Acceptability and utility of a broad test battery to evaluate physical functioning and frailty in community-based settings for people experiencing homelessness and addiction–Findings from the LEAP trials

Abstract

BackgroundPhysical function deficits and frailty are commonly reported in people experiencing homelessness and addiction. Typically, geriatric, or general physical performance measures are employed to evaluate these constructs. Objectives and settingWe aimed to investigate the feasibility of a broad test battery to evaluate physical functioning and frailty in a non-geriatric community-based population of people experiencing homelessness and addiction. Design and methodsPhysical function and the presence of frailty was evaluated using combined data from two linked low-threshold exercise pre-post intervention studies (LEAP I and II). ParticipantsSeventy-four participants attending an open-access day-service centre (18 to 65 years) were evaluated. Participants with acute confusion or behavioural issues, or major medical condition precluding safe participation were excluded. InterventionA broad test battery was performed which evaluated physical functioning and frailty. Main outcome measuresOutcome measures included were the Short Physical Performance Battery, Single Leg Stance, Chair Stand Test, 10 m and 2 minute Walk Tests, limb circumference, dynamometry, Clinical Frailty Scale, SHARE-Frailty Instrument, numerical pain rating and Short Form-12. ResultsTest completion was 100% for all outcomes except pain rating (81% and 79% for LEAPI and II, respectively), and balance and walking tests (95% and 93% in LEAP II). A ceiling effect was detected for the Short Physical Performance Battery. ConclusionHigh feasibility of the test batteries was demonstrated. An optimised test battery was proposed based on findings. This has important implications for clinicians working in inclusion health settings. Clinical Trial Registration NumberClinical Trials.gov: NCT05700305. Contribution of the Paper•This paper proposes a suitable test battery to enable clinicians to evaluate physical functioning and frailty in people experiencing homelessness and addiction challenges in community settings.•There is a paucity of research evaluating outcome measures for this population and no core outcome set has been reported.•This test battery would allow the effect of treatment and targeted interventions to be evaluated in this marginalised population.