Performance of Different Timed Up and Go Subtasks in Frailty Syndrome

Ansai, Juliana Hotta; Farche, Ana Cláudia Silva; Rossi, Paulo Giusti; Andrade, Larissa Pires de; Nakagawa, Theresa Helissa; Takahashi, Anielle Cristhine de Medeiros

doi:10.1519/jpt.0000000000000162

Cited by 35 publications

(41 citation statements)

References 21 publications

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“…The past decade has seen tremendous advances in the development and testing of wearable sensors to evaluate important outcomes like physical performance. However, to date, wearable sensors are either very expensive [ 15 - 18 ], proprietary [ 19 , 20 ], require technicians present for testing [ 15 , 17 , 21 ], and/or involve complex programming code to process the data [ 22 ]. For example, commercially available systems that include wearable sensors, such as LEGSys or the Opal, and software to administer and score standard gait tests (eg, Timed Up and Go, or TUG test), provide a range of useful gait parameters [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Remote Assessment of Functional Mobility and Strength in Older Cancer Survivors: Protocol for a Validity and Reliability Study

et al. 2020

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Background Older cancer survivors, faced with both age- and treatment-related morbidity, are at increased and premature risk for physical function limitations. Physical performance is an important predictor of disability, quality of life, and premature mortality, and thus is considered an important target of interventions designed to prevent, delay, or attenuate the physical functional decline. Currently, low-cost, valid, and reliable methods to remotely assess physical performance tests that are self-administered by older adults in the home-setting do not exist, thus limiting the reach, scalability, and dissemination of interventions. Objective This paper will describe the rationale and design for a study to evaluate the accuracy, reliability, safety, and acceptability of videoconferencing and self-administered tests of functional mobility and strength by older cancer survivors in their own homes. Methods To enable remote assessment, participants receive a toolkit and instructions for setting up their test course and communicating with the investigator. Two standard gerontologic performance tests are being evaluated: the Timed Up and Go test and the 30-second chair stand test. Phase 1 of the study evaluates proof-of-concept that older cancer survivors (age ≥60 years) can follow the testing protocol and use a tablet PC to communicate with the study investigator. Phase 2 evaluates the criterion validity of videoconference compared to direct observation of the two physical performance tests. Phase 3 evaluates reliability by enrolling 5-10 participants who agree to repeat the remote assessment (without direct observation). Phase 4 enrolls 5-10 new study participants to complete the remote assessment test protocol. Feedback from participants in each phase is used to refine the test protocol and instructions. Results Enrollment began in December 2019. Ten participants completed the Phase 1 proof-of-concept. The study was paused in mid-March 2020 due to the COVID-19 pandemic. The study is expected to be completed by the end of 2020. Conclusions This validity and reliability study will provide important information on the acceptability and safety of using videoconferencing to remotely assess two tests of functional mobility and strength, self-administered by older adults in their homes. Videoconferencing has the potential to expand the reach, scalability, and dissemination of interventions to older cancer survivors, and potentially other older adults, especially in rural areas. Trial Registration ClinicalTrials.gov NCT04339959; https://clinicaltrials.gov/ct2/show/NCT04339959 International Registered Report Identifier (IRRID) DERR1-10.2196/20834

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Section: Introductionmentioning

confidence: 99%

Remote Assessment of Functional Mobility and Strength in Older Cancer Survivors: Protocol for a Validity and Reliability Study

et al. 2020

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“…In our study, we identified older adults who took a longer time to complete the TUG test to be at higher risk of frailty, implying that less than optimal functional mobility and dynamic balance results in susceptibility to being frail. This finding is supported by a study conducted among Brazilian older adults, whereby time taken to complete the TUG was significantly longer among frail older adults [43]. Although the parameter of ‘slowness’ measured using the gait speed test is one of the five Fried’s frailty criteria, the TUG test has been identified as a reliable measure of frailty in its own right [44].…”

Section: Discussionmentioning

confidence: 68%

Prevalence of Frailty and its Association with Cognitive Status and Functional Fitness among Ambulating Older Adults Residing in Institutions within West Coast of Peninsular Malaysia

