Reliability, measurement error and minimum detectable change in mobility measures: a cohort study of community-dwelling adults aged 50 years and over in Ireland

ObjectiveTo estimate the effects of repeat assessments, rater and time of day on mobility measures and to estimate their variation between and within participants in a population-based sample of Irish adults aged ≥50 years.DesignTest–retest study in a population representative sample.SettingAcademic health assessment centre of The Irish Longitudinal Study on Ageing (TILDA).Participants128 community-dwelling adults from the Survey for Health, Ageing and Retirement in Europe (SHARE) Ireland study who agreed to take part in the SHARE-Ireland/TILDA collaboration.InterventionsNot applicable.Outcome measuresParticipants performed timed up-and-go (TUG), repeated chair stands (RCS) and walking speed tests administered by one of two raters. Repeat assessments were conducted 1–4 months later. Participants were randomised with respect to a change in time (morning, afternoon) and whether the rater was changed between assessments. Within and between-participant variance for each measure was estimated using mixed-effects models. Intraclass correlation (ICC), SE of measurement and minimum detectable change (MDC) were reported.ResultsAverage performance did not vary between baseline and repeat assessments in any test, except RCS. The rater significantly affected performance on all tests except one, but time of day did not. Reliability varied from ICC=0.66 (RCS) to ICC=0.88 (usual gait speed). MDC was 2.08 s for TUG, 4.52 s for RCS and ranged from 19.49 to 34.73 cm/s for walking speed tests. There was no evidence for lower reliability of gait parameters with increasing time between assessments.ConclusionsReliability varied for each test when measurements are obtained over 1–4 months with most variation due to rater effects. Usual and motor dual task gait speed demonstrated highest reliability.

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Reliability and minimal detectable change values for performance-based measures of physical functioning in the Canadian Longitudinal Study on Aging (CLSA)

The Journals of Gerontology Series A ◽

10.1093/gerona/glab175 ◽

2021 ◽

Author(s):

Marla K Beauchamp ◽

Qiukui Hao ◽

Ayse Kuspinar ◽

Cassandra D’Amore ◽

Giulia Scime ◽

...

Keyword(s):

Longitudinal Study ◽

Grip Strength ◽

Gait Speed ◽

Community Dwelling ◽

Minimal Detectable Change ◽

Age Group ◽

Detectable Change ◽

Timed Up And Go ◽

Single Leg Stance ◽

Chair Rise

Abstract BACKGROUND The aim of this study was to determine the relative and absolute reliabilities of five key performance-based measures of physical function in the Canadian Longitudinal Study on Aging (CLSA). METHODS An age-stratified sub-sample of 147 participants from the CLSA who were undergoing their 3-year data collection visit participated in two repeat visits (within one week). Participants underwent tests of grip strength, 4-metre gait speed, Timed Up and Go (TUG), chair-rise and single-leg stance (left, right, mean, maximum). Intra-class correlation coefficients (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) values were calculated. RESULTS The relative reliability for grip strength was excellent (ICC = 0.95); the TUG and single-leg stance tests had good reliability (ICC = 0.80 or 0.78-0.82, respectively); gait speed and the chair-rise test had moderate reliability (ICC=0.64 for both) for participants overall. For participants between 50 and 64 years, TUG and gait speed had poor reliabilities (ICC = 0.38 or 0.33, respectively). For participants aged 75+ years, the single-leg stance had poor reliability (ICC=0.30-0.39). The MDC90 was about 6 kg for grip strength, 2.3 seconds for TUG, 0.2 metres/second for gait speed, 5.2 seconds for chair-rise, and ranged from 22.8 to 26.2 seconds for the single-leg stance. CONCLUSIONS Among community-dwelling Canadians >50 years old, the reliabilities of the CLSA measures were moderate to excellent. The TUG and gait speed in the youngest age group, and the single-leg stance in oldest age group, showed poor reliability. MDC values can be used to interpret changes over time.

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Safety, Feasibility, and Reliability of the Maximal Step Length, Gait Speed, and Chair Test Measured by Seniors Themselves: The Senior Step Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2013-0231 ◽

2015 ◽

Vol 23 (3) ◽

pp. 438-443 ◽

Cited By ~ 6

Author(s):

Kim T.J. Bongers ◽

Yvonne Schoon ◽

Maartje J. Graauwmans ◽

Marlies E. Hoogsteen-Ossewaarde ◽

Marcel G.M. Olde Rikkert

Keyword(s):

Older Adults ◽

Gait Speed ◽

Fall Risk ◽

Intraclass Correlation ◽

Step Length ◽

Community Dwelling ◽

Self Management ◽

Training Effect ◽

Community Dwelling Older Adults ◽

At Home

Self-management of mobility and fall risk might be possible if older adults could use a simple and safe self-test to measure their own mobility, balance, and fall risk at home. The aim of this study was to determine the safety, feasibility, and intraindividual reliability of the maximal step length (MSL), gait speed (GS), and chair test (CT) as potential self-tests for assessing mobility and fall risk. Fifty-six community-dwelling older adults performed MSL, GS, and CT at home once a week during a four-week period, wherein the feasibility, test-retest reliability, coefficients of variation, and linear mixed models with random effects of these three self-tests were determined. Forty-nine subjects (mean age 76.1 years [SD: 4.0], 19 females [42%]) completed the study without adverse effects. Compared with the other self-tests, MSL gave the most often (77.6%) valid measurement results and had the best intraclass correlation coefficients (0.95 [95% confidence interval: 0.91−0.97]). MSL and GS gave no significant training effect, whereas CT did show a significant training effect (p < .01). Community-dwelling older adults can perform MSL safely, correctly, and reliably, and GS safely and reliably. Further research is needed to study the responsiveness and beneficial effects of these self-tests on self-management of mobility and fall risk.

