5. Field-based testing in OA Flashcards
When testing OA, which physical parameters (2) should we focus on and why?
Fall prevention and reducing frailty (strength training very important)
Performing assessments on OA will help you: (6)
- Identify and predict mobility problems & disability
- Determine if program is appropriate
- Motivate
- Select exercises
- Provide feedback
- Document the benefits of PA program
Define physical impairment
Loss or abnormality at the tissue, organ, or body system level
Define functional limitation
Restriction in physical behaviors such as rising from a chair, lifting or climbing stairs
Define physical disability
Any restriction or lack of ability to perform a task or an activity in the manner considered normal
According to the functional fitness framework, give an example of physical impairment — functional limitation — physical disability/dependence
Muscle strength or endurance —- walking/stair climbing —- personal care (shopping/errands)
Should we do squats with OA?
Yes, very functional, good for balance and strength
What variable has the strongest correlation with stair climbing and ramp up in the quadriceps muscle strength study?
Time to peak torque in knee extension = better time will be faster to climb stairs and ramp up
4 common obstacles with assessments
- Lack of time and space and budget
- Lack of trained personnel
- Lack of assessments tools
- Absence of a requirement by facility management
Are most PA centers for OA good at conducting field-based assessments?
Yes for initial assessment but not for follow-up
2 major criteria for selection and evaluation of test instruments
1) Practicality
2) Psychometric properties
Another word to define practicality of the test
Usability of the test
Factors that influence usability/practicality? (5)
- Medical permission or supervision required and available
- Time needed to administer and score the test
- Personnel and expertise needed to administer test
- Level of fatigue to participant per test
- Is the test meaningful to your participants?
Refers to the degree the test will meet specific and established test construction guidelines
Psychometric properties
4 parts of psychometric properties
- reliability
- validity
- discrimination power
- performance standards
Refers to the degree that two test scores are similar when tested under identical conditions
Reliability
A reliable test would be free of _____
measurement error
What should the test-re-test- reliability score be?
Should be > 0.80
What is inter-rater reliability?
When scores obtained from multiple testers are very similar (high correlation)
Refers to the test having shown to measure what it is intended to measure
Validity
Most important characteristic of any test?
Validity
Evaluates a test’s validity by comparing its scores with other scores already found to be valid
Criterion-related validity
Validity is acceptable when correlation values are ____
> 0.70
What is the goal of the 6-minute chair stand test?
Measure cardiorespiratory endurance
Does the 6-minute chair stand test have good or poor validity? explain
Poor validity because it measures more muscular endurance than cardio endurance
Ability of a test to predict the future outcome of the test
Predictive validity
Example of predictive validity?
Score ≤ 25 on the Fullerton Balance Scale = high risk of falls (out of 40)
Ability of the test to detect changes in performance over time
Discrimination power
What is the floor effect?
Test is too difficult for specific subjects being tested
What is the ceiling effect?
Test is too easy for specific subjects being tested
Minimal VO2 to remain functionally independent at age 85? male vs female
Female 15
Male 18
What are the two field-based ax tools designed to measure physical impairments and functional limitations in OA?
- Short physical performance Battery protocol
- Fullerton Advanced Balance (FAB) scale
Name the 3 tests for the SPPB
Balance tests
Gait speed test
Chair stand test
3 types of balance test for the SPPB
Feet side to side
Feet big toe to heel
Feet tandem
Distance for the gait speed test in the SPPB
4 meters walk
Average speed for OA to perform a chair stand 1 rep?
2 seconds
Average walking speed of young adults
1.0 to 1.2 m/s
4 good reasons to use the SPPB
- Meets psychometric properties
- Convenient and practical
- Safe because sub-maximal effort
- Evaluates physical abilities and function
Series of 10 functional tests which assess both ___ and ____ under varied _____
static and dynamic balance under varied sensory conditions
Maximum score of FAB scale
40 (4 points per test)
FAB test has high: (4)
- predictive reliability
- test-re-test
- intra & inter-rater reliability
- content validity
FAB scale is excellent to use with what type of OA? and what do you do for the ones who don’t fit in that category?
Excellent test for OA with no major balance issues
Lower functioning OA due to chronic diseases and disabilities can use the Berg Balance scale
What test should be used for lower functioning OA due to chronic diseases or disabilities?
Better to use easier test such as Berg Balance Scale
What is the score for the FAB Scale? cut-off for long form vs short form
≤ 25/40 = high risk
≤ 9/16 = high risk
Prior to the test, participants must complete 3 things
- A health and PA questionnaire
- Informed consent form
- Medical clearance if required
Participants must be advised of what 3 things for assessment day?
To avoid heavy exertion and alcohol use 24h before testing
To eat a light meal one hour before testing
To wear appropriate clothing for exercise
Are OA stressed out before their assessment?
Yes because they want to do well - can influence the results
What is the threshold score when interpreting test results?
Where the OA becomes at risk for loss of physical independence
