Predicting the Probability of Falls in Community-Residing Older Adults Using the 8-Foot Up-and-Go: A New Measure of Functional Mobility

The purpose of this study was to determine whether performance on the 8-ft up-and-go test (UG) could discriminate between older adult fallers (n= 71) and nonfallers (n= 63) and whether it would be as sensitive and specific a predictor of falls as the timed up-and-go test (TUG). Performance on the UG was significantly different between the recurrent faller and nonfaller groups (p< .01), as was performance on the TUG (p< .001). Older adults who required 8.5 s or longer to complete the UG were classified as fallers, with an overall prediction rate of 82%. The specificity of the test was 86% and the sensitivity was 78%. Conversely, the overall prediction rate for older adults who completed the TUG in 10 s or longer was 80%. The specificity of the TUG was 86% and the sensitivity was 71%.

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Effects of Periodic Task-Specific Test Feedback on Physical Performance in Older Adults Undertaking Band-Based Resistance Exercise

Journal of Aging Research ◽

10.1155/2014/171694 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Ryuichi Hasegawa ◽

Mohammod Monirul Islam ◽

Ryuji Watanabe ◽

Naoki Tomiyama ◽

Dennis R. Taaffe

Keyword(s):

Older Adults ◽

Physical Performance ◽

Functional Mobility ◽

Muscle Performance ◽

Timed Up And Go ◽

Feedback Group ◽

Specific Test ◽

Periodic Task ◽

Test Feedback ◽

Home Based

The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65–83 years) were assigned to a muscular perfsormance feedback group (MPG,n=32) or a functional mobility feedback group (FMG,n=20). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant (P<0.05) interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities.

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Towards Using the Instrumented Timed Up-and-Go Test for Screening of Sensory System Performance for Balance Control in Older Adults

Sensors ◽

10.3390/s19030622 ◽

2019 ◽

Vol 19 (3) ◽

pp. 622 ◽

Cited By ~ 3

Author(s):

Thomas Gerhardy ◽

Katharina Gordt ◽

Carl-Philipp Jansen ◽

Michael Schwenk

Keyword(s):

Older Adults ◽

System Performance ◽

Fall Risk ◽

Balance Control ◽

Sensory System ◽

Sensory Systems ◽

Community Dwelling ◽

Functional Mobility ◽

Timed Up And Go ◽

Community Dwelling Older Adults

Background: Decreasing performance of the sensory systems’ for balance control, including the visual, somatosensory and vestibular system, is associated with increased fall risk in older adults. A smartphone-based version of the Timed Up-and-Go (mTUG) may allow screening sensory balance impairments through mTUG subphases. The association between mTUG subphases and sensory system performance is examined. Methods: Functional mobility of forty-one community-dwelling older adults (>55 years) was measured using a validated mTUG. Duration of mTUG and its subphases ‘sit-to-walk’, ‘walking’, ‘turning’, ‘turn-to-sit’ and ‘sit-down’ were extracted. Sensory systems’ performance was quantified by validated posturography during standing (30 s) under different conditions. Visual, somatosensory and vestibular control ratios (CR) were calculated from posturography and correlated with mTUG subphases. Results: Vestibular CR correlated with mTUG total time (r = 0.54; p < 0.01), subphases ‘walking’ (r = 0.56; p < 0.01), and ‘turning’ (r = 0.43; p = 0.01). Somatosensory CR correlated with mTUG total time (r = 0.52; p = 0.01), subphases ‘walking’ (r = 0.52; p < 0.01) and ‘turning’ (r = 0.44; p < 0.01). Conclusions: Supporting the proposed approach, results indicate an association between specific mTUG subphases and sensory system performance. mTUG subphases ‘walking’ and ‘turning’ may allow screening for sensory system deterioration. This is a first step towards an objective, detailed and expeditious balance control assessment, however needing validation in a larger study.

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94 Association between Dual-Task Timed “UP and GO” Test and Occurrence of Falls According to Age Group (Young-Older or Old-Older Adults): A Longitudinal Observation Study

Age and Ageing ◽

10.1093/ageing/afz164.94 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Tsuyoshi Asai ◽

Kensuke Oshima ◽

Yoshihiro Fukumoto ◽

Shogo Misu

Keyword(s):

Older Adults ◽

Older Adult ◽

Dual Task ◽

Community Dwelling ◽

Age Group ◽

Adult Group ◽

Observation Study ◽

Timed Up And Go ◽

Community Dwelling Older Adults

Abstract Aim To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group. Methods This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. Results For old-older adults, there were significant associations between the occurrence of falls and DTC value (odds ratio [OR] 0.981, 95% confidence interval [CI]: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults. Conclusions Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.

