A Systematic Review of Thirty-One Assessment Tests to Evaluate Mobility in Older Adults

Soubra, Racha; Chkeir, Aly; Novella, Jean‐Luc

doi:10.1155/2019/1354362

Cited by 97 publications

(74 citation statements)

References 80 publications

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“…These can be even more demanding than gait in terms of cognitive resources required for planning, orientation in space and organization purposes [15]. The ability to perform such activities, which are commonly classified under the umbrella of "functional mobility", can be easily assessed using a wide range of tools [16]. Among them, the Timed-Up-and-Go test (TUG, [17]) is one of the most common, owing to its clinical utility in diagnosing risk of falls [18,19] in community-dwelling and frail older adults.…”

Section: Introductionmentioning

confidence: 99%

Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors

et al. 2020

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Aim The main purpose of the present study was to verify the feasibility of wearable inertial sensors (IMUs) in a clinical setting to screen gait and functional mobility in Italian older persons. In particular, we intended to verify the capability of IMUs to discriminate individuals with and without cognitive impairments and assess the existence of significant correlations between mobility parameters extracted by processing trunk accelerations and cognitive status. Methods This is a cross-sectional study performed on 213 adults aged over 65 years (mean age 77.0 ± 5.4; 62% female) who underwent cognitive assessment (through Addenbrooke’s Cognitive Examination Revised, ACE-R) instrumental gait analysis and the Timed Up and Go (TUG) test carried out using a wearable IMU located in the lower back. Results Individuals with cognitive impairments exhibit a peculiar gait pattern, characterized by significant reduction of speed (− 34% vs. healthy individuals), stride length (− 28%), cadence (− 9%), and increase in double support duration (+ 11%). Slight, but significant changes in stance and swing phase duration were also detected. Poorer performances in presence of cognitive impairment were observed in terms of functional mobility as overall and sub-phase TUG times resulted significantly higher with respect to healthy individuals (overall time, + 38%, sub-phases times ranging from + 22 to + 34%), although with some difference associated with age. The severity of mobility alterations was found moderately to strongly correlated with the ACE-R score (Spearman’s rho = 0.58 vs. gait speed, 0.54 vs. stride length, 0.66 vs. overall TUG time). Conclusion The findings obtained in the present study suggest that wearable IMUs appear to be an effective solution for the clinical assessment of mobility parameters of older persons screened for cognitive impairments within a clinical setting. They may represent a useful tool for the clinician in verifying the effectiveness of interventions to alleviate the impact of mobility limitations on daily life in cognitively impaired individuals.

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Section: Introductionmentioning

confidence: 99%

Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors

et al. 2020

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“…Our knowledge of physical tests has not kept up with the global population increase of older adults. There is a lack of normative values in outcome measures for older adults living in RAC as most work to date has been on healthy older adults living in the community [54]. An example of this is of the outcome measures used in this study only three have had a minimal detectable change identified: MoCA 4 points [36]; Brief BESTest 4 points [55]; SPPB total 1 point [56]; however, only the Brief BESTest established this for a population of older adults living in RAC.…”

Section: Objective 2 To Test the Appropriateness Of Data Collection mentioning

confidence: 99%

Combining cognitive stimulation therapy and fall prevention exercise (CogEx) in older adults with mild to moderate dementia: a feasibility randomised controlled trial

Binns

Kerse

Peri

et al. 2020

Pilot Feasibility Stud

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Background: People living with dementia (PLwD) have a high fall risk as cognitive impairment compromises control of gait and balance. Fall prevention exercises that are effective in healthy older adults may not work for PLwD. Cognitive stimulation therapy (CST) has been shown to improve global cognition in PLwD. A programme which combines cognitive (CST) with physical exercises may reduce falls in PLwD. The aim of this study was to assess the feasibility of undertaking a full scale randomised controlled trial to test the effectiveness of CogEx in decreasing falls in PLwD. Specific objectives included recruitment strategy, data collection, outcome measures, intervention fidelity and facilitator/participant experience. Methods: A mixed methods feasibility randomised controlled trial recruited people from residential aged care. Inclusion criteria were ≥ 65 years old, Montreal Cognitive Assessment (MoCA) score of 10 to 26 and able to participate in a group. Participants were randomised to CST or CST combined with strength and balance exercises (CogEx). Both CST and CogEx groups were for an hour twice a week for 7 weeks. Descriptive statistics were used to report pre-and post-intervention outcome measures (MoCA, Geriatric Depression Scale-15, Quality of Life-Alzheimer's Disease, Alzheimer's Disease Assessment Scale-Cognitive 11, Brief Balance Evaluation Systems Test and Short Form Physical Performance Battery) and attendance. Qualitative analysis of participant focus groups and facilitator interviews used a conventional approach. Sessions were video recorded and exercise completion documented. Results: Thirty-six residents were screened with 23 participants randomised to intervention (CogEx, n = 10) or control (CST, n = 13). The assessments took 45 min to 1.5 h, and there was repetition between two cognitive measures. Ten facilitators completed training with the manualised programme. Exercises were combined into the hour-long CST session; however, limited balance training occurred with participants exercising predominantly in sitting. The facilitators felt the participants engaged more and were safer in sitting.

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“…Specifically, the Timed Up and Go and the Six-Minute Walk Test are two commonly used measures particularly in older hospitalized patients. However, previous studies showed that these measures have ceiling effects in older hospitalized patients, which severely limit their ability to measure older patients' mobility function [12]. Thus, the commonly used measures cannot validly assess older patients' mobility.…”

Section: Introductionmentioning

confidence: 99%

Reliability, validity, interpretability and responsiveness of the DEMMI mobility index for Brazilian older hospitalized patients

et al. 2020

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To translate and adapt cross-culturally the De Morton Mobility Index from English to Brazilian Portuguese. Furthermore, to test the content validity, reliability, construct validity, interpretability and responsiveness for older hospitalized patients. Methods After we carried out the translation and the cross-cultural adaptation of the De Morton Mobility Index and its administration instructions according to international guidelines, the content validity of De Morton Mobility Index was tested by experienced physiotherapists. In the sequence, the reliability, construct validity, interpretability and responsiveness were tested in a test-retest design with 93 older patients hospitalized in ward for clinical reasons. The reliability was tested by Cronbach's alpha coefficient (internal consistency), standard error measurement (agreement), and interclass correlation coefficients (intra and inter-examiner reliability). The construct validity was tested by Pearson's correlation between the De Morton Mobility Index score and the number of steps. Interpretability was analyzed by determining the minimum detectable change and the floor and ceiling effects (frequency of maximum and minimum scoring). Responsiveness was analyzed by effect size. Results The Brazilian version of the De Morton Mobility Index was made and adapted. The internal consistency (α = 0.89), reliability intra-(ICC = 0.94) and inter-examiners (ICC = 0.82), agreement were all adequate. The De Morton Mobility Index is validity when correlated with number of steps (r = 0.46). Floor or ceiling effects (<15%) were not observed and the responsiveness was high (ES = 3.65).

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A Systematic Review of Thirty-One Assessment Tests to Evaluate Mobility in Older Adults

Cited by 97 publications

References 80 publications

Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors

Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors

Combining cognitive stimulation therapy and fall prevention exercise (CogEx) in older adults with mild to moderate dementia: a feasibility randomised controlled trial

Reliability, validity, interpretability and responsiveness of the DEMMI mobility index for Brazilian older hospitalized patients

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