학술논문
Balance measures for fall risk screening in community-dwelling older adults with COPD: A longitudinal analysis.
Document Type
Academic Journal
Author
Nguyen KT; School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.; Brooks D; School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.; Macedo LG; School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada.; Ellerton C; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.; Goldstein R; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Rehabilitation Sciences Institute, School of Graduate Studies, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.; Alison JA; School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Allied Health, Sydney Local Health District, Sydney, Australia.; Dechman G; School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.; Harrison SL; School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom.; Holland AE; Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia; Respiratory Research, Monash University, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia.; Lee AL; Institute for Breathing and Sleep, Melbourne, VIC, Australia; Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia.; Marques A; Lab3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.; Spencer L; School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.; Stickland MK; Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; G.F. MacDonald Centre for Lung Health, Covenant Health, Edmonton, AB, Canada.; Skinner EH; Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia; Physiotherapy Department, Western Health, The University of Melbourne, Melbourne, VIC, Australia.; Haines KJ; Physiotherapy Department, Western Health, The University of Melbourne, Melbourne, VIC, Australia.; Beauchamp MK; School of Rehabilitation Science, Faculty of Health Science, McMaster University, Hamilton, ON, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada. Electronic address: beaucm1@mcmaster.ca.
Source
Publisher: Elsevier Country of Publication: England NLM ID: 8908438 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-3064 (Electronic) Linking ISSN: 09546111 NLM ISO Abbreviation: Respir Med Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Chronic obstructive pulmonary disease (COPD) increases fall risk, but consensus is lacking on suitable balance measures for fall risk screening in this group. We aimed to evaluate the reliability and validity of balance measures for fall risk screening in community-dwelling older adults with COPD.
Methods: In a secondary analysis of two studies, participants, aged ≥60 years with COPD and 12-month fall history or balance issues were tracked for 12-month prospective falls. Baseline balance measures - Brief Balance Evaluation Systems Test (Brief BESTest), single leg stance (SLS), Timed Up and Go (TUG), and TUG Dual-Task (TUG-DT) test - were assessed using intra-class correlation (ICC2,1 ) for reliability, Pearson/Spearman correlation with balance-related factors for convergent validity, t-tests/Wilcoxon rank-sum tests with fall-related and disease-related factors for known-groups validity, and area under the receiver operator characteristic curve (AUC) for predictive validity.
Results: Among 174 participants (73 ± 8 years; 86 females) with COPD, all balance measures showed excellent inter-rater and test-retest reliability (ICC2,1 = 0.88-0.97) and moderate convergent validity (r = 0.34-0.77) with related measures. Brief BESTest and SLS test had acceptable known-groups validity (p < 0.05) for 12-month fall history, self-reported balance problems, and gait aid use. TUG test and TUG-DT test discriminated between groups based on COPD severity, supplemental oxygen use, and gait aid use. All measures displayed insufficient predictive validity (AUC<0.70) for 12-month prospective falls.
Conclusion: Though all four balance measures demonstrated excellent reliability, they lack accuracy in prospectively predicting falls in community-dwelling older adults with COPD. These measures are best utilized within multi-factorial fall risk assessments for this population.
Competing Interests: Declaration of competing interest There is no conflict of interest.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Methods: In a secondary analysis of two studies, participants, aged ≥60 years with COPD and 12-month fall history or balance issues were tracked for 12-month prospective falls. Baseline balance measures - Brief Balance Evaluation Systems Test (Brief BESTest), single leg stance (SLS), Timed Up and Go (TUG), and TUG Dual-Task (TUG-DT) test - were assessed using intra-class correlation (ICC
Results: Among 174 participants (73 ± 8 years; 86 females) with COPD, all balance measures showed excellent inter-rater and test-retest reliability (ICC
Conclusion: Though all four balance measures demonstrated excellent reliability, they lack accuracy in prospectively predicting falls in community-dwelling older adults with COPD. These measures are best utilized within multi-factorial fall risk assessments for this population.
Competing Interests: Declaration of competing interest There is no conflict of interest.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)