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Measuring physical performance in later life: reliability of protocol variations for common performance-based mobility tests

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Abstract

Background and aims

Performance-based tests of mobility or physical function such as the Timed Up and Go (TUG), gait speed, chair-rise, and single-leg stance (SLS) are often administered using different protocols in aging populations, however, the reliability of their assessment protocols is not often considered. The purpose of this study was to examine the reliabilities of frequently used assessment protocols for the TUG, gait speed, chair-rise, and SLS in different age groups.

Methods

We administered the following assessment protocols in an age-stratified (50–64, 65–74, 75+ years) sample of participants (N = 147) from the Canadian Longitudinal Study on Aging (CLSA): TUG fast pace and TUG normal pace: TUG-cognitive counting backwards by ones and counting back by threes, gait speed with 3-m and 4-m course, chair-rise with arms crossed and allowing the use of arms, and SLS using preferred leg or both legs—on two occasions within 1 week. We assessed the relative (intra-class correlation) and absolute reliability (standard error of measurement, SEM and minimal detectable change, MDC) for each protocol variation and provided recommendations based on relative reliability.

Results

For participants aged 50–64 years, our results suggest better reliability for TUG fast-pace compared with normal-pace (ICC and 95% CI 0.70; 0.41–0.85 versus 0.38; 0.12–0.59). The reliability values for 3-m gait speed were potentially higher than for 4-m gait speed (ICC 0.75; 0.67–0.82 versus 0.64; 0.54–0.73) and values for chair-rise suggested better reliability allowing participants to use their arms than with arms crossed (ICC 0.79; 0.66–0.86 versus 0.64; 0.45–0.77) for participants overall. For participants aged 75+ years, ICCs for SLS with the preferred leg showed better reliability than for both legs (ICC = 0.62–0.79 versus 0.30–0.39).

Conclusions and discussion

These reliability data and the recommendations can help guide the selection of the most appropriate performance-based test protocols for measuring mobility in middle-aged and older community-dwelling adults.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author (M.B.) on reasonable request.

References

  1. Zhang L, Guo L, Wu H et al (2019) Role of physical performance measures for identifying functional disability among Chinese older adults: data from the China health and retirement longitudinal study. PLoS One 14:e0215693–e0215693. https://doi.org/10.1371/journal.pone.0215693

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Sunde S, Hesseberg K, Skelton DA et al (2021) Associations between health-related quality of life and physical function in older adults with or at risk of mobility disability after discharge from the hospital. Eur Geriatr Med 12:1247–1256. https://doi.org/10.1007/s41999-021-00525-0

    Article  PubMed  PubMed Central  Google Scholar 

  3. Braun T, Thiel C, Peter RS et al (2022) Association of clinical outcome assessments of mobility capacity and incident disability in community-dwelling older adults - a systematic review and meta-analysis. Ageing Res Rev 81:101704. https://doi.org/10.1016/j.arr.2022.101704

    Article  PubMed  Google Scholar 

  4. Gafner SC, Allet L, Hilfiker R et al (2021) Reliability and diagnostic accuracy of commonly used performance tests relative to fall history in older persons: a systematic review. Clin Interv Aging 16:1591–1616. https://doi.org/10.2147/CIA.S322506

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bohannon RW (2006) Single limb stance times: a descriptive meta-analysis of data from individuals at least 60 years of age. Top Geriatr Rehabil 22:70–77

    Article  Google Scholar 

  6. Barry E, Galvin R, Keogh C et al (2014) Is the timed up and go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr 14:14. https://doi.org/10.1186/1471-2318-14-14

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bloch ML, Jønsson LR, Kristensen MT (2017) Introducing a third timed up & go test trial improves performances of hospitalized and community-dwelling older individuals. J Geriatr Phys Ther 40:121–126. https://doi.org/10.1519/jpt.0000000000000080

