The ability to perform sit-to-stand from a chair and getting down and up from the floor, or the ability to safely perform a floor transfer are important transitional activities for independent ...living. The sit-to-stand maneuver is frequently performed by community-dwelling older adults and is routinely evaluated as a part of geriatric physical therapy assessment. Conversely, a floor transfer is rarely performed by older adults or addressed by clinicians, even when working with frail patients who live alone and are at high risk for falls. Accordingly, the specific aim of this cross-sectional study was to determine the concurrent, predictive, and discriminant validity of the five times sit-to-stand (5xSTS) test against 3-point floor transfer performance.
A total of 46 community-dwelling adults, ages 65-96 years, were recruited using a stratified sampling technique based on self-reported levels of floor transfer ability: independent (n = 16); assisted (n = 15); and dependent (n = 15). Forty-five of the 46 participated in the data collection process. Participants were first assessed for the 5xSTS test and were categorized based on performance as unable to perform (n = 14), poor performance (>13.6 seconds), or good performance (≤13.6 seconds). Participants then performed the 3-point floor transfer test and were classified based on results as independent (n = 18), assisted (n = 10), or dependent (n = 17). Spearman correlations were calculated to assess the concurrent validity for the 5xSTS testing procedure against 3-point floor transfer performance. The Kruskal-Wallis test was used to: 1) determine the discriminant validity of 5xSTS test outcome performance among groups that differ in 3-point floor transfer test performance; and 2) examine the significance level of the socio-demographic data.
Moderate to strong positive correlations were found between the 3-point floor transfer test and the categorical performance outcomes of the 5xSTS test (rho ranged from 0.67 to 0.88,
< .001). A strong negative correlation was found between 5xSTS scores and the 3-point floor transfer test (rho = 0.86,
< .001). There was moderate sensitivity (71%) and strong specificity (93%) for the 5xSTS test to predict floor transfer performance. The outcomes of 5xSTS performance differed significantly among 3-point floor transfer performance outcome groups. Older adults who were unable to perform 5xSTS test were also dependent in floor transfer performance. In contrast, older adults who demonstrated good performance in the 5xSTS test were independent in floor transfer performance (p ≤ 0.012).
Floor transfer is a highly important safety maneuver for older adults, although it is rarely performed and assessed. This study documents that the 5xSTS test displays concurrent, predictive, and discriminative validity properties, making it a potentially useful initial screening tool to predict floor transfer ability. Failure to complete the 5xSTS test may also be a reliable indicator of floor transfer performance dependency among community-dwelling older adults.
The present study aimed to define the physical function and lipid profile for physical and cognitive frailty in community-dwelling Korean older adults. A total of 229 participants (age = 76.76 ± 3.72 ...years; body mass index = 24.83 ± 3.15) were classified into four groups: robust, pre-frailty, cognitive decline, and cognitive frailty. An analysis on the four groups was performed to measure their physical and cognitive function, as well as blood biomarkers. The area under (AUC) the receiver operating characteristic curve (ROC) indicated that the 6-min Walk Test (6MWT), Timed Up and Go test (TUG), and Five Times Sit-to-Stand test (FTSS) had the potential to distinguish the capacity of an old adult to predict cognitive frailty. The 6MWT had a higher sensitivity and the TUG and FTSS tests had greater specificity. With cognitive frailty as a categorical variable, cognitive frailty status was a significant predictor of the TUG (odds ratio (OR) 2.897; 95% confidence interval (CI), 1.283-6.541), FTSS (OR 3.337; 95% CI 1.451-7.673), and 6MWT (OR 0.204; 95% CI 0.070-0.591) tests. Our findings indicate that the 6MWT, TUG, and FTSS tests are closely related to cognitive frailty and can provide potential prognostic cutoff points.