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50 Sociodemographic, Physical Performance and Fear of Falls Profile of Older Adult Fallers and Non Fallers: A Preliminary Study

Age and Ageing ◽

10.1093/ageing/afz164.50 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Azianah Ibrahim ◽

Nur Aimuni Abu Hassan ◽

Halizahanim Hassan

Keyword(s):

Older Adults ◽

Older Adult ◽

Physical Performance ◽

Cross Sectional Study ◽

Falls Prevention ◽

Timed Up And Go ◽

Cross Sectional ◽

Sit To Stand ◽

Management Plans ◽

Fear Of Falls

Abstract Introduction It is important to identify older adult fallers in order to implement early prevention management also prevent recurrent falls. This study aimed to explore the profiles of older adult fallers and non-fallers in regards to socio-demographic, physical performance, fear of falls that includes the activities that were feared in regard to falls. Analysis Descriptive and mean comparison test. Methodology Participants for this study were recruited among individuals aged 60 years and above, able to walk 3m, able to stand independently for longer than 1min and able to comprehend and follow instructions. Exclusion criteria include recent vertebral or lower limb fracture (less than 6months), unstable angina, unable to follow command and severe hearing and vision impairment. Design: Cross-sectional study. Results A number of 27 older adults were screened for falls. Based on Timed Up and Go test (cut off 11.18s), 8 (29.6%) of them were identified as fallers. Fallers were majority females (10, 37%), had visual impairment (4,14.8%), older (77.4±2.9years versus 68.4±5.7years) and had slightly higher in fear of falls score (13.2±5.5 versus 12.0±7.0). In view of physical performance, fallers were slower in Timed Up and Go test (13.6±2.4 versus 9.1±1.4), weaker in hand grip strength (14.3±2.5kg versus 21.5±19.3kg) and weaker in sit-to-stand performance (13.3±2.7s versus 10.7±2.7s). Age (p<0.05) and sit-to-stand performance (p<0.05) significantly differed between fallers and non-fallers. Among seven activities assessed using short Falls Efficacy Scale-International, non-fallers were found to have more fear during various activities compared to fallers. Implication Exploration of falls risk profiles in older adults will hopefully allow better understanding and further improvement in developing falls prevention management plans.

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Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants

Journal of Applied Gerontology ◽

10.1177/0733464816675422 ◽

2016 ◽

Vol 37 (1) ◽

pp. 79-98 ◽

Cited By ~ 18

Author(s):

Tiffany E. Shubert ◽

Matthew Lee Smith ◽

Luohua Jiang ◽

Marcia G. Ory

Keyword(s):

United States ◽

Older Adults ◽

Physical Performance ◽

Functional Performance ◽

Exercise Program ◽

The United States ◽

Functional Mobility ◽

Self Report ◽

Timed Up And Go ◽

Logistic Regression Models

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program. Baseline and 8-week functional and self-report data were collected on 210 older adults from 2013 to 2015. Linear mixed models and general estimating equations logistic regression models adjusted for socio-demographic factors were performed to assess changes. At 8 weeks, scores dramatically improved on self-report and physical performance tests: Timed Up-and-Go ( p < .001), 30-Second Chair Rise ( p < .001), and Four-Stage Balance ( p < .001). Findings support that participation in the U.S. OEP as part of a plan of care can result in significant improvements in objective functional mobility, balance measures, and self-reported ability.

