Comparison of Standard Clinical and Instrumented Physical Performance Tests in Discriminating Functional Status of High-Functioning People Aged 61⁻70 Years Old.

Alice Coni,Sabato Mellone,Mirjam Pijnappels,A Stefanie Mikolaizak,Andrea B Maier,Ronny Bergquist,Lorenzo Chiari,Jeanine M Van Ancum

doi:10.3390/s19030449

Abstract

Assessment of physical performance by standard clinical tests such as the 30-s Chair Stand (30CST) and the Timed Up and Go (TUG) may allow early detection of functional decline, even in high-functioning populations, and facilitate preventive interventions. Inertial sensors are emerging to obtain instrumented measures that can provide subtle details regarding the quality of the movement while performing such tests. We compared standard clinical with instrumented measures of physical performance in their ability to distinguish between high and very high functional status, stratified by the Late-Life Function and Disability Instrument (LLFDI). We assessed 160 participants from the PreventIT study (66.3 ± 2.4 years, 87 females, median LLFDI 72.31, range: 44.33–100) performing the 30CST and TUG while a smartphone was attached to their lower back. The number of 30CST repetitions and the stopwatch-based TUG duration were recorded. Instrumented features were computed from the smartphone embedded inertial sensors. Four logistic regression models were fitted and the Areas Under the Receiver Operating Curve (AUC) were calculated and compared using the DeLong test. Standard clinical and instrumented measures of 30CST both showed equal moderate discriminative ability of 0.68 (95%CI 0.60–0.76), p = 0.97. Similarly, for TUG: AUC was 0.68 (95%CI 0.60–0.77) and 0.65 (95%CI 0.56–0.73), respectively, p = 0.26. In conclusion, both clinical and instrumented measures, recorded through a smartphone, can discriminate early functional decline in healthy adults aged 61–70 years.

Highlights

Identification of people at risk of functional decline is essential for targeting preventive interventions for the ones at risk
The aim of this study was to assess whether standard clinical measures of physical performance and instrumented measures collected through a smartphone during 30-s Chair Stand Test (30CST) and Timed Up and Go (TUG) tests, can distinguish between older individuals with a High and Very High Functional Status, stratified by the Late-Life Function and Disability Instrument (LLFDI)
Participants were invited by a random draw from local registries and included if they were (i) aged between 61 and 70 years, (ii) retired for more than six months, (iii) home-dwelling, (iv) able to read newspaper or text on smartphone (SP), (v) able to walk 500 m without walking aids, (vi) without cognitive impairments (Montreal Cognitive Assessment, MoCA > 24 points [14]), and (vii) they were excluded if they participated in exercise classes more than once a week or did sport for more than 150 min per week

Summary

Introduction

Identification of people at risk of functional decline is essential for targeting preventive interventions for the ones at risk. The application of these instruments is recommended and clinically useful to identify people at risk or assess changes over time, they have some limitations. They may suffer from floor or ceiling effects, and since they are self-reports, the accuracy of the data collected could be affected by social desirability or response biases [4]. The standard clinical outcomes of these physical performance tests are commonly used assessing older or patient populations [5,6], their ability to detect early signs of functional decline in relatively healthy and fit older adults is not clear

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Conclusion