode of physical therapy for balance retraining on a 15-point global rating of change (GROC) scale. Weighted kappa statistics were calculated to express agreement between patients' and physical therapists' GROC ratings. Functional Gait Assessment change scores were plotted on receiver operating characteristic curves. A cutoff of +3 on the GROC was the criterion used for important change. The optimal FGA change cutoff score for MCID was determined, and sensitivity (SN), specificity (SP), and likelihood ratios (LRs) were calculated.ResultsOne hundred thirty-five community-dwelling older adults (average age=78.8 years) and 14 physical therapists participated. There was poor agreement between the patients' and therapists' ratings of change (weighted kappa=.163). The estimated MCID value for the FGA using physical therapists' ratings of change as an anchor was 4 points (SN=0.66, SP=0.84, LR+=4.07, LR−=0.40). No accurate value for the FGA MCID could be determined based on the patients' ratings of change.LimitationsThe small sample size was a limitation.ConclusionPoor agreement between therapists' and patients' ratings indicate the need for further communication relative to patient goals. The 4-point MCID value for the FGA can be used for goal setting, tracking patient progress, and program evaluation.

scholarly journals A Pilot Study Using the Life Space Assessment Among Community-Dwelling Older Adults in Ireland

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 673-673
Author(s):  
Tadhg Stapleton
Keyword(s):  
Older Adults ◽  
Small Sample Size ◽  
Significant Negative Correlation ◽  
Daily Basis ◽  
Small Sample ◽  
Community Dwelling ◽  
Significant Difference ◽  
Vas Scores ◽  
Rural Dwellers ◽  
Community Dwelling Older Adults

Abstract Forty older adults (27, 67.5% female), mean age 74.3 years (range 65- 89), current drivers 31 (77.5%), 23 (57.5%) rural dwellers and 17 (42.5%) urban dwellers participated in the survey. Median LSA score was 74 (range 27-102). All participants were readily accessing life spaces within and immediately outside their own home. Over half (n=23, 57.5%) accessed spaces in their neighbourhood on a daily basis. Decreased frequency of access to spaces outside of local neighbourhood and town was noted. No significant difference in LSA scores between genders (P=0.549), current driving status (P=0.235), but urban dwellers had significantly higher LSA scores than rural dwellers (P=0.024). Spearman correlations found statistically significant negative correlation between age and LSA scores (rho= -0.445, P=0.004), and significant positive correlation between LSA and Euroqol (EQ) VAS scores (rho=0.405, P=0.010). Findings are limited by the small sample size but highlight decreasing frequency of wider community participation with increasing age.

scholarly journals CROSS-CULTURAL ADAPTATION AND RELIABILITY OF THE FUNCTIONAL GAIT ASSESSMENT FOR OLDER BRAZILIANS

2021 ◽  
Author(s):  
Renata Noce Kirkwood ◽  
Natália Cristina Lisboa Batista ◽  
Larissa Bragança Falcão Marques ◽  
Juliana de Melo Ocarino ◽  
Lucas Lobo Alcântara Neves ◽  
...  
Keyword(s):  
Older Adults ◽  
Cultural Adaptation ◽  
Community Dwelling ◽  
Gait Assessment ◽  
Functional Gait ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Community Dwelling Older Adults ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

INTRODUCTION: Many instruments have been used to identify older adults at risk of falling, including performance-oriented mobility assessment, timed up and go test, Berg balance scale, and dynamic gait index. However, there have been reports of these clinical tests having a ceiling effect on community-dwelling older adults. To address this issue, the functional gait assessment was developed based on the dynamic gait index. Therefore, the functional gait assessment is an instrument that assesses postural stability during tasks that cause changes in gait patterns. OBJECTIVES: To translate and cross-culturally adapt the functional gait assessment to the Brazilian Portuguese language and to assess its psychometric properties in older Brazilians living in the community. METHODS: The process of translation and cross-cultural adaptation followed the recommendations of international guidelines. The pre-final version was administered to a sample of 30 older adults, both male and female, living independently in the community. To examine the psychometric properties (reliability, standard error of measurement, and internal consistency), 70 older adults aged 60 to 87 years were evaluated. RESULTS: The original and the translated versions were considered conceptually equivalent. All functional gait assessment items whose numbers were measured in inches and feet were converted to centimeters and rounded off to comply with the unit of measurement used in Brazil. The functional gait assessment-Brazil showed excellent inter- and intraexaminer reliability (intraclass correlation coefficient > 0.90), low standard error of measurement (range = 1.03 to 1.52), and good internal consistency (Cronbach alpha = 0.858). CONCLUSIONS: The functional gait assessment-Brazil is a semantically, linguistically, and psychometrically appropriate instrument for assessing balance during walking in community-dwelling older adults.

