O'Brien Myles W, Neyedli Heather F, Bosquet Laurent, Leadbetter Brianna, Smith Alex, Gallant Francois, Tanguay Pamela, Bélanger Mathieu, Mekari Said
School of Physiotherapy (Faculty of Health), Department of Medicine (Faculty of Medicine), Dalhousie University, Halifax, NS, Canada.
Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada.
Front Aging. 2023 Jun 20;4:1196389. doi: 10.3389/fragi.2023.1196389. eCollection 2023.
Lower-limb physical function declines with age and contributes to a greater difficulty in performing activities of daily living. Existing assessments of lower-limb function assess one dimension of movement in isolation or are not time-efficient, which discourages their use in community and clinical settings. We aimed to address these limitations by assessing the inter-rater reliability and convergent validity of a new multimodal functional lower-limb assessment (FLA). FLA consists of five major functional movement tasks (rising from a chair, walking gait, stair ascending/descending, obstacle avoidance, and descending to a chair) performed consecutively. A total of 48 community-dwelling older adults (32 female participants; age: 71 ± 6 years) completed the FLA as well as timed up-and-go, 30-s sit-to-stand, and 6-min walk tests. Slower FLA time was correlated with a slower timed up-and-go test ( = 0.70), less sit-to-stand repetitions ( = -0.65), and a shorter distance in the 6-min walk test ( = -0.69; all, < 0.001). Assessments by two raters were not different (12.28 ± 3.86 s versus 12.29 ± 3.83 s, = 0.98; inter-rater reliability = 0.993, < 0.001) and were statistically equivalent (via equivalence testing). Multiple regression and relative weights analyses demonstrated that FLA times were most predicted by the timed up-and-go performance [adjusted = 0.75; < 0.001; raw weight 0.42 (95% CI: 0.27, 0.53)]. Our findings document the high inter-rater reliability and moderate-strong convergent validity of the FLA. These findings warrant further investigation into the predictive validity of the FLA for its use as an assessment of lower-limb physical function among community-dwelling older adults.
下肢身体功能会随着年龄增长而下降,这使得进行日常生活活动变得更加困难。现有的下肢功能评估方法要么单独评估运动的一个维度,要么缺乏时间效率,这使得它们在社区和临床环境中的应用受到限制。我们旨在通过评估一种新的多模式功能性下肢评估(FLA)的评分者间信度和收敛效度来解决这些局限性。FLA由五个主要的功能性运动任务组成(从椅子上起身、步行步态、上下楼梯、避开障碍物以及坐到椅子上),这些任务需连续完成。共有48名社区居住的老年人(32名女性参与者;年龄:71±6岁)完成了FLA以及计时起立行走测试、30秒坐立测试和6分钟步行测试。FLA时间越慢与计时起立行走测试时间越慢(r = 0.70)、坐立重复次数越少(r = -0.65)以及6分钟步行测试距离越短(r = -0.69;所有,P < 0.001)相关。两位评分者的评估结果没有差异(12.28±3.86秒对12.29±3.83秒,r = 0.98;评分者间信度ICC = 0.993,P < 0.001)且在统计学上等效(通过等效性测试)。多元回归和相对权重分析表明,FLA时间最能由计时起立行走表现预测[调整后r = 0.75;P < 0.001;原始权重0.42(95%CI:0.27,0.53)]。我们的研究结果证明了FLA具有较高的评分者间信度和中到强的收敛效度。这些发现值得进一步研究FLA作为社区居住老年人下肢身体功能评估的预测效度。