Development of an Annual Mobility Screen for Preclinical Mobility Limitation: Test Selection and Interpretation Guidelines

IF 4.5 2区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of the American Geriatrics Society Pub Date : 2025-05-10 DOI:10.1111/jgs.19521

Michelle M. Lusardi, Victoria Hamby, Sterling Eckert, Jason Dring

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引用次数: 0

Abstract

Background

Preclinical mobility limitation (PCML) is an emerging public health issue in the United States. A standardized assessment to identify those with PCML has not been established. A Task Force of the American Physical Therapy Association's Academy of Geriatric Physical Therapy (APTA Geriatrics) developed an evidence-based protocol for an Annual Mobility Screen (AMS) with the potential to meet this gap in practice. Early identification of PCML increases the potential for remediation, improved function, and a slower rate of decline. Because mobility is key for independence and quality of life, aging adults would value access to mobility screening. Physical therapists, experts in movement, are uniquely qualified to provide this service.

Methods

This report reviews decision-making for the selection of test/measures and the development of an interpretation rationale for an AMS. Test selection criteria included ratio level measures (time, distance, repetition), time or equipment requirements, ability to predict adverse health events, and availability of reference values.

Results

Four performance-based measures met inclusion criteria: self-selected and fast walking speed (overall mobility and functional reserve), 30 s Chair Stand (lower extremity muscle performance), Four Square Step test (dynamic balance stepping over low obstacles and changing direction), and Timed Up Go cognitive (ability to dual task while moving). Classification of mobility was based on normal distribution of performance across the population of aging adults as follows: PCML unlikely (at or above—0.5 SD or more from mean for age/gender), PCML likely (between −0.5 SD and − 1.0 SD from mean), and impending mobility limitation (−1 SD below the mean).

Conclusion

The AMS was developed to identify older adults with PCML. The reliability and validity of the AMS and its interpretation strategies will be evaluated as the screening protocol is piloted.

Abstract Image

查看原文本刊更多论文

临床前活动能力限制的年度活动能力筛查的发展：测试选择和解释指南。

背景：临床前活动受限（PCML）是美国一个新兴的公共卫生问题。鉴别PCML患者的标准化评估尚未建立。美国物理治疗协会老年物理治疗学会（APTA Geriatrics）的一个工作组为年度活动能力筛查（AMS）制定了一项基于证据的方案，有望在实践中填补这一空白。PCML的早期识别增加了修复的潜力，改善了功能，并减缓了下降的速度。因为行动能力是独立和生活质量的关键，老年人会重视行动能力筛查。物理治疗师是运动方面的专家，是唯一有资格提供这项服务的人。方法：本报告回顾了决策的选择测试/措施和发展的解释基本原理的AMS。试验选择标准包括比率水平测量（时间、距离、重复）、时间或设备要求、预测不良健康事件的能力以及参考值的可用性。结果：四项基于性能的测试满足入选标准：自选和快速步行速度（整体活动能力和功能储备）、30 s椅子站立（下肢肌肉表现）、四方步测试（跨低障碍物和改变方向的动态平衡）和Timed Up Go认知（运动时双重任务的能力）。活动能力的分类基于整个老年人群体的表现的正态分布，如下所示：不太可能的PCML（与年龄/性别的平均值相比等于或高于0.5 SD或更高），可能的PCML（与平均值相比介于-0.5 SD和- 1.0 SD之间），以及即将到来的活动能力限制（低于平均值-1 SD）。结论：AMS可用于识别老年PCML。随着筛选方案的试点，将对AMS及其解释策略的可靠性和有效性进行评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Geriatrics Society 医学-老年医学

CiteScore

10.00

自引率

6.30%

发文量

504

审稿时长

3-6 weeks

期刊介绍： Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.