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Performance on a test of rapid stepping in community-dwelling older adults: validity, relative and absolute reliability and minimum detectable change

Physiotherapy Theory and Practice ◽

10.3109/09593985.2015.1024805 ◽

2015 ◽

Vol 31 (7) ◽

pp. 483-488 ◽

Cited By ~ 4

Author(s):

Allon Goldberg ◽

Susan Ann Talley

Keyword(s):

Older Adults ◽

Community Dwelling ◽

Detectable Change ◽

Minimum Detectable Change ◽

Community Dwelling Older Adults ◽

Absolute Reliability

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Accuracy and Reliability of X-ray Measurements in the Cervical Spine

Asian Spine Journal ◽

10.31616/asj.2019.0069 ◽

2020 ◽

Vol 14 (2) ◽

pp. 169-176

Author(s):

Catarina Marques ◽

Emma Granström ◽

Anna MacDowall ◽

Nuno Canto Moreira ◽

Martin Skeppholm ◽

...

Keyword(s):

Cobb Angle ◽

Controlled Trial ◽

Intraclass Correlation ◽

Vertical Axis ◽

Minimal Detectable Change ◽

Detectable Change ◽

Sagittal Vertical Axis ◽

Minimum Detectable Change ◽

Spine Surgeon ◽

Segmental Angle

Study Design: This study is a post hoc analysis of a multicenter prospective randomized controlled trial which compared artificial disc replacement and anterior cervical discectomy and fusion.Purpose: Useful radiographic parameters for assessing cervical alignment include the Cobb angles, T1 slope (T1S), occipitocervical inclination (OCI), K-line tilt (KLT), and cervical sagittal vertical axis (cSVA). This study aimed to determine measurement accuracy and reliability for these parameters.Overview of Literature: Various authors have assessed repeatability by comparing different methods of measurement, but knowledge of measurement error and minimal detectable change is scarce.Methods: We evaluated 758 lateral cervical radiographs. One medical student and one spine surgeon (i.e., measured ×2 within 4 weeks) independently measured the parameters obtaining 5,850 values. Standard error of measurement (SEm) and minimum detectable change (MDC) were calculated for each parameter. The accuracy and reliability of the Cobb angle measurements were calculated for the different types of angles: cervical lordosis, prosthesis angle, segmental angle with two bone surfaces (SABB), and segmental angle with one bone and one metal surface. Reliability was determined with intraclass correlation coefficient (ICC).Results: SEm was 1.8° and MDC was 5.0° for the Cobb angle, with an intraobserver/interobserver ICC of 0.958/0.886. All the different subtypes of Cobb angles had an ICC higher than 0.950, except SABB (intraobserver/interobserver ICC of 0.922/0.716). The most accurate and reliable measurement was for KLT.Conclusions: This study provides normative data on SEm and MDC for Cobb angles, T1S, KLT, OCI, and cSVA in cervical lateral radiographs. Reliability was excellent for all parameters except SABB (e.g., good).

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Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111083 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11083

Author(s):

Hyungchul Park ◽

Jihye Lim ◽

Ji Yeon Baek ◽

Eunju Lee ◽

Hee-Won Jung ◽

...

Keyword(s):

Older Adults ◽

Gait Speed ◽

Population Based ◽

Cross Sectional Study ◽

Clinical Suspicion ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Iadl Disability ◽

Community Dwelling Older Adults

(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.

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Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

10.21203/rs.3.rs-29886/v2 ◽

2020 ◽

Author(s):

Yuki Kusagawa ◽

Toshiyuki Kurihara ◽

Aiko Imai ◽

Sumiaki Maeo ◽

Takashi Sugiyama ◽

...

Keyword(s):

Older Adults ◽

Young Adults ◽

Older Women ◽

Walking Speed ◽

Community Dwelling ◽

Timed Up And Go ◽

Chair Stand ◽

Foot Posture ◽

Toe Flexor Strength ◽

Flexor Strength

Abstract Background: Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods: Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-second chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results: TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = -0.32, p = 0.07) and supinated (r = -0.56, p = 0.08) groups, and positively correlate with 30-second chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions: The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

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Effectiveness of a Treadmill Training Programme in Improving the Postural Balance on Institutionalized Older Adults

Journal of Aging Research ◽

10.1155/2020/4980618 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Natalia Moya Pereira ◽

Marcel Jean Pierre Massè Araya ◽

Marcos Eduardo Scheicher

Keyword(s):

