ch5: field-based physical & mobility assessments Flashcards
performing assessments will help you:
- identify & predict if a participant is at risk for mobility problems & disability
- determine if the prog is appropriate for the older exercising population
- motivate your participants to set personal goals (YA)
- select exercises that meet specific needs of older participants
use of functional fitness framework
- identifies physical fitness parameters associated with func mobility
- relates func mobility to ability and active daily living
components of func fitness framwork
- physical parameters
- functions
- ADLs
what are physical parameters
- muscle
- aerobic endurance
- flexibility
- motor ability
what are functions
walking
standing up from a chair
-lifting/reaching
-bending/kneeling
- jogging/running
what are activity goals
personal care
housework
gardening
sports
traveling
how does the function fitness framework work
physical impairment –> func limitation –> physical disability/dependence
what is physical impairment
loss of abnormality at the tissue, organ, or body system level
what is func limitation
restriction in physical behaviours such as rising from a chair, lifting or climbing stairs
what are physical disability
any restriction or lack of ability to perform a task or an activity in the manner considered normal
stair climbing test
test quad strength vs function in OA
11 steps
ramp up test
test quad strength vs function in oa
3.66m ramp
common obstacles with assessments
- lack or time, space and budget
- lack of trained personnel
- lack of assessment tools
- absence of a requirement by facility management
are most PA centres for OA good at conducting field-based assessments
yes for initial assessment but not for follow up
criteria for selection & evaluation of test instruments
- practicality
- psychometric properties
what is practicality
- usability of the test
factors that influence usability include:
- medical permission 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 participant
what are psychometric properties
refers to the degree the test will meet specific and established test construction guidelines
what are the psychometric properties
- reliability
- validity
- discrimination power
- performance standards
what is reliability
- refers to the degree that two test scores are similar when tested under identical conditions
- test would then be free of measurement error
- must originate from published protocol
what should test-re-test be if reliable
should be >0.80
what is inter-rater reliability
when scores obtained from multiple testers are very similar
(high correlation)
what is vallidity
- refers to the test having shown to measure what it is intended to measure
- most important characteristic of any test
what is criterion-related validity
evaluates a tests validity by comparing its scores with other scores already found to be valid
- acceptable when correlation values are >0.70
what is the 6min chair stand test
goal: measure cardiorespiratory endurance
in reality it measures muscular endurance more then cardio endurance
what is predictive validity
- ability of a test to predict the futur outcome of the test
- research data must show a strong statistical prediction to the futur outcome
what is discrimination power
ability of the test to detect changes in performance over time
what should the test have to assess a change in performance over time or in relation to an intervention
should have a minimum floor or ceiling effects
what are floor effects
test is too difficult for specific subjects being tested
what are ceiling effects
test is too easy for specific subjects been g tested
what is the norm referenced standards
gender & age
what is performance standards
interpretation of the scores
provide feedback to participants
what is criterion-referenced standards
- evaluates performance in relation to a particular reference point or specific goal such as: fitness level to climb stairs or to remain functionally independent
minimal VO2 to remain func independent at age 85 for men and women
men: 18
W: 15
recommended assessment tools
two field based assessment tools designed to measure physical impairments and func limitations in OA
1- short physical performance battery protocol
2- Fullerton advanced balance scale
what is the short performance battery
- balance test
- gait speed test
- chair stand test
scoring SPPB
0-3: worst performance, high mortality
4-9: reduced physical performance
10-12: best physical performance, low mortality
good reasons to use short physical performance battery (SPPB)
- meets psychometric properties
- is convenient and practical in terms of equipment, space, and time requirements
- allow OA to perform that test safely (bc sub-max effort) without the need for a medical release
- evaluates physical abilities and func
what is Fullerton advanced balance scale (FAB)
series of 10 func tests which assess both static & dynamic balance under varied sensory conditions
what is used to measure the outcome of the test FAB
4 point scale
max= 40 points
what does FAB test have high:
- predictive validity
- test-re-test reliability
- intra & interrater relliability
- content validity
what can Fullerton advanced balance test predict
faller status
score 25 or lower = at risk
who is the FAB test good for
- OA with no major balance issues
- for lower func OA due to chronic diseases and disability –> better to use easier test such as Berg Balance scale
what does the FAB test assess
posture
stepping
time
what should participants complete prior to test
- health & PA questionnaire
- informed consent form
- medical clearance, if required
what should participants be advised of prior to the test
- avoid heavy exertion and alcohol use for 24h before testing
- to eat a light meal one hour before testing
- to wear appropriate clothing for exercise
interpreting test results for the SFT performance norms
- norms based on over 7000 community dwelling OA between 60 and 94 y/o
- normal defined as the middle 50% of the population
criterion standards when interpreting test results for the sft
- scores compared to a threshold score
can be used to identify participants at risk for mobility prob, falls or disability