Background Hip adductor and abductor strength were both reduced in KOA patients. But to date, most of the researches have only focused on quadriceps combined with hip abductor strengthening versus ...quadriceps strengthening. Objective The aim of the study is to evaluate the effect of adding hip abductor and adductor strengthening to quadriceps strengthening on lower limb strength, knee pain and physical function in patients with medial compartmental knee osteoarthritis. Methods In this study, 42 participants, were randomly divided into two groups: the general treatment group (GT group) and the added-hip-exercise group (AH group). All participants were given a general rehabilitation treatment. The AH group performed hip abductor and adductor strengthening in addition to the general rehabilitation treatment. Knee and hip muscle strength, Five Times Sit-to-Stand Test (FTSST), the Timed Up and Go Test (TUGT), Numerical Rating Scale (NRS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were assessed at baseline and 6 weeks. A two-sided 2-sample unpaired t test was performed to compare the difference in mean change scores between AH and GT groups. Results Finally, 36 participants completed the study: both groups consist of 18 participants. In the per-protocol analysis, the AH group had a greater improvement in knee extension strength (mean changes, 7.84 versus 36.48; P < 0.001) and hip abduction strength (mean changes, 5.05 versus 26.62; P = 0.001) than the control group. Similarly, the AH group had a greater improvement in the FTSST time (mean changes, 0.40 s versus 3.57 s; P < 0.001) and the TUFT time (mean changes, 0.18 s versus 1.67 s; P = 0.002) than the GH group. No statistical difference was found in the change of WOMAC pain scores and NRS between the 2 groups. Conclusions Older adults with knee OA in the AH group had superior muscle strength, symptoms and daily activity performance at the 6th week than those in the GT group. And adding hip exercises could expedite improvement of pain at the 2th week, but not at the 6th week. Trial registration Clinical trial registration numbers and date of registration: ChiCTR-IOR-16009124, Registered 30 August 2016. Keywords: Hip exercises, Knee, Osteoarthritis, Rehabilitation, Isometric muscle strengthening, The Western Ontario and McMaster Universities, Numerical Rating Scale, Five times Sit-to-Stand Test, Timed Up and Go Test
To assess changes in locomotor function in HIV-infected patients and to evaluate the determinants of variations in lower limb muscle performance.
Longitudinal study within the ANRS CO3 Aquitaine ...Cohort.
Standardized locomotor tests, including global functional capacity 6-min walk distance (6MWD) and lower limb muscle performance tests five times sit-to-stand (5STS) test, were performed in HIV-infected adults at baseline and 2-year follow-up. Evolution of performances and determinants of 5STS time were studied in linear mixed-effects models.
At baseline (354 patients, 90% on antiretroviral treatment), median 5STS time was 9.8 s and 6MWD 549 m. Poorer performances were associated with falls, reported by 12% of 178 patients at follow-up. Estimated mean deterioration was +0.24 s/year (P < 10) for 5STS time and -11 m/year (P < 10) for 6MWD. In multivariable analyses, older age was associated with worse baseline 5STS time (+0.47 s/10-year age increase; P = 10), but not with further deterioration. Deterioration was greater in prior injecting drug users compared to others (difference in slope +0.62 s/year; P = 0.04). 5STS time at any time point was worse in patients with history of cerebral AIDS conditions (+2.47 s; P < 10) and diabetes (+0.95 s; P = 0.02) than in others. No significant associations were found for antiretroviral treatment type, viral load or CD4 cell count.
Compared to published data from healthy persons of similar age, baseline 5STS time and 6MWD were poorer in HIV-infected adults and associated with subsequent falls. Test performances deteriorated further over time. Age, diabetes, neurologic complications and injection drug use, rather than virologic factors, contribute to variations in lower limb muscle performance.
Introduction
Previous studies suggested that physical and cognitive function can be indicators to assess the risk of falls in the elderly. Various tests are widely used in geriatric clinical studies ...as assessment tools of physical and cognitive function. However, large sample studies comparing the fall predictive value of these tests are still sparse. This study was conducted to investigate the value of cognitive and physical function tests in predicting the risk of subsequent falls in the elderly, with the overarching goal of providing more evidence on fall-risk assessment.
Methods
The current study was based on the data of respondents aged 60 and above from the China Health and Retirement Longitudinal Study (CHARLS). Data from the 2015 CHARLS national survey were used as the baseline data, and the fall data in 2018 were used as the follow-up data. Physical function tests included balance, walking speed, the five times sit-to-stand test (FTSST), and grip strength. The value of cognitive and physical function tests in predicting falls was evaluated by logistic regression analysis and receiver operating characteristic (ROC) curves.