scholarly journals Construct and criterion validity of the functional gait assessment—Brazil in community-dwelling older adults

2020 ◽  
Author(s):  
Larissa Bragança Falcão Marques ◽  
Bruno de Souza Moreira ◽  
Juliana de Melo Ocarino ◽  
Rosana Ferreira Sampaio ◽  
Alessandra de Carvalho Bastone ◽  
...  
Keyword(s):  
Older Adults ◽  
Criterion Validity ◽  
Community Dwelling ◽  
Gait Assessment ◽  
Functional Gait ◽  
Community Dwelling Older Adults

scholarly journals Multisensory integration involved in the body perception of community-dwelling older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Hide ◽  
Y. Ito ◽  
N. Kuroda ◽  
M. Kanda ◽  
W. Teramoto
Keyword(s):  
Older Adults ◽  
Multisensory Integration ◽  
Fall Risk ◽  
Community Dwelling ◽  
The Body ◽  
Risk Of Falling ◽  
Body Perception ◽  
Rubber Hand ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

scholarly journals Fall Risk Classification in Community-Dwelling Older Adults Using a Smart Wrist-Worn Device and the Resident Assessment Instrument-Home Care: Prospective Observational Study (Preprint)

2018 ◽  
Author(s):  
Yang Yang ◽  
John P Hirdes ◽  
Joel A Dubin ◽  
Joon Lee
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Prospective Observational Study ◽  
Risk Classification ◽  
Community Dwelling ◽  
Assessment Instrument ◽  
Classification Models ◽  
Resident Assessment ◽  
Community Dwelling Older Adults ◽  
Resident Assessment Instrument

BACKGROUND  Little is known about whether off-the-shelf wearable sensor data can contribute to fall risk classification or complement clinical assessment tools such as the Resident Assessment Instrument-Home Care (RAI-HC). OBJECTIVE  This study aimed to (1) investigate the similarities and differences in physical activity (PA), heart rate, and night sleep in a sample of community-dwelling older adults with varying fall histories using a smart wrist-worn device and (2) create and evaluate fall risk classification models based on (i) wearable data, (ii) the RAI-HC, and (iii) the combination of wearable and RAI-HC data. METHODS  A prospective, observational study was conducted among 3 faller groups (G0, G1, G2+) based on the number of previous falls (0, 1, ≥2 falls) in a sample of older community-dwelling adults. Each participant was requested to wear a smart wristband for 7 consecutive days while carrying out day-to-day activities in their normal lives. The wearable and RAI-HC assessment data were analyzed and utilized to create fall risk classification models, with 3 supervised machine learning algorithms: logistic regression, decision tree, and random forest (RF). RESULTS  Of 40 participants aged 65 to 93 years, 16 (40%) had no previous falls, whereas 8 (20%) and 16 (40%) had experienced 1 and multiple (≥2) falls, respectively. Level of PA as measured by average daily steps was significantly different between groups (P=.04). In the 3 faller group classification, RF achieved the best accuracy of 83.8% using both wearable and RAI-HC data, which is 13.5% higher than that of using the RAI-HC data only and 18.9% higher than that of using wearable data exclusively. In discriminating between {G0+G1} and G2+, RF achieved the best area under the receiver operating characteristic curve of 0.894 (overall accuracy of 89.2%) based on wearable and RAI-HC data. Discrimination between G0 and {G1+G2+} did not result in better classification performance than that between {G0+G1} and G2+. CONCLUSIONS  Both wearable data and the RAI-HC assessment can contribute to fall risk classification. All the classification models revealed that RAI-HC outperforms wearable data, and the best performance was achieved with the combination of 2 datasets. Future studies in fall risk assessment should consider using wearable technologies to supplement resident assessment instruments.

Single-Session Evidence-Based Intervention and Fall Risk Awareness in Community-Dwelling Older Adults

2021 ◽  
Vol 37 (3) ◽  
pp. 198-206
Author(s):  
Brenda S. Howard ◽  
Fiona Brown Jones ◽  
Aundrea Sellers Steenblock ◽  
Kiersten Ham Butler ◽  
Ellen Thomas Laub ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Community Dwelling ◽  
Evidence Based ◽  
Risk Awareness ◽  
Single Session ◽  
Community Dwelling Older Adults
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