Murukesu

Singh

Subramaniam

et al. 2019

IJERPH

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Aim: There is limited information about the association between frailty, cognitive status and functional fitness in older adults living in institutions. We aimed to determine the prevalence of frailty and its association with cognitive status and functional fitness among pre-frail and frail Malaysian older adults residing in institutions on the west coast of Peninsular Malaysia. Methods: This study included 302 ambulating Malaysian institutionalised older adults. Frailty was identified using Fried’s frailty criteria. Cognitive status was assessed using the Mini Mental State Examination and Addenbrooke’s Cognitive Examination. Functional fitness was assessed using the Senior Fitness test. The association between frailty groups, cognitive status and functional fitness was analysed using binary logistic regression. Results: Prevalence of frailty, prefrailty and robustness in the older adults was 56.6%, 40.7% and 2.9%, respectively. Frailty was found to be associated with hypertension (OR 2.15, 95% CI: 1.11–4.16, p = 0.024), lower cognitive status (Addenbrooke’s Cognitive Examination) (OR 0.98, 95% C.I: 0.96–0.99, p = 0.038), and lower dynamic balance and mobility (Timed Up and Go test) (OR 1.09, 95% CI: 1.01–1.16, p = 0.024). Conclusion: Frailty is highly prevalent among Malaysian institutionalised older adults. Hypertension, cognitive impairment and lower dynamic balance and mobility were found to be risk factors of frailty. Screening of frailty and its associated factors should be prioritized among institutionalised older adults in view of early prevention and rehabilitation.

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“…We found that despite the high sensitivity and accuracy of motion capture cameras [44], this technology is not ideal for TUG, given the cameras’ restricted field view, preventing simultaneous capture of all body sensors throughout all TUG phases. In a previous study using the Qualisys™ MCC, subjects repeated the TUG test six times, prioritizing different TUG phases during distinctive test repeats, and while wearing approximately 50 body markers [45]. Despite the robust procedure, the physical field of views of the cameras made it impossible to analyze biomarkers such as the complete gait cycle [45].…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study using the Qualisys™ MCC, subjects repeated the TUG test six times, prioritizing different TUG phases during distinctive test repeats, and while wearing approximately 50 body markers [45]. Despite the robust procedure, the physical field of views of the cameras made it impossible to analyze biomarkers such as the complete gait cycle [45]. MCC further require a large physical space to house the system, cumbersome procedures (e.g.…”

Section: Discussionmentioning

confidence: 99%

Pilot Study of the EncephaLog Smartphone Application for Gait Analysis

Tchelet¹,

Stark‐Inbar²,

Yekutieli³

2019

Sensors

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Gait disorders and falls are common in elders and in many clinical conditions, yet they are typically infrequently and subjectively evaluated, limiting prevention and intervention. Completion-time of the Timed-Up-and-Go (TUG) test is a well-accepted clinical biomarker for rating mobility and prediction of falls risk. Using smartphones’ integral accelerometers and gyroscopes, we already demonstrated that TUG completion-time can be accurately measured via a smartphone app. Here we present an extended app, EncephaLogTM, which provides gait analysis in much more detail, offering 9 additional gait biomarkers on top of the TUG completion-time. In this pilot, four healthy adults participated in a total of 32 TUG tests; simultaneously recorded by EncephaLog and motion sensor devices used in movement labs: motion capture cameras (MCC), pressure mat; and/or wearable sensors. Results show high agreement between EncephaLog biomarkers and those measured by the other devices. These preliminary results suggest that EncephaLog can provide an accurate, yet simpler, instrumented TUG (iTUG) platform than existing alternatives, offering a solution for clinics that cannot afford the cost or space required for a dedicated motion lab and for monitoring patients at their homes. Further research on a larger study population with pathologies is required to assess full validity.

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Performance of Different Timed Up and Go Subtasks in Frailty Syndrome

Abstract: The findings support the value of analyzing the TUG subtasks to improve understanding of mobility impairment in frailty syndrome.

Cited by 35 publications

References 21 publications

Remote Assessment of Functional Mobility and Strength in Older Cancer Survivors: Protocol for a Validity and Reliability Study

Remote Assessment of Functional Mobility and Strength in Older Cancer Survivors: Protocol for a Validity and Reliability Study

Prevalence of Frailty and its Association with Cognitive Status and Functional Fitness among Ambulating Older Adults Residing in Institutions within West Coast of Peninsular Malaysia

Pilot Study of the EncephaLog Smartphone Application for Gait Analysis

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