Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test

Physical Therapy - Tập 90 Số 1 - Trang 89-99 - 2010
Rebecca J. Hess1, Jennifer S. Brach2, Sara R. Piva3, Jessie M. VanSwearingen4
1R.J. Hess, BS, is a graduate physical therapist student in the Department of Physical Therapy, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260 (USA).
2J.S. Brach, PT, PhD, GCS, is Assistant Professor, University of Pittsburgh.
3S.R. Piva, PT, PhD, OCS, is Assistant Professor, University of Pittsburgh.
4J.M. VanSwearingen, PT, PhD, FAPTA, is Associate Professor, University of Pittsburgh.

Tóm tắt

Background The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life. Objective The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure. Design Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study. Methods The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed. Results Figure-of-8 Walk Test time correlated with gait (gait speed, r=−.570; GARS-M, r=.281), physical function (LLFDI function, r=−.469; SAFFE restriction subscale, r=.370; PPT, r=−.353), confidence in walking (GES, r=−.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=−.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=−.339) and was related to fear of falling (t=−2.50). All correlations were significant (P<.05). Limitations This pilot study had a small sample size, and further research is needed. Conclusions The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed.

Từ khóa


Tài liệu tham khảo

Capaday, 2002, The special nature of human walking and its neural control, Trends Neurosci, 25, 370, 10.1016/S0166-2236(02)02173-2

Schneider, 2003, Progressive adaptation of the soleus H-Reflex with daily training at walking backward, J Neurophysiol, 89, 648, 10.1152/jn.00403.2002

Ferrucci, 2000, Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study, J Am Geriatr Soc, 48, 1618, 10.1111/j.1532-5415.2000.tb03873.x

Brach, 2005, Too much or too little step width variability is associated with a fall history in older persons who walk at or near normal gait speed, J Neuroeng Rehabil, 2, 21, 10.1186/1743-0003-2-21

Maki, 1997, Gait changes in older adults: predictors of falls or indicators of fear?, J Am Geriatr Soc, 45, 313, 10.1111/j.1532-5415.1997.tb00946.x

Hausdorff, 2001, Gait variability and fall risk in community-living older adults: a 1-year prospective study, Arch Phys Med Rehabil, 82, 1050, 10.1053/apmr.2001.24893

Brach, 2007, Gait variability and the risk of incident mobility disability, J Gerontol A Biol Sci Med Sci, 62, 983, 10.1093/gerona/62.9.983

Guralnik, 1994, A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission, J Gerontol, 49, M85, 10.1093/geronj/49.2.M85

Imms, 1981, Studies of gait and mobility in the elderly, Age Ageing, 10, 147, 10.1093/ageing/10.3.147

VanSwearingen, 1996, The modified Gait Abnormality Rating Scale and recognizing recurrent fall risk of community-dwelling, frail older veterans, Phys Ther, 76, 994, 10.1093/ptj/76.9.994

Verghese, 2002, Validity of divided attention tasks in predicting falls in older individuals: a preliminary study, J Am Geriatr Soc, 50, 1572, 10.1046/j.1532-5415.2002.50415.x

Courtine, 2003, Human walking along a curved path, I: body trajectory, segment orientation and the effect of vision, Eur J Neurosci, 18, 177, 10.1046/j.1460-9568.2003.02736.x

Kiriyama, 2005, Medial-lateral balance during stance phase of straight and circular walking of human subjects, Neurosci Lett, 388, 91, 10.1016/j.neulet.2005.06.041

Brauer, 2001, The interacting effects of cognitive demand and recovery of postural stability in balance-impaired elderly persons, J Gerontol A Biol Sci Med Sci, 56, 489, 10.1093/gerona/56.8.M489

Lovden, 2005, Environmental topography and postural control demands shape aging-associated decrements in spatial navigation performance, Psychol Aging, 20, 683, 10.1037/0882-7974.20.4.683

Bloem, 2001, The Multiple Tasks Test: development and normal strategies, Gait Posture, 14, 191, 10.1016/S0966-6362(01)00141-2

Podsiadlo, 1991, The Timed “Up & Go”: a test of basic functional mobility for frail elderly persons, J Am Geriatr Soc, 39, 142, 10.1111/j.1532-5415.1991.tb01616.x

Wolf, 1999, Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile, Phys Ther, 79, 1122, 10.1093/ptj/79.12.1122

Shumway-Cook, 2001, Motor Control: Theory and Practical Applications, 2nd ed.