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Fall Awareness Behaviour And Its Associated Factors Among Community Dwelling Older Adults

10.21203/rs.3.rs-54230/v1 ◽

2020 ◽

Author(s):

GOH JING WEN ◽

Devinder Kaur Ajit Singh ◽

NORMALA MESBAH ◽

ANIS AFIFA MOHD HANAFI ◽

ADLYN FARHANA AZWAN

Keyword(s):

Older Adults ◽

Associated Factors ◽

Linear Regression Analysis ◽

Community Dwelling ◽

Functional Mobility ◽

Timed Up And Go ◽

Mortality And Morbidity ◽

Falls In Older Adults ◽

Causes Of Mortality ◽

Community Dwelling Older Adults

Abstract Falls are one of the major causes of mortality and morbidity in older adults. However, despite adoption of prevention strategies, the number of falls in older adults has not declined. The aim of this study was to examine fall awareness behaviour and its associated factors. A total of 140 community dwelling older adults (mean age of 70.69±4.3 years) participated in this study. Physical performance was assessed using timed up and go(TUG), gait speed(GS), chair stand and hand grip tests. Fall Awareness Behaviour (FaB) and Fall Risk Assessment Questionnaires (FRAQ) were administered to assess behaviours and fall prevention knowledge respectively. Stepwise linear regression analysis showed that the practice of fall awareness behaviours (R2=.256) was significantly associated with being male [95% C.I: 2.178 to 7.789, p<.001], having lower BMI [95% C.I: -0.692 to -0.135, p<.05], living with family [95% C.I: 0.022 to 5.953, p<.05] and those having higher functional mobility [95% C.I: -2.008 to -0.164, p<.05]. Fall awareness behaviours should be emphasized among older females, those with lower functional mobility, higher BMI and living alone.

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Effects of Vitamin D3 Supplementation and Resistance Training on 25-Hydroxyvitamin D Status and Functional Performance of Older Adults: A Randomized Placebo-Controlled Trial

Nutrients ◽

10.3390/nu14010086 ◽

2021 ◽

Vol 14 (1) ◽

pp. 86

Author(s):

Rudolf Aschauer ◽

Sandra Unterberger ◽

Patrick A. Zöhrer ◽

Agnes Draxler ◽

Bernhard Franzke ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Resistance Training ◽

Muscle Strength ◽

Vitamin D3 ◽

Functional Mobility ◽

Timed Up And Go ◽

Chair Stand ◽

Hydroxyvitamin D ◽

Vitamin D3 Supplementation

Vitamin D status is associated with muscle strength and performance in older adults. To examine the additive effects of vitamin D3 supplementation during resistance training, 100 seniors (65–85 years) participated in a 16-week intervention. Besides a daily dose of 400 mg of calcium, participants received either 800 IU vitamin D3 per day (VDD), 50,000 IU vitamin D3 per month (VDM) or nothing (CON). After the initial loading phase of four weeks, all groups started a 10-week resistance training program. Assessments of 25-hydroxyvitamin D (25(OH)D) status, muscle strength endurance (30-s chair stand and arm curl tests), aerobic capacity (6-min walk test) and functional mobility (gait speed and timed up and go test) were undertaken at baseline, after four weeks and at the end of the study. 25(OH)D status significantly improved in VDD and VDM, but not in CON (time x group: p = 0.021), as 15.2% of CON, 40.0% of VDD and 61.1% of VDM reached vitamin D sufficiency (>30 ng/mL; p = 0.004). Chair stand test, arm curl test, 6-min walk test, gait speed and timed up and go test improved over the whole intervention period (p < 0.05), however only chair stand and arm curl test were selectively affected by resistance training (p < 0.001). Neither muscle strength endurance, nor functional mobility or aerobic capacity were modulated by vitamin D supplementation. Therefore, the mere amelioration of 25(OH)D status of older adults does not lead to an additive effect on muscular performance during RT.

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Minimally Supervised Multimodal Exercise to Reduce Falls Risk in Economically and Educationally Disadvantaged Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.21.3.241 ◽

2013 ◽

Vol 21 (3) ◽

pp. 241-259 ◽

Cited By ~ 6

Author(s):

Taís L. Almeida ◽

Neil B. Alexander ◽

Linda V. Nyquist ◽

Marcos L. Montagnini ◽

Angela C.S. Santos ◽

...

Keyword(s):

Older Adults ◽

Community Dwelling ◽

Functional Mobility ◽

Timed Up And Go ◽

Walk Speed ◽

Educationally Disadvantaged ◽

Home Based ◽

History Of ◽

The Mean ◽

Minimally Supervised

Few studies have evaluated the benefit of providing exercise to underprivileged older adults at risk for falls. Economically and educationally disadvantaged older adults with previous falls (mean age 79.06, SD = 4.55) were randomized to 4 mo of multimodal exercise provided as fully supervised center-based (FS, n = 45), minimally supervised home-based (MS, n = 42), or to nonexercise controls (C, n = 32). Comparing groups on the mean change in fall-relevant mobility task performance between baseline and 4 mo and compared with the change in C, both FS and MS had significantly greater reduction in timed up-and-go, F(2,73) = 5.82, p = .004, η2p = .14, and increase in tandem-walk speed, F(2,73) = 7.71, p < .001 η2p = .17. Change in performance did not statistically differ between FS and MS. In community-dwelling economically and educationally disadvantaged older adults with a history of falls, minimally supervised home-based and fully supervised center-based exercise programs may be equally effective in improving fall-relevant functional mobility.

