Banarjee Chitra, Choudhury Renoa, Park Joon-Hyuk, Xie Rui, Fukuda David, Stout Jeffrey, Thiamwong Ladda
College of Medicine, University of Central Florida, Orlando, FL, United States.
Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States.
Interact J Med Res. 2024 Nov 29;13:e53304. doi: 10.2196/53304.
Interdisciplinary evaluation of older adults' health care is a priority in the prevention of chronic health conditions and maintenance of daily functioning. While many studies evaluate different physical performance tests (PPTs) from a retrospective view in predicting mortality or cardiopulmonary health, it remains unclear which of the commonly used PPTs is the most effective at evaluating the current health of older adults. Additionally, the time and participant burden for each PPT must be considered when planning and implementing them for clinical or research purposes.
This cross-sectional study aimed to determine how elements of overall physical capacity, performance, and other nongait factors in older adults affect the results of 3 commonly used tests: the Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT), and Incremental Shuttle Walk Test (ISWT).
A total of 53 community-dwelling older adults met the inclusion and exclusion criteria (mean age 77.47, SD 7.25 years; n=41, 77% female; and n=21, 40% Hispanic). This study evaluated older adults using 3 different PPTs including the SPPB, 6MWT, and ISWT, as well as constructed multiple linear regression models with measures of physical activity, static balance, and fear of falling (FoF). The nongait measures included 7 days of physical activity monitoring using the ActiGraph GT9X Link instrument, objective measurement of static balance using the BTrackS Balance System, and FoF using the short Fall Efficacy Scale-International.
The models revealed that the complete SPPB provided the most comprehensive value, as indicated by a greater R value (0.523), and that performance on the SPPB was predicted by both moderate to vigorous physical activity (P=.01) and FoF (P<.001). The ISWT was predicted by moderate to vigorous physical activity (P=.02), BMI (P=.02), and FoF (P=.006) and had a similar R value (0.517), whereas the gait component of the SPPB (P=.001) and 6MWT (P<.001) was predicted by only FoF and had lower R values (0.375 and 0.228, respectively).
The results indicated the value of a multicomponent, comprehensive test, such as the SPPB, in evaluating the health of older adults. Additionally, a comparison of the 2 field walking tests (ISWT and 6MWT) further distinguished the ISWT as more responsive to overall health in older adults. In comparing these commonly used PPTs, clinicians and researchers in the field can determine and select the most optimal test to evaluate older adults in communities and research settings.
对老年人的医疗保健进行跨学科评估是预防慢性健康状况和维持日常功能的重点。虽然许多研究从回顾性角度评估了不同的身体性能测试（PPT）在预测死亡率或心肺健康方面的作用，但目前尚不清楚哪种常用的PPT在评估老年人当前健康状况方面最有效。此外，在为临床或研究目的规划和实施PPT时，必须考虑每个PPT的时间和参与者负担。
本横断面研究旨在确定老年人的总体身体能力、表现和其他非步态因素如何影响3种常用测试的结果：简短身体性能测试（SPPB）、6分钟步行测试（6MWT）和递增往返步行测试（ISWT）。
共有53名社区居住的老年人符合纳入和排除标准（平均年龄77.47岁，标准差7.25岁；n = 41，77%为女性；n = 21，40%为西班牙裔）。本研究使用3种不同的PPT对老年人进行评估，包括SPPB、6MWT和ISWT，并构建了多个线性回归模型，纳入身体活动、静态平衡和跌倒恐惧（FoF）的测量指标。非步态测量包括使用ActiGraph GT9X Link仪器进行7天的身体活动监测、使用BTrackS平衡系统对静态平衡进行客观测量以及使用简短国际跌倒效能量表测量FoF。
模型显示，完整的SPPB提供了最全面的价值，R值更高（0.523），并且中度至剧烈身体活动（P = 0.01）和FoF（P < 0.001）均可预测SPPB的表现。ISWT可由中度至剧烈身体活动（P = 0.02）、BMI（P = 0.02）和FoF（P = 0.006）预测，其R值相似（0.517），而SPPB（P = 0.001）和6MWT（P < 0.001）的步态部分仅由FoF预测，R值较低（分别为0.375和0.228）。
结果表明多组分综合测试（如SPPB）在评估老年人健康方面的价值。此外,对2项现场步行测试（ISWT和6MWT）的比较进一步表明，ISWT对老年人的整体健康状况更敏感。在比较这些常用的PPT时，该领域的临床医生和研究人员可以确定并选择最适合的测试来评估社区和研究环境中的老年人。