Brooks, 1986, The Neural Basis of Motor Control

Menz, 2003, Acceleration patterns of the head and pelvis when walking on level and irregular surfaces, Gait Posture, 18, 35, 10.1016/S0966-6362(02)00159-5

VanSwearingen, Clinical correlates of motor control in walking: the Figure-of-8 Walk Test

VanSwearingen, 2009, A randomized trial of two forms of therapeutic activity to improve walking: effect on the energy cost of walking, J Gerontol A Biol Sci Med Sci, 64, 1190, 10.1093/gerona/glp098

Folstein, 1975, Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician, J Psych Res, 12, 189, 10.1016/0022-3956(75)90026-6

Studenski, 2003, Physical performance measures in the clinical setting, J Am Geriatr Soc, 51, 314, 10.1046/j.1532-5415.2003.51104.x

Walsh, 1995, Foot fall measurement technology, Gait Analysis: Theory and Application, 125

Tager, 1998, Reliability of physical performance and self-reported functional measures in an older population, J Gerontol A Biol Sci Med Sci, 53, M295, 10.1093/gerona/53A.4.M295

VanSwearingen, 1998, Assessing recurrent fall risk of community-dwelling, frail older veterans using specific tests of mobility and the Physical Performance Test of function, J Gerontol A Biol Sci Med Sci, 53, M457, 10.1093/gerona/53A.6.M457

Haley, 2002, Late Life Function and Disability Instrument, II: development and evaluation of the function component, J Gerontol A Biol Sci Med Sci, 57, M217, 10.1093/gerona/57.4.M217

Jette, 2002, Late Life Function and Disability Instrument, I: development and evaluation of the disability component, J Gerontol A Biol Sci Med Sci, 57, M209, 10.1093/gerona/57.4.M209

Lachman, 1998, Fear of falling and activity restriction: the Survey of Activities and Fear of Falling in the Elderly (SAFFE), J Gerontol B Psychol Sci Soc Sci, 53, 43, 10.1093/geronb/53B.1.P43

Rosengren, 1998, Gait adjustments in older adults: activity and efficacy influences, Psychol Aging, 13, 375, 10.1037/0882-7974.13.3.375

Reuben, 1990, An objective measure of physical function of elderly outpatients: the Physical Performance Test, J Am Geriatr Soc, 38, 1105, 10.1111/j.1532-5415.1990.tb01373.x

Reuben, 1992, The predictive validity of self-report and performance-based measures of function and health, J Gerontol A Biol Sci Med Sci, 47, M106, 10.1093/geronj/47.4.M106

Studenski, 1994, Predicting falls: the role of mobility and nonphysical factors, J Am Geriatr Soc, 42, 297, 10.1111/j.1532-5415.1994.tb01755.x

Gabell, 1984, The effect of age and variability in gait, J Gerontol, 39, 662, 10.1093/geronj/39.6.662

Owings, 2003, Measuring step kinematic variability on an instrumented treadmill: how many steps are enough?, J Biomech, 36, 1215, 10.1016/S0021-9290(03)00108-8

Brach, 2008, Reliability and validity of measures of gait variability in community-dwelling older adults, Arch Phys Med Rehabil, 89, 2293, 10.1016/j.apmr.2008.06.010

Lovden, 2008, Walking variability and working-memory load in aging: a dual-process account relating cognitive control to motor control performance, J Gerontol B Psychol Sci Soc Sci, 63, P121, 10.1093/geronb/63.3.P121

Rosano, 2007, Gait variability is associated with subclinical brain vascular abnormalities in high-functioning older adults, Neuroepidemiology, 29, 193, 10.1159/000111582

Reitan, 1985, The Hasltead-Reitan Neuropsychological Test Battery: Therapy and Clinical Interpretation

Fals-Stewart, 1992, An interrater reliability study of the Trail Making Test (Parts A and B), Percept Mot Skills, 74, 39, 10.2466/pms.1992.74.1.39

Johnson, 2007, Executive function, more than global cognition, predicts functional decline and mortality in elderly women, J Gerontol A Biol Sci Med Sci, 62, 1134, 10.1093/gerona/62.10.1134

Cohen, 1988, Statistical Power Analysis for the Behavioral Sciences, 2nd ed.

Craik, 1989, Changes in locomotion in the aging adult, Development of Posture and Gait Across the Lifespan, 176

Brach, Values of stance time variability related to mobility disability, 10.1519/00139143-200612000-00013

Lord, 2001, Choice stepping reaction time: a composite measure of falls risk in older people, J Gerontol, 56, M627, 10.1093/gerona/56.10.M627

McConvey, 2005, Reliability of the Dynamic Gait Index in individuals with multiple sclerosis, Arch Phys Med Rehabil, 86, 130, 10.1016/j.apmr.2003.11.033

Alexander, 2005, Age differences in timed accurate stepping with increasing cognitive and visual demand: a walking trail making test, J Gerontol A Biol Sci Med Sci, 60, 1558, 10.1093/gerona/60.12.1558

Morgan, 1994, Age-related motor slowness: simply strategic?, J Gerontol, 49, M133, 10.1093/geronj/49.3.M133

Connelly, 2000, Motor skill learning and eccentric isokinetic movements in older adults, Exp Aging Res, 26, 209, 10.1080/036107300404868