Original article
Validity of 3 Physical Performance Measures in Inpatient Geriatric Rehabilitation

https://doi.org/10.1016/j.apmr.2005.08.109Get rights and content

Abstract

Brooks D, Davis AM, Naglie G. Validity of 3 physical performance measures in inpatient geriatric rehabilitation.

Objective

To evaluate the construct validity and the responsiveness of 3 measures of physical performance measures as outcome measures for frail older persons.

Design

Pre-post design with measures at admission and discharge.

Setting

Three inpatient geriatric rehabilitation programs.

Participants

Fifty-two subjects (35 women, 17 men; age, 80±8y).

Interventions

Not applicable.

Main Outcome Measures

Physical performance measures were Timed Up & Go (TUG) test, two-minute walk test (2MWT), and functional reach. Functional status was measured with the FIM instrument and the Modified Barthel Index.

Results

The TUG and 2MWT scores differed significantly in groups of patients using different ambulatory aids (P=.006), whereas no such difference was observed for the functional reach (P=.40). The correlations between the TUG test and FIM and between the 2MWT and FIM were –.59 and .59 (P<.001), respectively, at admission, and –.42 and .47 (P≤.04), respectively, at admission and discharge. The correlations between functional reach and the FIM were not significant (P≥.09). Standardized response means were 1.1 for the TUG, 0.7 for the 2MWT, and 0.5 for functional reach.

Conclusions

The TUG test and 2MWT are valid and responsive outcome measures in older persons participating in geriatric rehabilitation. Functional reach was a moderately responsive outcome measure but did not consistently reflect ambulatory or functional status.

Section snippets

Sample

Patients admitted to 1 of 3 inpatient geriatric rehabilitation programs were recruited for the study. The 3 programs were comparable in terms of the admission criteria for the patients (ie, degree of impairment), goals for mobility and functional improvement, and the program characteristics (eg, staff composition, amount of rehabilitation provided, average length of stay). Study inclusion criteria were the ability to ambulate a few meters without physical assistance and to perform at least 1 of

Sample

A total of 52 individuals participated in the study, including 35 (67%) women and 17 (33%) men. Before admission to the hospital, 86% lived at home and 12% lived in a retirement home; none lived in a nursing home. At discharge, 69% went to a private residence, 19% to a retirement home, and 4% to a nursing home. A total of 12 (23%) subjects experienced a change in residence after discharge. Other demographic characteristics are presented in table 1. The most common primary diagnoses were

Discussion

In the absence of strong evidence supporting the use of different physical performance measures for geriatric rehabilitation populations, the choice of which tests to use as outcome measures in geriatric rehabilitation remains a matter of clinical judgment. In this study, we examined aspects of construct validity and responsiveness of 3 physical performance measures in inpatient geriatric rehabilitation settings because the literature on the measurement properties of these measures is

Conclusions

The TUG test and 2MWT reflected ambulatory and functional status and showed good responsiveness, with the TUG being the most responsive measure. The functional reach was the least responsive, was less consistently correlated with functional status, and did not discriminate between different levels of ambulatory status. Additional studies are needed to further examine the predictive validity of physical performance measures and their usefulness for outcomes evaluation in frail elderly

Acknowledgments

We acknowledge the following people for their assistance with data collection and subject recruitment: Kathy Scott, Sara Sharp, Carol Fancott, Adrianna Ventutinni, Theresa Yeung, Jan Goldstein, and the staff of the Inpatient Geriatric Rehabilitation Unit.

References (23)

  • M.E. Tinetti et al.

    Risk factors for falls among elderly persons living in the community

    N Engl J Med

    (1988)
  • Cited by (0)

    Supported by the Toronto Rehabilitation Institute and Collaborative Research Program, Rehabilitation and Long-Term Care, the Canadian Institute for Health Research (New Investigator Awards), and the Mary Trimmer Chair in Geriatric Medicine Research, University of Toronto.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

    View full text