Develop a Mobility Task to Identify Risk for Disability

该项目的目标是开发一种可用于补充目前用于评估老年人功能的活动性任务。这项研究开发了一项任务，简化了所需的设备，同时保留了CAR任务的心理测量特性，这是一项客观的性能测试，使用汽车的铝框架模型，并测量打开车门，进入桶形座椅，关闭车门，重新打开车门，并立即移动到直立位置所需的时间。这项新任务结合了横向移动、弯腰、体重转移和转移等元素，类似于CAR任务的当前要求，同时使用了许多研究人员可以复制的简单便携式设备。先前的研究已经表明，CAR任务具有一些任务中不存在的属性，例如爬楼梯的时间（最大性能任务），首选步行速度（自定进度的性能任务）或自我报告残疾。例如，已经发现平衡测量（前后方向上的支撑的功能基础）预测CAR任务表现的下降，但不能预测自我报告的残疾、爬楼梯时间或优选的步行速度。从实际的角度来看，作为乘客进出汽车的困难或无法进出汽车会严重限制虚弱的老年人旅行的能力。该任务的标准是，它是可靠的，有效的，易于在诊所/社区管理，并通过身体活动干预策略的变化敏感。在为期1-2年的几项次级研究中，正在对新任务的测量特性进行评估，目前正在对数据进行分析。首先，将在50名老年人中检查新任务的重测信度，利用其功能状态范围从非残疾到严重残疾的人。将评估天花板和地板效应。其次，进行了已知组检验。两组25人，一个没有/很少的残疾，其他中度/重度残疾，已被利用来检查测试的有效性。第三，将在新测试与力量、平衡和功能表现指标之间进行相关性分析。第四，在2-D额面运动学分析中检查了参与者的样本，以确定在任务上的较差表现是否与运动策略的变化相关。

The goal of this project is to develop a mobility task that can be used to complement those currently used to assess function in older adults. This research has developed a task that simplifies the equipment needed while preserving the psychometric properties of the CAR task, an objective performance test that uses an aluminum frame mock-up of an automobile and measures the time needed to open the door, get into a bucket seat, close the door, re-open the door, and step out, immediately moving to an erect position. The new task incorporates elements of lateral mobility, stooping, weight shift, and transfer, similar to the current demands of the CAR task, while using simple, portable equipment that can be reproduced by many researchers. Previous research has shown that the CAR task has some properties that do not exist in tasks such as time to climb stairs (a maximal performance task), preferred walking speed (a self-paced performance task), or in a self-report of disability. For example, it was have found that a balance measure (functional base of support in the anterior-posterior direction) was predictive of decline in CAR task performance, but not in self-reported disability, stair climb time, or preferred walking speed. From a practical perspective, difficulty or inability to enter and exit a car as a passenger can severely limit the ability of a frail older person to travel. Criteria for the task were that it be reliable, valid, easy to administer in the clinic/community, and sensitive to change via physical activity intervention strategies. The measurement properties of the new task are being evaluated in several sub-studies over a 1-2 year period and analyses of the data are now under way. First, test-retest reliability of the new task will be examined in 50 older adults, utilizing persons whose functional status ranges from non-disabled to severely disabled. Ceiling and floor effects will be evaluated. Second, a known groups test has been performed. Two groups of 25, one with no/little disability, the other with moderate/severe disability, has been utilzed to examine the validity of the test. Third, correlation analyses will be conducted between the new test and measures of strength, balance, and functional performance. Fourth, a sample of participants hs been examined in a 2-D frontal plane kinematic analysis to determine if poorer performance on the task is associated with changes in movement strategies.