Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients
Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients
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DOI：
10.1016/j.jclinepi.2007.04.016
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发表时间：
2008-02-01
影响因子：
7.2
通讯作者：
Rikkert, Marcel G. M. Olde
中科院分区：
文献类型：
--
作者：
van Lersel, Marianne B.;Munneke, Marten;Rikkert, Marcel G. M. Olde
目的：评估虚弱老年患者群体和个体水平功能活动测试和定量步态测量的临床相关性变化。研究设计和地点：本研究是一项连续入院的虚弱老年患者的队列研究。在入院时和2周后测量步态速度、计时起跳试验(TUG)和其他活动能力测试。在此期间，患者接受了多学科治疗。三位专家通过录像判断患者是否有临床上相关的步态变化，定义为预期跌倒风险的变化。结果：共有85名患者(平均年龄75.8岁，女性46例)参与研究。其中，45%患有痴呆症；59名患者病情稳定，26名患者步态出现临床相关变化。步态速度和拖拽对群体水平的变化最为敏感。在个体患者中，步态速度较基线改变5%和TUG改变9%对检测临床相关改变的敏感度分别为92%和93%，但特异度分别为27%和34%。结论：在组水平，从所有调查的测试来看，步态速度和TUG对变化最敏感，在这一角度下是最佳结果变量。在个体患者中，较高的个体内变异性使得这些测量方法不适合作为临床相关步态变化的独立筛查工具。(C)2008 Elsevier Inc.保留所有权利。
Objective: To estimate clinically relevant changes in functional mobility tests and quantitative gait measures at group and individual level in frail elderly patients.Study Design and Setting: This study was a cohort study of consecutively admitted frail elderly patients. Gait velocity; Timed-Up-and-Go test (TUG), and other mobility tests were measured on admission and 2 weeks later. In between, patients received multidisciplinary treatment. Three experts decided from video recordings if patients had a clinically relevant change in gait, defined as change in the expected risk of falling.Results: A total of 85 patients (mean age 75.8 years, 46 female) participated. Of whom, 45% had dementia; 59 patients were stable and 26 showed a clinically relevant change in gait. Gait velocity and TUG were most sensitive to change at group level. In individual patients, a 5% change from baseline in gait velocity and 9% change in TUG had a sensitivity of 92% and 93% for detection of clinically relevant change, but specificity of 27% and 34%, respectively.Conclusion: At group level, gait velocity and TUG were, from all investigated tests, most sensitive to change and in this perspective the best outcome variables. In individual patients, the high intraindividual variability makes these measures unsuitable as independent screening instruments for clinically relevant changes in gait. (C) 2008 Elsevier Inc. All rights reserved.