    Article  PubMed  Google Scholar 

  8. Ibrahim A, Singh DKA, Shahar S (2017) “Timed up and go” test: age, gender and cognitive impairment stratified normative values of older adults. PLoS One 12:e0185641. https://doi.org/10.1371/journal.pone.0185641

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Steffen TM, Hacker TA, Mollinger L (2002) Age- and gender-related test performance in community-dwelling elderly people: six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther 82:128–137. https://doi.org/10.1093/ptj/82.2.128

    Article  PubMed  Google Scholar 

  10. Beauchamp MK, Hao Q, Kuspinar A et al (2021) Reliability and minimal detectable change values for performance-based measures of physical functioning in the Canadian Longitudinal Study on Aging (CLSA). J Gerontol A Biol Sci Med Sci. https://doi.org/10.1093/gerona/glab175

    Article  PubMed  PubMed Central  Google Scholar 

  11. Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163. https://doi.org/10.1016/j.jcm.2016.02.012

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kristensen MT, Bloch ML, Jonsson LR et al (2019) Interrater reliability of the standardized timed up and go test when used in hospitalized and community-dwelling older individuals. Physiother Res Int 24:e1769. https://doi.org/10.1002/pri.1769

    Article  PubMed  Google Scholar 

  13. Hofheinz M, Schusterschitz C (2010) Dual task interference in estimating the risk of falls and measuring change: a comparative, psychometric study of four measurements. Clin Rehabil 24:831–842. https://doi.org/10.1177/0269215510367993

    Article  PubMed  Google Scholar 

  14. Fernández-Huerta L, Córdova-León K (2019) Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons. Medwave 19:e7611. https://doi.org/10.5867/medwave.2019.03.7611

    Article  PubMed  Google Scholar 

  15. Lin MR, Hwang HF, Hu MH et al (2004) Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc 52:1343–1348. https://doi.org/10.1111/j.1532-5415.2004.52366.x

    Article  PubMed  Google Scholar 

  16. Khuna L, Thaweewannakij T, Wattanapan P et al (2020) Five times sit-to-stand test for ambulatory individuals with spinal cord injury: a psychometric study on the effects of arm placements. Spinal Cord 58:356–364. https://doi.org/10.1038/s41393-019-0372-3

    Article  PubMed  Google Scholar 

  17. Ng SS, Cheung SY, Lai LS et al (2013) Association of seat height and arm position on the five times sit-to-stand test times of stroke survivors. Biomed Res Int 2013:642362. https://doi.org/10.1155/2013/642362

    Article  PubMed  PubMed Central  Google Scholar 

  18. Muñoz-Bermejo L, Adsuar JC, Mendoza-Muñoz M et al (2021) Test-retest reliability of five times sit to stand test (ftsst) in adults: a systematic review and meta-analysis. Biology (Basel) 10:510. https://doi.org/10.3390/biology10060510

    Article  PubMed  Google Scholar 

  19. Battaglia G, Giustino V, Messina G et al (2020) Walking in natural environments as geriatrician’s recommendation for fall prevention: preliminary outcomes from the “passiata day” model. Sustainability 12:2684

    Article  Google Scholar 

  20. Lacroix A, Hortobágyi T, Beurskens R et al (2017) Effects of supervised vs. unsupervised training programs on balance and muscle strength in older adults: a systematic review and meta-analysis. Sports Med 47:2341–2361. https://doi.org/10.1007/s40279-017-0747-6

    Article  PubMed  Google Scholar 

  21. Raina PS, Wolfson C, Kirkland SA et al (2009) The Canadian Longitudinal Study on Aging (CLSA). Can J Aging 28:221–229. https://doi.org/10.1017/S0714980809990055

    Article  PubMed  Google Scholar 

  22. Raina P, Wolfson C, Kirkland S et al (2019) Cohort profile: the Canadian Longitudinal Study on Aging (CLSA). Int J Epidemiol 48:1752–1753j. https://doi.org/10.1093/ije/dyz173

