WHAT CAN BRIEF GAIT AND BALANCE PHYSICAL PERFORMANCE MEASURES TELL US ABOUT MORE DEMANDING TASK PERFORMANCE IN COMMUNITY-DWELLING OLDER ADULTS?

Abstract

Purpose/Hypothesis: Abnormalities of gait and balance are common contributors to falls and functional decline in older adults. Physical performance measures are often used to assess gait and balance, and as indicators of overall function. Previous studies support use of these measures to identify older adults at risk for functional decline. However, usefulness of these measures to infer performance of more demanding, comprehensive tasks is less clear. We examined the association of gait and balance physical performance measures with selfreport of more demanding walking ability and balance confidence during functional tasks. Subjects: Community-dwelling older adults (N=66, 81.5 ± 5.9 years, 71% female), who volunteered for physical function assessments. Materials/Methods: Physical performance of gait and balance were assessed using gait speed and timed 360° turn. Self-reports assessed walking ability (“Does your health now limit you in walking more than a mile? If so, how much?”) and balance confidence during functional tasks [Activities-specific Balance Confidence Scale (ABC)]. Correlations examined associations between physical performance and self-report variables. Differences between subjects reporting and not reporting limitations were examined via T- tests. Sensitivity and specificity examined accuracy of performance measures to detect self-reported limitations. Results: Gait speed and 360° turn were associated with self-report of walking a mile (rpb= −.34, p<.01) and ABC (r =−.42, p<.01), respectively. Subjects who reported limitations in walking a mile demonstrated slower gait speed than those reporting no limitations (t64 = 2.9, p<.005). Subjects with low balance confidence turned 360° slower compared to those with high balance confidence (t43 = 3.7, p<.001). Sensitivity and specificity of the 360° turn for detecting low ABC score were 40% and 30%, respectively. Sensitivity and specificity of gait speed for detecting limitations in walking a mile were 50% and 80%, respectively. Conclusions: Gait and balance physical performance measures were moderately correlated with self-report of more demanding walking ability and balance confidence during functional tasks. Subjects who reported limitations in walking a mile or had low balance confidence also scored more poorly on gait and balance measures. Gait speed demonstrated higher sensitivity and specificity for limitations in walking a mile than 360° turn demonstrated for low balance confidence. Performance measures provide limited information regarding limitations in more demanding walking tasks and balance confidence. Clinical Relevance: Physical therapists should be cautious about inferring older adults' abilities to perform more demanding, comprehensive tasks based on physical performance measure scores. Gait and balance physical performance measures are valuable clinical assessments; however, combination of physical performance and self-report of more demanding tasks provides a more accurate description of daily functioning for communitydwelling older adults.