主观筛查识别老年人行动障碍的诊断准确性。

IF 1.5 4区 医学 Q4 GERIATRICS & GERONTOLOGY
Dalerie Lieberz, Molly Watkins, Emily J Johnson, Kylie Butterfield, Kellie Huschle, Madilyn Jankila, Mallery Johnson, Amy Leopold, Brayden Mogg
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引用次数: 0

摘要

背景和目的:确定临床前活动受限(PCML)和活动障碍是预防物理治疗模式的关键。主观跌倒风险和活动能力筛查问题用于确定是否需要进行客观测试。本研究旨在确定主观筛查对行动障碍的诊断准确性。方法:参与者回答8个基于证据的主观跌倒风险和活动能力筛查问题,然后用短物理性能电池(SPPB)和握力测试进行评估。根据SPPB计算步态速度和五次坐立试验时间。使用试验的参考标准将结果二值化,分为等于/高于或低于标准。用Phi (φ)相关系数分析二值化主观筛选与客观检验结果的关系。计算敏感性和特异性与可接受临界值的关系(P < 0.05, φ > 0.3)。采用二项回归法确定多问的敏感性和特异性。如果综合敏感性和特异性≥1.5,筛选问题被认为是客观检测结果的有用预测因子。结果与讨论:参与研究的65 ~ 92岁的流动成年人(N = 83) (M = 70)。一个问题——“你在平衡方面有困难吗?”-满足预测SPPB预后的诊断准确度阈值,敏感性为0.632,特异性为0.871。结论:主观筛查不能充分预测鉴别PCML的客观检测结果。研究结果表明,需要改进的筛查工具或更多的转诊进行客观测试,以发现老年早期活动能力丧失。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Journal of Geriatric Physical Therapy
Journal of Geriatric Physical Therapy GERIATRICS & GERONTOLOGY-REHABILITATION
CiteScore
3.70
自引率
4.20%
发文量
58
审稿时长
>12 weeks
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.
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