Validation of the revised multi-sensor-based electronic Short Physical Performance Battery (eSPPB) kiosk in community-dwelling older adults.

Abstract

Purpose: Recent studies highlight how technology can mitigate the reliance on trained staff for scalability of the Short Physical Performance Battery (SPPB). Although the original multi-sensor-based electronic SPPB (eSPPB) kiosk was previously validated in the outpatient setting, technical limitations and lack of user-friendliness impeded scalability to community settings where SPPB assessments are most often performed. We aim to evaluate the revised eSPPB kiosk in terms of construct validity, agreement, inter-rater, and test-retest reliability vis-à-vis manual SPPB (mSPPB) in community-dwelling older adults.

Methods: Fifty-eight community-dwelling older adults (81% women, mean age = 75.0 ± 5.5, median FRAIL = 0 [range 0-2]) from active ageing centers performed the mSPPB and eSPPB concurrently. Twenty (34%) had a repeat assessment 2 weeks later for test-retest reliability. Convergent validity, discriminant ability, agreement, inter-rater, and test-retest reliability were evaluated using partial correlation adjusted for age and gender, independent sample t tests using SPPB cutoff ≤ 9, and cross-tabulation of mSPPB against eSPPB, Bland-Altman plots, and intra-class correlation coefficients (ICC), respectively.

Results: eSPPB demonstrated excellent correlation with mSPPB (r = 0.922, p < 0.001); weak-moderate correlation with frailty and sarcopenia; and good discriminant ability for sarcopenia and frailty using SPPB cutoff ≤ 9. Bland-Altman plots showed good agreement between eSPPB and mSPPB (mean difference = 0.12, 95%CI - 1.10 to 1.34; r = -0.035, p = 0.505). Inter-rater reliability was excellent (ICC = 0.92, 95%CI 0.87-0.95), while test-retest reliability was comparable between mSPPB and eSPPB (ICC = 0.66, 95%CI 0.33-0.85 versus 0.61, 95%CI 0.25-0.82 respectively).

Conclusion: Our study corroborates the construct validity, agreement, inter-rater, and test-retest reliability between the eSPPB kiosk and mSPPB in healthy community-dwelling older adults. This paves the way for scalability studies examining real-world eSPPB screening of sarcopenia and frailty in the community setting.