Many persons with spinal cord injury (SCI) require an ambulatory assistive device (AAD). An effective monitoring method enables the use of an appropriate AAD and promotes levels of independence for patients. This study investigated the discriminative ability of the three-functional tools relating to walking ability, including the 10-meter walk test (10MWT), the five times sit-to-stand test (FTSST), and the timed up and go test (TUGT), in independent ambulatory persons with SCI who walked with walker, crutches, cane, and non-AAD. Eighty-five persons with SCI who could perform sit-to-stand and walk independently at least 50 m were cross-sectionally assessed for their functional ability using the 10MWT, FTSST, and TUGT. The findings for persons not using AADs were significantly better than the other groups for every test (P < 0.001). In addition, persons who walked with cane were significantly different from those who used walkers (P < 0.001) but there were no significant differences between persons who used walker and crutches for every test (P > 0.05). The findings supported the discriminative validity of the tools, allowing them to indicate functional changes in persons with SCI who walk with different AADs. However, the non-significant differences between subjects who used a walker and crutches may relate to the method of subject arrangement and inclusion criteria that recruit subjects with rather good walking capability and lower limb function. The findings may also suggest the use of the sit-to-stand maneuver as a simple screening tool for walking advancement of walker users, pending further investigation.
7 November 2013 in The Journal of Spinal Cord Medicine
More than half of independent ambulatory patients with spinal cord injury (SCI) need a walking device to promote levels of independence. However, long-lasting use of a walking device may introduce negative impacts for the patients. Using a standard objective test relating to the requirement of a walking device may offer a quantitative criterion to effectively monitor levels of independence of the patients. Therefore, this study investigated (1) ability of the three functional tests, including the five times sit-to-stand test (FTSST), timed up and go test (TUGT), and 10-meter walk test (10MWT) to determine the ability of walking without a walking device, and (2) the inter-tester reliability of the tests to assess functional ability in patients with SCI. Sixty independent ambulatory patients with SCI, who walked with and without a walking device (30 subjects/group), were assessed cross-sectionally for their functional ability using the three tests. The first 20 subjects also participated in the inter-tester reliability test. The time required to complete the FTSST <14 seconds, the TUGT < 18 seconds, and the 10MWT < 6 seconds had good-to-excellent capability to determine the ability of walking without a walking device of subjects with SCI. These tests also showed excellent inter-tester reliability. Methods of clinical evaluation for walking are likely performed using qualitative observation, which makes the results difficult to compare among testers and test intervals. Findings of this study offer a quantitative target criterion or a clear level of ability that patients with SCI could possibly walk without a walking device, which would benefit monitoring process for the patients.
This study aimed to examine the validity of balance tests and compare their diagnostic accuracy to determine the risk of falls among older community-dwelling individuals. Eighty-five older participants were assessed based on their demographics and fall data. They were then assessed for the ability to perform balance measures, including five times sit-to-stand tests (FTSSTs), timed up and go tests (TUGs), three times stand and walk tests (TTSWs), functional reach tests (FRTs), and single-leg stance tests (SLSs). The correlation between fall data and balance measures was found to be significant for all parameters (p < 0.05). The TTSW showed the highest level of ability to indicate the risk of falls among older community-dwelling adults with sensitivity = 92.68%, specificity = 84.09%, and AUC = 0.931 (95%CI = 0.860 to 1.000). These findings confirm the benefits of the practical functional balance measures to determine the risk of falls among older community-dwelling individuals.
1 October 2022 in Journal of Aging and Physical Activity
This study was to develop and validate the circular tandem walk test (CTWT) by deriving an optimal cutoff score to indicate the fall risk in 89 active community-dwelling older individuals. The participants aged 65 years and older were assessed for their demographic data, fear of fall variables, and history of falls in the past 6 months. Subsequently, participants were randomized for the sequence of tests between the tandem walk test and the CTWT. The outcomes of CTWT showed the highest significant correlation with all the fall variables (ranging from .631 to .827, p < .001). Moreover, the time to perform the CTWT ≥ 14.6 s and ≥ two error scores had excellent and acceptable diagnostic accuracy to determine the risk of falls in the older individuals, respectively. The CTWT can be used as alternative screening tests for assessing the fall risk in active older adults in community settings.
The senior population is at increased risk of falling due to a reduction in ankle muscle strength. Evaluating the strength of the ankle muscles in older adults is of paramount importance. The purpose of this study was to formulate an equation to estimate ankle muscle strength by utilizing the basic physical characteristics of the subject and the variables related to their ability to perform the standing heel-rise test (SHRT). One hundred and thirty-two healthy elderly participants (mean age 67.30 ± 7.60) completed the SHRT and provided demographic information. Ankle plantar flexor (PF) muscle strength was evaluated using a push–pull dynamometer. Multiple regression analysis was utilized to develop a prediction equation for ankle PF muscle strength. The study revealed that the ankle PF strength equation was derived from variables including the power index of the SHRT, gender, age, calf circumference, and single-leg standing balance test. The equation exhibited a strong correlation (r = 0.816) and had a predictive power of 65.3%. The equation is represented as follows: ankle PF strength = 24.31 − 0.20(A) + 8.14(G) + 0.49(CC) + 0.07(SSEO) + 0.20(BW/t-SHRT). The equation had an estimation error of 5.51 kg. The strength of ankle PFs in elderly individuals can be estimated by considering demographic variables, including gender, age, calf circumference, single-leg standing balance test, and the power index of the SHRT. These factors were identified as significant determinants of ankle PF strength in this population.