Ruiz F-J-M, Kergoat M-J, Andriamampionona F, Brodeur C, Beauchet O, Tannou T, Buckinx F, Aubertin-Leheudre M
Département des Sciences de l'Activité Physique, Groupe de Recherche en Activité Physique Adapté, Université du Québec à Montréal, Pavillon des Sciences Biologiques, 141 President-Kennedy Ave, Montreal, QC, SB-4615H3C 3P8, Canada.
Research Center, l'Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud de-l'Île-de-Montréal, Montreal, Québec, Canada.
Eur Geriatr Med. 2025 Sep 18. doi: 10.1007/s41999-025-01305-w.
A tool called PACE, including two decisional trees (SDT for physicians and ODT for exercise professionals), was co-created to integrate PA prescriptions in outpatient geriatric care. The SDT comprised 13 questions from validated questionnaires (FRAIL, FIND, and SARC-F), and the ODT included four geriatric functional tests (30-s chair test, functional reach test, balance, and normal walking speed). SDT and ODT were administered to ninety-seven patients. Cronbach's alpha, confirmatory factor analysis, Pearson's correlation, Kappa, and Tau-B correlation were conducted.
The SDT and ODT demonstrated good internal consistency (α = 0.74-0.86 and α = 0.75, respectively). Concurrent validity showed significant correlations between the SDT and indices of frailty and sarcopenia (r = 0.62-0.90, p < 0.001) and objective functional tests (r = 0.66-0.72, p < 0.001). The ODT showed significant correlations with functional tests (r = 0.65-0.88, p < 0.001). Despite some correlations between the decisional trees (r = 0.48-0.68, p < 0.001), their concordance was limited (kappa = 0.08-0.41). Sub-analyses revealed higher correlations and concordances when the caregiver living with the patient was involved in SDT responses.
The SDT and ODT demonstrated good validity for assessing the functional performance profile of older adults and can be used to prescribe exercise programs using PACE. This study highlights the importance of involving caregivers in the SDT assessment to refine PACE prescriptions.
共同创建了一种名为PACE的工具，其中包括两个决策树（医生用的SDT和运动专业人员用的ODT），以将体力活动处方纳入老年门诊护理。SDT包含来自经过验证的问卷（FRAIL、FIND和SARC-F）的13个问题，ODT包括四项老年功能测试（30秒椅子测试、功能性伸展测试、平衡和正常步行速度）。对97名患者进行了SDT和ODT测试。进行了克朗巴哈系数分析、验证性因素分析、皮尔逊相关性分析、卡方检验和Tau-B相关性分析。
SDT和ODT显示出良好的内部一致性（分别为α = 0.74 - 0.86和α = 0.75）。同时效度表明，SDT与衰弱和肌肉减少症指标之间存在显著相关性（r = 0.62 - 0.90，p < 0.001），与客观功能测试之间也存在显著相关性（r = 0.66 - 0.72，p < 0.001）。ODT与功能测试之间存在显著相关性（r = 0.65 - 0.88，p < 0.001）。尽管决策树之间存在一些相关性（r = 0.48 - 0.68，p < 0.001），但它们的一致性有限（kappa = 0.08 - 0.41）。亚分析显示，当与患者同住的护理人员参与SDT回答时，相关性和一致性更高。
SDT和ODT在评估老年人的功能表现方面显示出良好的效度，可用于使用PACE开具运动计划。本研究强调了让护理人员参与SDT评估以完善PACE处方的重要性。
