{"title":"主观筛查识别老年人行动障碍的诊断准确性。","authors":"Dalerie Lieberz, Molly Watkins, Emily J Johnson, Kylie Butterfield, Kellie Huschle, Madilyn Jankila, Mallery Johnson, Amy Leopold, Brayden Mogg","doi":"10.1519/JPT.0000000000000460","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Identifying preclinical mobility limitation (PCML) and mobility disability are critical for a preventative model of physical therapy. Subjective fall risk and mobility screening questions are used to determine the need for objective testing. This study aimed to determine the diagnostic accuracy of subjective screening for mobility impairment.</p><p><strong>Methods: </strong>Participants answered 8 evidence-based subjective fall risk and mobility screening questions followed by evaluation with the Short Physical Performance Battery (SPPB) and the grip strength test. Gait speed and the Five Times Sit to Stand Test time were calculated from the SPPB. Reference standards for the tests were used to binarize results as at/above or below standards. Relationships between binarized subjective screening and objective test results were analyzed with Phi (φ) correlation coefficients. Sensitivity and specificity were calculated for relationships with acceptable cutoff values ( P < .05, φ > 0.3). Binomial regression was used to determine the sensitivity and specificity of asking multiple questions. Screening questions were considered useful predictors of the objective test result if combined sensitivity and specificity were ≥1.5.</p><p><strong>Results and discussion: </strong>Ambulatory adults (N = 83) aged 65 to 92 years ( M = 70) participated. One question-\"Do you have difficulty with balance?\"-met the diagnostic accuracy threshold for predicting the SPPB outcome with a sensitivity of 0.632 and a specificity of 0.871.</p><p><strong>Conclusions: </strong>Subjective screening does not adequately predict objective test results for identifying PCML. The findings indicate that improved screening tools or more referrals for objective testing are needed to detect early mobility loss with aging.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Diagnostic Accuracy of Subjective Screening for Identifying Mobility Impairment in Older Adults.\",\"authors\":\"Dalerie Lieberz, Molly Watkins, Emily J Johnson, Kylie Butterfield, Kellie Huschle, Madilyn Jankila, Mallery Johnson, Amy Leopold, Brayden Mogg\",\"doi\":\"10.1519/JPT.0000000000000460\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Identifying preclinical mobility limitation (PCML) and mobility disability are critical for a preventative model of physical therapy. Subjective fall risk and mobility screening questions are used to determine the need for objective testing. This study aimed to determine the diagnostic accuracy of subjective screening for mobility impairment.</p><p><strong>Methods: </strong>Participants answered 8 evidence-based subjective fall risk and mobility screening questions followed by evaluation with the Short Physical Performance Battery (SPPB) and the grip strength test. Gait speed and the Five Times Sit to Stand Test time were calculated from the SPPB. Reference standards for the tests were used to binarize results as at/above or below standards. Relationships between binarized subjective screening and objective test results were analyzed with Phi (φ) correlation coefficients. Sensitivity and specificity were calculated for relationships with acceptable cutoff values ( P < .05, φ > 0.3). Binomial regression was used to determine the sensitivity and specificity of asking multiple questions. Screening questions were considered useful predictors of the objective test result if combined sensitivity and specificity were ≥1.5.</p><p><strong>Results and discussion: </strong>Ambulatory adults (N = 83) aged 65 to 92 years ( M = 70) participated. One question-\\\"Do you have difficulty with balance?\\\"-met the diagnostic accuracy threshold for predicting the SPPB outcome with a sensitivity of 0.632 and a specificity of 0.871.</p><p><strong>Conclusions: </strong>Subjective screening does not adequately predict objective test results for identifying PCML. The findings indicate that improved screening tools or more referrals for objective testing are needed to detect early mobility loss with aging.</p>\",\"PeriodicalId\":49035,\"journal\":{\"name\":\"Journal of Geriatric Physical Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Geriatric Physical Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1519/JPT.0000000000000460\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Geriatric Physical Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1519/JPT.0000000000000460","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
The Diagnostic Accuracy of Subjective Screening for Identifying Mobility Impairment in Older Adults.
Background and purpose: Identifying preclinical mobility limitation (PCML) and mobility disability are critical for a preventative model of physical therapy. Subjective fall risk and mobility screening questions are used to determine the need for objective testing. This study aimed to determine the diagnostic accuracy of subjective screening for mobility impairment.
Methods: Participants answered 8 evidence-based subjective fall risk and mobility screening questions followed by evaluation with the Short Physical Performance Battery (SPPB) and the grip strength test. Gait speed and the Five Times Sit to Stand Test time were calculated from the SPPB. Reference standards for the tests were used to binarize results as at/above or below standards. Relationships between binarized subjective screening and objective test results were analyzed with Phi (φ) correlation coefficients. Sensitivity and specificity were calculated for relationships with acceptable cutoff values ( P < .05, φ > 0.3). Binomial regression was used to determine the sensitivity and specificity of asking multiple questions. Screening questions were considered useful predictors of the objective test result if combined sensitivity and specificity were ≥1.5.
Results and discussion: Ambulatory adults (N = 83) aged 65 to 92 years ( M = 70) participated. One question-"Do you have difficulty with balance?"-met the diagnostic accuracy threshold for predicting the SPPB outcome with a sensitivity of 0.632 and a specificity of 0.871.
Conclusions: Subjective screening does not adequately predict objective test results for identifying PCML. The findings indicate that improved screening tools or more referrals for objective testing are needed to detect early mobility loss with aging.
期刊介绍:
Journal of Geriatric Physical Therapy is the leading source of clinically applicable evidence for achieving optimal health, wellness, mobility, and physical function across the continuum of health status for the aging adult.
The mission of the Academy of Geriatric Physical Therapy is building a community that advances the profession of physical therapy to optimize the experience of aging.