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hachisuka K, Ogata H, Ohkuma H et al (1997) Test-retest and inter-method reliability of the self-rating Barthel index. Clin Rehabil 11:28–35. https://doi.org/10.1177/026921559701100105

    Article  CAS  PubMed  Google Scholar 

  24. Bonett DG (2002) Sample size requirements for estimating intraclass correlations with desired precision. Stat Med 21:1331–1335. https://doi.org/10.1002/sim.1108

    Article  PubMed  Google Scholar 

  25. Matthias Gamer JL, Ian Fellows, Puspendra Singh (2019) Various coefficients of interrater reliability and agreement. R package version 0.84.1

  26. Andre Schuetzenmeister FD (2020) Vca: variance component analysis. R package version 1.4.3

  27. Gautschi OP, Smoll NR, Corniola MV et al (2016) Validity and reliability of a measurement of objective functional impairment in lumbar degenerative disc disease: the timed up and go (tug) test. Neurosurgery 79:270–278. https://doi.org/10.1227/NEU.0000000000001195

    Article  PubMed  Google Scholar 

  28. Smith E, Walsh L, Doyle J et al (2016) The reliability of the quantitative timed up and go test (qtug) measured over five consecutive days under single and dual-task conditions in community dwelling older adults. Gait Posture 43:239–244. https://doi.org/10.1016/j.gaitpost.2015.10.004

    Article  PubMed  Google Scholar 

  29. Bedoya-Belmonte JJ, Rodríguez-González MDM, González-Sánchez M et al (2020) Inter-rater and intra-rater reliability of the extended tug test in elderly participants. BMC Geriatr 20:56. https://doi.org/10.1186/s12877-020-1460-0

    Article  PubMed  PubMed Central  Google Scholar 

  30. van Lummel RC, Walgaard S, Hobert MA et al (2016) Intra-rater, inter-rater and test-retest reliability of an instrumented timed up and go (itug) test in patients with Parkinson’s disease. PLoS One 11:e0151881. https://doi.org/10.1371/journal.pone.0151881

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Peters DM, Fritz SL, Krotish DE (2013) Assessing the reliability and validity of a shorter walk test compared with the 10-meter walk test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther 36:24–30. https://doi.org/10.1519/JPT.0b013e318248e20d

    Article  PubMed  Google Scholar 

  32. Kim HJ, Park I, Lee HJ et al (2016) The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults. J Exerc Nutrition Biochem 20:46–50. https://doi.org/10.20463/jenb.2016.09.20.3.7

    Article  PubMed  PubMed Central  Google Scholar 

  33. Fernandez-Huerta L, Cordova-Leon K (2019) Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons. Medwave 19:e7611. https://doi.org/10.5867/medwave.2019.03.7611

    Article  PubMed  Google Scholar 

  34. Ng SSM, Kwong PWH, Chau MSP et al (2015) Effect of arm position and foot placement on the five times sit-to-stand test completion times of female adults older than 50 years of age. J Phys Ther Sci 27:1755–1759. https://doi.org/10.1589/jpts.27.1755

    Article  PubMed  PubMed Central  Google Scholar 

  35. Wolinsky FD, Miller DK, Andresen EM et al (2005) Reproducibility of physical performance and physiologic assessments. J Aging Health 17:111–124. https://doi.org/10.1177/0898264304272784

    Article  PubMed  Google Scholar 

  36. Goldberg A, Casby A, Wasielewski M (2011) Minimum detectable change for single-leg-stance-time in older adults. Gait Posture 33:737–739. https://doi.org/10.1016/j.gaitpost.2011.02.020

    Article  PubMed  Google Scholar 

  37. de Ortega-Pérez Villar L, Martínez-Olmos FJ, Junqué-Jiménez A et al (2018) Test-retest reliability and minimal detectable change scores for the short physical performance battery, one-legged standing test and timed up and go test in patients undergoing hemodialysis. PLoS One 13:e0201035. https://doi.org/10.1371/journal.pone.0201035