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Duration or Timing? What is the Optimal Core for Older Adults to Engage in Moderate-to-vigorous Physical Activity to Prevent Disability?

10.21203/rs.3.rs-41437/v1 ◽

2020 ◽

Author(s):

Ting-Fu Lai ◽

Yung Liao ◽

Chien-Yu Lin ◽

Wan-Chi Huang ◽

Ming-Chun Hsueh ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Function ◽

Gait Speed ◽

Handgrip Strength ◽

Vigorous Physical Activity ◽

Total Duration ◽

Functional Mobility ◽

Linear Regression Models ◽

Timed Up And Go

Abstract Background The positive association between the total duration of physical activity and performances of physical function may vary at different times of the day as circadian rhythm regulates individuals in response to external stimulations. We aimed to examine the association of timing-specific and overall moderate-to-vigorous physical activity (MVPA) with performances of physical function in older adults. Methods A cross-sectional analysis was conducted among 118 older adults (mean age = 70.0 ± 5.0 years). We assessed and identified timing-specific (morning: 06:01-12:00; afternoon: 12:01-18:00; evening: 18:01-24:00) and overall MVPA using a triaxial accelerometer. Different measures of physical function were evaluated including handgrip strength (by grip dynamometer), gait speed (five-meter walk test), basic functional mobility (timed up and go test), and lower limb strength (five times sit-to-stand test). Multivariate linear regression models adjusting for covariates were used to investigate the associations. Results Participants spent 0.4 hours in MVPA per day on average, half the time spent during the morning (47.7%), followed by during the afternoon (29.9%) and evening (21.6%). The time spent on overall MVPA was generally associated with better physical function performances. There was statistical evidence for the percentages of MVPA engagement during the morning ( B = 0.214, 95% confidence interval [CI] 0.001 to 0.428) and afternoon ( B = -0.273, 95% CI -0.518 to -0.027) associated with basic functional mobility but with contrary directions; the percentage of MVPA engagement during the evening was associated with less time spent in gait speed performance ( B = -0.237, 95% CI -0.468 to -0.006). Conclusions Our findings inform implications that the overall MVPA engagement was more important than timing-specific MVPA to older adults’ physical function performances. Strategies for accumulating time of MVPA is more practical and effective than encouraging to engage MVPA in specific timing for the enhancement of functional ability and therefore prevent disability among older adults.

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Using machine learning to investigate the relationship between domains of functioning and functional mobility in older adults

PLoS ONE ◽

10.1371/journal.pone.0246397 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246397

Author(s):

Keisuke Hirata ◽

Makoto Suzuki ◽

Naoki Iso ◽

Takuhiro Okabe ◽

Hiroshi Goto ◽

...

Keyword(s):

Machine Learning ◽

Older Adults ◽

Knee Extension ◽

The Body ◽

Functional Mobility ◽

Support Vector ◽

Timed Up And Go ◽

Explanatory Variables ◽

Machine Learning Classification ◽

Age Related

Previous studies have shown that functional mobility, along with other physical functions, decreases with advanced age. However, it is still unclear which domains of functioning (body structures, body functions, and activities) are most closely related to functional mobility. This study used machine learning classification to predict the rankings of Timed Up and Go tests based on the results of four assessments (soft lean mass, FEV1/FVC, knee extension torque, and one-leg standing time). We tested whether assessment results for each level could predict functional mobility assessments in older adults. Using support vector machines for machine learning classification, we verified that the four assessments of each level could classify functional mobility. Knee extension torque (from the body function domain) was the most closely related assessment. Naturally, the classification accuracy rate increased with a larger number of assessments as explanatory variables. However, knee extension torque remained the highest of all assessments. This extended to all combinations (of 2–3 assessments) that included knee extension torque. This suggests that resistance training may help protect individuals suffering from age-related declines in functional mobility.

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