Validity of common physical function tests performed online for older adults

A McCain, C McGibbon, M Carroll, E MacKenzie, M Sénéchal, D R Bouchard, A McCain, C McGibbon, M Carroll, E MacKenzie, M Sénéchal, D R Bouchard

Abstract

Background: Objectively measured physical function tests are important predictors of institutionalization, disability, and premature mortality. Although physical function was usually assessed in person prior to the COVID-19 pandemic, there is a need to investigate whether physical function tests performed online are valid.

Objective: The purpose of this study was to determine the validity of common physical function tests conducted online compared to in-person testing in older adults.

Methods: Physical functions included gait speed, one leg stance balance, 30-second chair stands, and the 2-minute steps were tested online and in-person using a random order for community dwellers aged 65 years and above. Using an alpha two way mixed model, average intraclass correlation coefficients (ICC) were calculated between the two settings and one sample T-test performed on the difference between the results of each test between the two settings. Finally, Bland-Altman plots were created, and proportional biases tested via linear regressions.

Results: Besides the one-leg stance balance with eyes closed, for which the ICC was 0.47 (0.23-0.74) the average ICC's were excellent ranging from 0.87 to 0.94. No proportional biases were observed based on Bland-Altman graphs.

Conclusion: For older adults living in the community, common physical function tests can be performed online.

Keywords: Bland-Altman; Intraclass correlation coefficient; Older adults; Physical function tests; Validity; Virtual.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2023 Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
Comparison between the two assessment settings for the normal pace gait speed.
Fig. 2
Fig. 2
Comparison between the two assessment settings for 30-second chair stand tests.
Fig. 3
Fig. 3
Comparison between the two assessment settings for the One-leg stance with eyes open.
Fig. 4
Fig. 4
Comparison between the two assessment settings for the Two-Minute Step Test.

References

    1. Araujo C.G., et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine. 2022;56(17):975–980. Sep.
    1. Blomqvist S., Wester A., Sundelin G., Rehn B. Test–retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability. Physiotherapy. 2012;98(4):313–319. Dec.
    1. Bootsman N.J.M., Skinner T.L., Lal R., Glindemann D., Lagasca C., G. M. E. E Geeske) Peeters, “The relationship between physical activity, and physical performance and psycho-cognitive functioning in older adults living in residential aged care facilities. Journal of Science and Medicine in Sport. 2018;21(2):173–178. Feb.
    1. Busch P.A., Hausvik G.I., Ropstad O.K., Pettersen D. Smartphone usage among older adults. Computers in Human Behavior. 2021;121 Aug.
    1. Canadian Society for Exercise Physiology, CSEP physical activity training for health resource manual (CSEP-PATH), Third Edition. 2021.
    1. Davidson J., Schimmele C. Evolving internet use among Canadian seniors. Statistics Canada. 2019 Jul. 10, (accessed Dec. 05, 2021)
    1. Doğan N.Ö. Bland-Altman analysis: A paradigm to understand correlation and agreement. Turkish Journal of Emergency Medicine. 2018;18(4):139–141. Dec.
    1. Fillenbaum G.G., Smyer M.A. The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of Gerontology. 1981;36(4):428–434. Jul.
    1. Fortuna K.L., et al. A future research agenda for digital geriatric mental healthcare. American Journal of Geriatric Psychiatry Off Journal of American. Association Geriatric Psychiatry. 2019;27(11):1277–1285. Nov.
    1. Gawel J., Vengrow D., Collins J., Brown S., Buchanan A., Cook C. The short physical performance battery as a predictor for long term disability or institutionalization in the community dwelling population aged 65 years old or older. Physical Therapy Reviews. 2012;17(1):37–44. Feb.
    1. Guralnik J.M., et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2000;55(4):M221–M231. Apr.
    1. Hardy S.E., Perera S., Roumani Y.F., Chandler J.M., Studenski S.A. Improvement in usual gait speed predicts better survival in older adults. Journal of the American Geriatrics Society. 2007;55(11):1727–1734.
    1. Kichloo A., et al. Telemedicine, the current COVID-19 pandemic and the future: A narrative review and perspectives moving forward in the USA. Family Medicine and Community Health. 2020;8(3) Aug.
    1. Koo T.K., Li M.Y. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine. 2016;15(2):155–163. Jun.
    1. Kopecek Z.M., Stepankova H., Lukavsky J., Ripova D., Nikolai T., Bezdicek O. Montreal cognitive assessment (MoCA): Normative data for old and very old Czech adults. Applied Neuropsychology: Adult. 2017;24(1):23–29.
    1. Kuo Y.L. The influence of chair seat height on the performance of community-dwelling older adults’ 30-second chair stand test. Aging Clinical and Experimental Research. 2013;25(3):305–309. Jun.
    1. Muellmann S., et al. Development and evaluation of two web-based interventions for the promotion of physical activity in older adults: Study protocol for a community-based controlled intervention trial. BMC Public Health. 2017;17:1–8. May.
    1. Ogawa E.F., Harris R., Dufour A.B., Morey M.C., Bean J. Reliability of virtual physical performance assessments in veterans during the COVID-19 pandemic. Archives of Rehabilitation Research and Clinical Translation. 2021;3(3) Sep.
    1. O'Hoski S., et al. Physical function and frailty for predicting adverse outcomes in older primary care patients. Archives of Physical Medicine and Rehabilitation. 2020;101(4):592–598. Apr.
    1. Petrella A.F.M., Gill D.P., Petrella R.J. Evaluation of the get active questionnaire in community-dwelling older adults. Applied Physiology, Nutrition, and Metabolism. Jun. 2018;43(6):587–594.
    1. Rikli R.E., Jones C.J. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. The Gerontologist. 2013;53(2):255–267. Apr.
    1. Sanchez-Villagomez P., et al. Shift to virtual self-management programs during COVID-19: Ensuring access and efficacy for older adults. Frontiers Public Health. 2021;9 Accessed: Aug. 07, 2022. [Online]. Available.
    1. Springer B.A., Marin R., Cyhan T., Roberts H., Gill N.W. Normative values for the unipedal stance test with eyes open and closed. Journal of Geriatric Physical Therapy. 2007;30(1):8–15. Apr.
    1. Weir J.P. Quantifying test-retest reliability using the intraclass correlation coefficient and the sem. The Journal of Strength & Conditioning Research. 2005;19(1):231–240. doi: 10.1519/15184.1. Feb.doi.

Source: PubMed

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