Older Adults ◽

Gait Speed ◽

Postural Balance ◽

Intervention Group ◽

Community Dwelling ◽

Treadmill Walking ◽

Control Group ◽

Timed Up And Go ◽

Positive Effects ◽

Before And After

Background. Institutionalized older adults have increased gait and balance impairment compared with community-dwelling older adults. The use of the treadmill for the rehabilitation process has been studied in different groups, but not in the institutionalized elderly. Objectives. The objective of this study was to assess the effects of a treadmill walking workout program on the postural balance of institutionalized older adults. Methods. Postural balance was assessed by the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), gait speed, and Timed Up and Go Test (TUG) on 37 institutionalized older adults (23 in the intervention group and 14 in the control group). Training consisted of a 20-minute treadmill walking workout carried out twice a week for 10 weeks. Measurements were obtained before and after 10 weeks and with 1 month of follow-up for the intervention group. For the control group, the data were obtained before and after the training period. Results. Significant improvement occurred in all motor function parameters (BBS: p<0.01; gait speed: p<0.001; SPPB: p<0.001; and TUG: p<0.001). Conclusions. The present results permit us to conclude that a treadmill walking program had positive effects on the postural balance of institutionalized older adults.

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Psychometric Proprieties of a Mobile Application to Measure the Craniovertebral Angle a Validation and Reliability Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186521 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6521

Author(s):

Tomas Gallego-Izquierdo ◽

Enrique Arroba-Díaz ◽

Gema García-Ascoz ◽

María del Alba Val-Cano ◽

Daniel Pecos-Martin ◽

...

Keyword(s):

Mobile Application ◽

Intraclass Correlation ◽

Smartphone Application ◽

Standing Position ◽

Detectable Change ◽

Rater Reliability ◽

Forward Head Posture ◽

Head Posture ◽

Minimum Detectable Change ◽

Craniovertebral Angle

The aim of this study was to assess the psychometric properties of the mobile application forward head posture in terms of validity, inter- and intra-rater reliability, minimum detectable change, sensitivity, and specificity to measure craniovertebral angle. In total, 44 subjects (mean age 23.30 ± 4.44 years) were evaluated in the standing position with markers on the tragus and cutaneous prominence of seventh cervical vertebra (C7). We had two experienced and trained physiotherapists assess cervical posture using the mobile application forward head posture and photogrammetry. Intraclass correlation coefficients were used to determine validity and reliability. A contingency table was made to determine sensitivity and specificity. Intra-rater reliability of the mobile application forward head posture had an intraclass correlation coefficient of 0.88. The inter-rater reliability generated an intraclass correlation coefficient of 0.83 to 0.89. Criterion validity data were above 0.82. The minimum detectable change was 4.96° for intra-rater and 5.52° for inter-rater reliability. The smartphone application exhibited 94.4% sensitivity and 84.6% specificity. The smartphone application forward head posture is a valid and reliable tool to measure craniovertebral angle in a standing position and, therefore, could be a useful assessment tool in clinical practice.

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Gonadotropins at Advanced Age - Perhaps They Are Not So Bad? Correlations Between Gonadotropins and Sarcopenia Indicators in Older Adults

Frontiers in Endocrinology ◽

10.3389/fendo.2021.797243 ◽

2021 ◽

Vol 12 ◽

Author(s):

Agnieszka Guligowska ◽

Zuzanna Chrzastek ◽

Marek Pawlikowski ◽

Malgorzata Pigłowska ◽

Hanna Pisarek ◽

...

Keyword(s):

Gait Speed ◽

Handgrip Strength ◽

Functional Decline ◽

Treatment Strategies ◽

Community Dwelling ◽

Blood Levels ◽

Timed Up And Go ◽

Female Community ◽

Age Related ◽

European Working

Many hormones fluctuate during the aging process. It has been suggested that gonadotropins, which increase with age, contribute to the occurrence of many diseases and syndromes in older life, such as cardiovascular diseases, obesity, frailty syndrome and osteoporosis. This study aims to assess the relationship between circulating gonadotropins and other hormones potentially contributing to age-related functional decline and sarcopenia indicators in 39 male and 61 female community-dwelling seniors, mean age 80 years. According to the definition developed by the second European Working Group on Sarcopenia in Older People (EWGSOP2), the following indicators of the sarcopenia were assessed: bioimpedance-measured body composition, gait speed, handgrip strength, timed up and go test (TUG), chair stand test, Short Physical Performance Battery (SPPB). Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone sulphate (DHEAS) and cortisol were also measured. In the men, FSH and partially LH correlated positively with muscle mass percentage, gait speed, handgrip strength and SPPB, and negatively with percent body fat. Additionally, testosterone and DHEAS correlated negatively with the percentage of fat mass in men. Whereas in the women, FSH and LH were mainly negatively associated with body mass and adipose tissue measures. Cortisol did not show any relationship with the examined indicators. The study shows that the indicators of sarcopenia are strongly associated with levels of gonadotropins, sex hormones and DHEAS, especially in older men. The obtained results, after being confirmed in a larger group, may modify prevention and treatment strategies of sarcopenia.

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