Results
The incidence of falls among the 4,857 subjects included in this study was 20.86%. Results showed that cognition (OR = 0.83, 95% CI: 0.70–0.98), the FTSST (OR = 3.51, 95% CI: 1.66–7.46), and grip strength (OR = 1.02, 95% CI: 1.01–1.03) were independent predictors of falls in the full sample after adjusting for various confounders. Notably, the above tests showed better predictive value for falls for the oldest-old (≥ 80 years) subjects.
Conclusion
Overall, results showed that grip strength, the FTSST, and cognition tests are simple and practicable tools for identifying individuals at higher risk of falls in the community. Moreover, the fall predictive performance of physical and cognitive function tests was age-dependent, with a higher predictive value in older adults aged 80 and above.
To provide up-to-date assessments of locomotor function in HIV-infected patients and to identify potential determinants of impaired function.
Cross-sectional study in 324 HIV-1-infected adults from ...the French Agency for AIDS and Hepatitis Research (ANRS) CO3 Aquitaine Cohort using standardized locomotor tests.
Patients underwent standardized testing assessing balance, walking ability, functional capacity and lower limb muscle performance. Poor test performance was defined by cut-offs based on age-specific data of the general population. Factors associated with poor test performance were studied by logistic regression.
Median age was 48 years, 80% were men and 89% were on antiretroviral treatment. The most frequently altered locomotor test was the five-times sit-to-stand (5STS) test, assessing lower limb muscle performance (poor performance: 53%). In multivariable analysis, time since HIV diagnosis was associated with poor 5STS performance odds ratio (OR) = 1.08 per year; 95% confidence interval (CI): 1.03, 1.13. In patients below 30 years, elevated BMI was associated with higher likelihood of good performance (OR = 0.81 per kg/m(2); 95% CI: 0.69, 0.93), whereas in those above 70 years this association was reversed (OR = 1.30 per kg/m(2); 95% CI: 1.10, 1.53; P < 10(-3) for interaction). We found no association with antiretroviral treatment.
One of two adults with controlled HIV infection had poor lower limb muscle performance, which might put this population at risk of falls and fracture. The 5STS test is a simple test that should be recommended to assess muscular performance in HIV care.
Five-times-sit-to-stand test (FTSST) is a reliable tool for measuring lower limb functional strength and balance ability. However, reports of the reliability of FTSST in children with cerebral palsy ...have been scarce. The purposes of this study were (1) to investigate the test-retest and inter-rater reliability of the FTSST and (2) to investigate the correlation between the FTSST and standard functional balance tests in children with cerebral palsy.
Cross-sectional study.
Thirty-three school children aged from 6 to 18 years with Gross motor functional classification system expanded and revised version (GMFCS-E&R) level I to III were recruited. Reliability of the FTSST and concurrent validity between FTSST and Timed up and go test (TUG) and Berg balance scale (BBS) were determined using the Pearson product moment correlation.
The intra-class correlation coefficient (ICC) for test-retest and inter-rater reliability of FTSST were 0.91 and 0.88 respectively. FTSST showed moderate correlation with TUG (r = 0.552, P < 0.01) and with BBS (r = -0.561, P < 0.01).
FTSST is a reliable assessment tool and correlates with functional balance ability tests in children with mild to moderate cerebral palsy.
Exercise is essential for maintaining quality of life (QOL) in elderly individuals. However, adherence to exercise programs is low. Here, we assessed the effectiveness of a self-directed home ...exercise program with serial telephone contacts to encourage exercise adherence among elderly individuals at high risk of locomotor dysfunction. We recruited community-dwelling adults (ｧ65 years) in Niigata, Japan, who were targets of the long-term care prevention project for locomotor dysfunction but did not participate in the government-sponsored prevention programs. The study was conducted from November 2011 to October 2012. Participants received exercise instruction and performed exercises independently for 3 months with serial telephone contacts. The single-leg stance and five-times sit-to-stand tests were used to assess physical function. The SF-8 was used to measure health-related QOL. Ninety-seven participants were enrolled in the study, representing 2.5% of eligible people;87 completed the intervention. Scores from physical function tests were significantly improved by the intervention, as were 7 of eight SF-8 subscales. Adherence was 85.4% for the single-leg standing exercise and 82.1% for squatting. Thus, self-directed home exercise with serial telephone contacts improved physical function and health-related QOL, representing a promising model for preventing the need for long-term care due to locomotor dysfunction.
