Rocky Mountain University of Health Professions, Provo, Utah.
Visiting Nurse Service of New York (VNSNY) Home Care, Brooklyn, New York.
J Geriatr Phys Ther. 2019 Jul/Sep;42(3):136-147. doi: 10.1519/JPT.0000000000000142.
The ability to get up from the floor after a fall is a basic skill required for functional independence. Consequently, the inability to safely get down to and up from the floor or to perform a floor transfer (FT) may indicate decreased mobility and/or increased frailty. A reliable and valid test of FT ability is a critical part of the clinical decision-making process. The FT test is a simple, performance-based test that can be administered quickly and easily to determine a patient's ability to safely and successfully get down and up from the floor using any movement strategy and without time restriction. The primary purpose of this cross-sectional study was to determine the intrarater reliability and validity of the FT test as a practical alternative to several widely used yet time-consuming measures of physical disability, frailty, and functional mobility.
A total of 61 community-dwelling older adults (65-96 years of age) participated in the study, divided into 2 separate subsamples: intrarater reliability was studied with 15 participants, while concurrent validity was studied with the remaining 46 participants. In both subsamples, the participants were stratified on the basis of the self-reported levels of FT ability as independent, assisted, and dependent. Intrarater reliability was assessed on 2 separate occasions and scores were analyzed by intraclass correlation coefficient and κ statistics. Concurrent validity of the FT test was assessed against the self-reported FT ability questionnaire, Physical Functioning Scale, Phenotype of Physical Frailty, and the Short Physical Performance Battery. Known-groups validity was tested by determining whether the FT test distinguished between (1) community-dwelling older adults with physical disabilities versus those without physical disabilities; and (2) community-dwelling older adults who were functionally dependent versus those who were independent. Participants were also categorized on the basis of FT test outcome as independent, assisted, or dependent. The Spearman correlation coefficients were calculated to examine the strength of the relationships between the FT test and physical status measures. The Kruskal-Wallis test was used to determine whether the FT test significantly discriminated between groups as categorized by the Physical Functioning Scale and Short Physical Performance Battery, and to examine the significance level of the sociodemographic data across the 3 FT test outcome groups.
The intrarater reliabilities of the measures were good (0.73-1.00). There were statistically positive and strong correlations between the FT test and all physical status measures (ρ ranged from 0.86 to 0.93, P < .001). Older adults who passed the FT test were collectively categorized as those without physical disabilities and functionally independent, whereas older adults who failed the FT test were categorized as those with physical disabilities and functionally dependent (P < .001).
The FT test is a reliable and valid measure for screening for physical disability, frailty, and functional mobility. It can determine which older adults have physical disabilities and/or functional dependence and hence may be useful in assessing readiness for independent living. Inclusion of the FT test at initial evaluation may reveal the presence of these conditions and address the safety of older adults in the community.
从地板上站起来的能力是实现功能独立所需的基本技能。因此，无法安全地从地板上下到或从地板上转移（FT），可能表明移动能力下降和/或脆弱性增加。可靠且有效的 FT 能力测试是临床决策过程的关键部分。FT 测试是一项简单的基于表现的测试，可以快速轻松地进行，以确定患者使用任何运动策略并在没有时间限制的情况下安全且成功地从地板上下到或从地板上转移的能力。本横断面研究的主要目的是确定 FT 测试的内部信度和有效性，作为几种广泛使用但耗时的身体残疾、脆弱性和功能性移动性测量的实用替代方法。
共有 61 名居住在社区的老年人（65-96 岁）参加了这项研究，分为 2 个独立的样本：15 名参与者进行了内部信度研究，其余 46 名参与者进行了同时效性研究。在这两个样本中，根据自我报告的 FT 能力水平将参与者分层为独立、辅助和依赖。内部信度在 2 个不同的场合进行评估，并通过组内相关系数和κ统计分析评分。FT 测试的同时效性评估与自我报告的 FT 能力问卷、身体功能量表、身体虚弱表型和简短身体表现电池进行比较。通过确定 FT 测试是否区分（1）有身体残疾的居住在社区的老年人与没有身体残疾的老年人；和（2）有功能性依赖的居住在社区的老年人与无功能性依赖的老年人，测试了 FT 测试的已知组有效性。还根据 FT 测试结果将参与者分为独立、辅助或依赖。计算 Spearman 相关系数以检查 FT 测试与身体状况测量之间的关系强度。Kruskal-Wallis 检验用于确定 FT 测试是否根据身体功能量表和简短身体表现电池对分组进行显著区分，并检查 3 个 FT 测试结果组中社会人口统计学数据的显著性水平。
测量的内部信度良好（0.73-1.00）。FT 测试与所有身体状况测量均呈正相关且具有统计学意义（ρ范围为 0.86 至 0.93，P<.001）。通过 FT 测试的老年人被归类为没有身体残疾和功能独立的人，而未通过 FT 测试的老年人被归类为有身体残疾和功能依赖的人（P<.001）。
FT 测试是一种可靠且有效的筛查身体残疾、脆弱性和功能性移动性的方法。它可以确定哪些老年人有身体残疾和/或功能依赖，因此可能有助于评估独立生活的准备情况。在初始评估中包含 FT 测试可以揭示这些情况的存在，并解决社区中老年人的安全问题。