    Article  CAS  Google Scholar 

  38. Sherrington C, Lord SR (2005) Reliability of simple portable tests of physical performance in older people after hip fracture. Clin Rehabil 19:496–504. https://doi.org/10.1191/0269215505cr833oa

    Article  PubMed  Google Scholar 

  39. Montero-Odasso M, Verghese J, Beauchet O et al (2012) Gait and cognition: a complementary approach to understanding brain function and the risk of falling. J Am Geriatr Soc 60:2127–2136. https://doi.org/10.1111/j.1532-5415.2012.04209.x

    Article  PubMed  PubMed Central  Google Scholar 

  40. Bongartz M, Kiss R, Lacroix A et al (2019) Validity, reliability, and feasibility of the sense activity monitor to register physical activity and gait performance in habitual settings of geriatric patients. Physiol Meas 40:095005

    Article  PubMed  Google Scholar 

  41. Rees-Punia E, Rittase MH, Patel AV (2021) A method for remotely measuring physical function in large epidemiologic cohorts: feasibility and validity of a video-guided sit-to-stand test. PLoS One 16:e0260332

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Veronese N, Honvo G, Amuthavalli Thiyagarajan J et al (2022) Attributes and definitions of locomotor capacity in older people: a World Health Organisation (WHO) locomotor capacity working group meeting report. Aging Clin Exp Res 34:481–483. https://doi.org/10.1007/s40520-022-02080-5

    Article  PubMed  PubMed Central  Google Scholar 

  43. Boulifard DA, Ayers E, Verghese J (2019) Home-based gait speed assessment: normative data and racial/ethnic correlates among older adults. J Am Med Dir Assoc 20:1224–1229. https://doi.org/10.1016/j.jamda.2019.06.002

    Article  PubMed  PubMed Central  Google Scholar 

  44. Atrsaei A, Dadashi F, Mariani B et al (2021) Toward a remote assessment of walking bout and speed: application in patients with multiple sclerosis. IEEE J Biomed Health Inform 25:4217–4228. https://doi.org/10.1109/jbhi.2021.3076707

    Article  PubMed  Google Scholar 

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Funding

Marla Beauchamp holds a tier 2 Canada Research Chair in Mobility, Aging, and Chronic Disease. This research was conducted in collaboration with the Canadian Longitudinal Study on Aging (CLSA). Funding for the CLSA is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and other researchers. Parminder Raina holds the Raymond and Margaret Labarge Chair in Research and Knowledge and holds a Tier 1 Canada Research Chair in Geroscience.

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Authors and Affiliations

  1. School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Hamilton, ON, Canada

    Qiukui Hao, Ayse Kuspinar & Marla Beauchamp

  2. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

    Lauren Griffith, Cassandra D’Amore, Alexandra J. Mayhew, Gordon Guyatt & Parminder Raina

  3. Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada

    Christina Wolfson

  4. Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, QC, Canada

    Christina Wolfson

  5. Research Institute of the McGill University Health Centre, Montreal, QC, Canada

    Christina Wolfson

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  1. Qiukui Hao
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Contributions

MB, AK, LG, and PR conceived the study and secured funding for this study. QH conducted the data analysis and drafted the initial manuscript supervised by MB. CD and AJM were involved in data collection and study design. MB, PR, LG, and AK helped with the data analysis and results interpretation. CW and GG gave critical feedback on the manuscript. All authors approved the final manuscript. No conflict of interest exists in the submission of this manuscript. All authors approved the final manuscript.

Corresponding author

Correspondence to Marla Beauchamp.

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The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Hamilton Integrated Research Ethics Board (2018-5280-GRA).

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All procedures performed in this study in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All participants gave their informed consent prior to their inclusion in the study.

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Hao, Q., Kuspinar, A., Griffith, L. et al. Measuring physical performance in later life: reliability of protocol variations for common performance-based mobility tests. Aging Clin Exp Res 35, 1087–1096 (2023). https://doi.org/10.1007/s40520-023-02384-0

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