测量活动受限老年人居家室内生活空间移动能力。
Measuring indoor life-space mobility at home in older adults with difficulty to perform outdoor activities.
机构信息
Department of Physical Therapy, School of Health Sciences, Kyorin University, Tokyo 192-8508, Japan.
出版信息
J Geriatr Phys Ther. 2013 Jul-Sep;36(3):109-14. doi: 10.1519/JPT.0b013e31826e7d33.
BACKGROUND
Measurement of indoor physical activity at home in older adults who have difficulty performing outdoor activities is a key to documenting baseline physical activity levels to guide physical activity interventions aimed at reducing the rate of decline in mobility.
PURPOSE
The purpose of this study was to describe indoor life-space mobility at home (LSH) and examine the association between LSH and mobility-related physical functions in older adults who have difficulty performing outdoor activities.
METHODS
The participants were 20 community-dwelling older adults (mean age [SD], 76.6 [5.1] years) receiving home-care rehabilitation. Participants were assessed for LSH and physical function related to mobility. Assessments included isometric knee extensor strength, the Timed Up and Go (TUG) Test, functional status (a 13-item Motor subscale of Functional Independence Measure, the Tokyo Metropolitan Institute of Gerontology Index of Competence, and outdoor life-space mobility (life-space assessment [LSA]). Life-space mobility at home documented how far and how often participants moved from a bedroom to 4 destinations (entrance, dining room, bathroom, and toilet) at home with or without assistance during the week prior to the assessment.
RESULTS
Reliability of LSH was high (intraclass correlation coefficient [ICC] (1,1) = 0.80, ICC (1,2) = 0.89). Simple bivariate correlations showed a significant relationship between LSH and isometric knee extensor strength (rs = 0.59, P = .01) and TUG Test (rs = -0.74 P = .01). Life-space mobility at home showed moderate correlations with the Functional Independence Measure (rs = 0.58, P = .01) and Tokyo Metropolitan Institute of Gerontology Index of Competence (rs = 0.49, P = .03), but no significant correlation with the LSA (rs = 0.33, P = .17).
DISCUSSION
Regarding intrarater reliability, the ICCs for measuring the LSH indicated high reproducibility. The results suggest that the LSA mainly reflects outdoor life-space mobility and activity rather than indoor life-space whereas the LSH reflects indoor life-space mobility and is considered an indicator of a major decline in indoor activities and physical abilities.
CONCLUSIONS
The LSH concept can measure with high reliability and concurrent or discriminant validity, and it is a different concept from outdoor life-space mobility. Life-space mobility at home may be an important factor associated with physical functions related to mobility and functional status, and measuring LSH may be useful to assess current indoor life-space activity in older adults who have difficulty performing outdoor activities.
背景
对于难以进行户外活动的老年人，测量其居家的身体活动，是记录其身体活动基线水平的关键，这有助于指导旨在降低活动能力下降速度的身体活动干预。
目的
本研究旨在描述居家生活空间移动性（LSH），并探讨其与难以进行户外活动的老年人移动相关身体功能之间的关系。
方法
研究对象为 20 名接受居家康复治疗的社区居住老年人（平均年龄 [标准差]，76.6 [5.1] 岁）。对参与者的 LSH 和与移动相关的身体功能进行评估。评估内容包括等长膝关节伸展力量、计时起立-行走测试（TUGT）、功能状态（功能独立性测量的 13 项运动子量表、东京都老年医学研究所能力指数和户外生活空间移动性（生活空间评估 [LSA]）。居家生活空间移动性记录了参与者在评估前一周内，在没有或有辅助的情况下，从卧室移动到家中 4 个目的地（入口、餐厅、浴室和厕所）的距离和频率。
结果
LSH 的可靠性较高（组内相关系数 [ICC]（1,1）=0.80，ICC（1,2）=0.89）。简单的双变量相关性分析显示，LSH 与等长膝关节伸展力量（rs=0.59，P=0.01）和 TUGT 测试（rs=-0.74，P=0.01）呈显著相关。居家生活空间移动性与功能独立性测量（rs=0.58，P=0.01）和东京都老年医学研究所能力指数（rs=0.49，P=0.03）呈中度相关，但与 LSA 无显著相关性（rs=0.33，P=0.17）。
讨论
关于内部一致性信度，LSH 的 ICC 表明具有较高的可重复性。结果表明，LSA 主要反映户外生活空间移动性和活动，而不是室内生活空间，而 LSH 反映室内生活空间移动性，被认为是室内活动和身体能力大幅下降的指标。
结论
LSH 概念可以高度可靠地测量，具有同时或判别效度，与户外生活空间移动性不同。居家生活空间移动性可能是与移动相关身体功能和功能状态相关的重要因素，测量 LSH 可能有助于评估难以进行户外活动的老年人的当前室内生活空间活动。
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