More and more elderly problems come to our life and the elderly health care become more important. Elderly people with lower extremities weakness usually use walkers to assist in walking. Although ...the commercial standard walkers (N-type) can improve elderly people's walking ability, users sometimes take risk of falling when using the standard walkers to perform sit-to-stand (STS). The purpose of this study is to design an additional armrest which can be attached to a standard walker for users performing STS more easily and evaluate it with clinical assessments and a body worn sensor.
The combination of the walker and the new armrest design are referred to as a better type (B-type). Clinical assessments and a motion analysis were performed on 34 elderly people (age, 83 ± 6 y/o) with a Five Times Sit-to-Stand Test (FTSST), a satisfaction survey and an inertial measurement unit (IMU) attached to the trunk to measure the acceleration data when using B-type and N-type during STS.
The FTSST result shows that the B-type can reduce about 5 s spending time of elderly people during STS and 63.7% of subjects were more satisfied on the B-type than the N-type. According to the IMU, the result reveals that the B-type can provide subjects higher peak–peak anterio-posterior acceleration, peak flexion acceleration and peak extension acceleration during STS.
There is a better assistance during STS when using our new armrests design combined with the commercial product which could provide larger acceleration to perform sit-to-stand.
The ability to perform sit-to-stand from a chair and getting down and up from the floor, or the ability to safely perform a floor transfer are important transitional activities for independent ...living. The sit-to-stand maneuver is frequently performed by community-dwelling older adults and is routinely evaluated as a part of geriatric physical therapy assessment. Conversely, a floor transfer is rarely performed by older adults or addressed by clinicians, even when working with frail patients who live alone and are at high risk for falls. Accordingly, the specific aim of this cross-sectional study was to determine the concurrent, predictive, and discriminant validity of the five times sit-to-stand (5xSTS) test against 3-point floor transfer performance.
A total of 46 community-dwelling adults, ages 65-96 years, were recruited using a stratified sampling technique based on self-reported levels of floor transfer ability: independent (n = 16); assisted (n = 15); and dependent (n = 15). Forty-five of the 46 participated in the data collection process. Participants were first assessed for the 5xSTS test and were categorized based on performance as unable to perform (n = 14), poor performance (>13.6 seconds), or good performance (≤13.6 seconds). Participants then performed the 3-point floor transfer test and were classified based on results as independent (n = 18), assisted (n = 10), or dependent (n = 17). Spearman correlations were calculated to assess the concurrent validity for the 5xSTS testing procedure against 3-point floor transfer performance. The Kruskal-Wallis test was used to: 1) determine the discriminant validity of 5xSTS test outcome performance among groups that differ in 3-point floor transfer test performance; and 2) examine the significance level of the socio-demographic data.
Moderate to strong positive correlations were found between the 3-point floor transfer test and the categorical performance outcomes of the 5xSTS test (rho ranged from 0.67 to 0.88, p < .001). A strong negative correlation was found between 5xSTS scores and the 3-point floor transfer test (rho = 0.86, p < .001). There was moderate sensitivity (71%) and strong specificity (93%) for the 5xSTS test to predict floor transfer performance. The outcomes of 5xSTS performance differed significantly among 3-point floor transfer performance outcome groups. Older adults who were unable to perform 5xSTS test were also dependent in floor transfer performance. In contrast, older adults who demonstrated good performance in the 5xSTS test were independent in floor transfer performance (p ≤ 0.012).
Floor transfer is a highly important safety maneuver for older adults, although it is rarely performed and assessed. This study documents that the 5xSTS test displays concurrent, predictive, and discriminative validity properties, making it a potentially useful initial screening tool to predict floor transfer ability. Failure to complete the 5xSTS test may also be a reliable indicator of floor transfer performance dependency among community-dwelling older adults.
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