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EXCI 455 > LECTURE SIX: Field-Based Physical & Mobility Assessments > Flashcards

LECTURE SIX: Field-Based Physical & Mobility Assessments Flashcards

1
Q

What will performing physical and mobility assessments help you to do with your older adult client (6)?

A
  1. Help identify and predict if a participant is at risk for mobility problems and disability
  2. Determine if the program is appropriate for the older exercising population
  3. Motivate your participants to set personal goals
  4. Select exercises that meet specific needs of older participants
  5. Provide meaningful feedback to participants
  6. Document the benefits of your physical activity program
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2
Q

Of the six physical and mobility assessments:
1. Help identify and predict if a participant is at risk for mobility problems and disability
2. Determine if the program is appropriate for the older exercising population
3. Motivate your participants to set personal goals
4. Select exercises that meet specific needs of older participants
5. Provide meaningful feedback to participants
6. Document the benefits of your physical activity program
Which assessments can be applied to the young adult population as well (3)?

A

3. Motivate your participants to set personal goals

(If they would have specified Older adult – it would no longer apply (technically) to younger adult clients)

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3
Q

When trying to identify fitness parameters associated with functional mobility, what could you consider your ‘toolbox’?

A

Functional Fitness Framework:

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4
Q

What does ‘Functional Fitness Framework’ refer to?

A
  • Identifies PHYSICAL FITNESS PARAMETERS associated with functional mobility
  • Relates FUNCTIONAL MOBILITY to ABILITY and ACTIVE DAILY LIVING
    EX. To Increase quadriceps (physical parameters), You can increase stair climbing (function) and in turn increase ADL’s (Activity / GOAL)
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5
Q

In the Functional Fitness Framework, what should be avoided under physical parameters, functions and the activity goals column (3)?

A
  1. Physical Impairment
  2. Functional limitation
  3. Physical disability / dependence
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6
Q

In the ‘Functional Fitness Framework’, how is Physical Impairment described?

A

Loss or abnormality at the tissue, organs or body system level

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7
Q

In the ‘Functional Fitness Framework’, how is Functional Limitation described?

A

RESTRICTION in physical behaviours, such as rising from chair, lifting or climbing stairs…

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8
Q

In the ‘Functional Fitness Framework’, how is Physical Disability described?

A

Restriction in ability to perform a task or an activity.

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9
Q

Is it safe, or appropriate to prescribe squats to an older adult within their exercise program?

A

YES

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10
Q

In the article “ Is quadriceps muscle strength a determinant of the physical function of the elderly?” by Altubasi, what was the correlation(s) of the isometric and isokinetic torques with the physical activity tests?

A

There was no significant correlations with any of the physical activity tests.

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11
Q

What was the purpose in the article “ Is quadriceps muscle strength a determinant of the physical function of the elderly?” by Altubasi?

A

To determine the relationships of the quadriceps RATE OF TORQUE development and the TIME TO PEAK TORQUE with the physical function of the elderly.

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12
Q

What were the correlation(s) found, if any, in the article “ Is quadriceps muscle strength a determinant of the physical function of the elderly?” by Altubasi,

A

The TIME TO PEAK TORQUE showed significant correlations with all measures of physical activity tests

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13
Q

In the article “ Is quadriceps muscle strength a determinant of the physical function of the elderly?” by Altubasi, when looking at the quadriceps strength vs. function in OA, what activity reached peak torque the fastest (4)?

A

The ones moving faster, can develop strength faster.
From fastest to slowest:

  1. Stair climbing
  2. Ramp up
  3. Timed up and go
  4. 4-m walking
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14
Q

What are some common obstacles when assessing older adults for physical activity (4)?

A
  1. Lack of time, space and budget
  2. Lack of trained personnel
    - Either administering test or interpreting test(s)
  3. Lack of assessment tools
  4. Absence of a requirement by facility management
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15
Q

Are most Physical Activity Centres for Older Adults good at conducting field-based assessments?

A

Yes, Initially, But NO for follow-up / program adjustments

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16
Q

What are two examples of Functional tests that can be performed in less than 2 minutes, and with little to no equipment?

A
  1. Functional arm test

2. Four square step test

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17
Q

What are the two major criteria for exercise test selection and evaluation of test instruments?

A
  1. Practicality

2. Psychometric properties

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18
Q

When considering exercise testing, what does practicality refer to?

A

The “usability” of the test

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19
Q

What factors will influence the “usability” of an exercise tests practicality (5)?

A
  1. Medical permission or supervision required and available (exercise stress test)
  2. Time needed to administer and score the test
  3. Personnel and expertise needed to administer test
  4. Level of fatigue to participant per test
  5. Is the test meaningful to your participants?

(results can tell them of their physical condition and is therefore meaningful / could aid motivation)

*1-3 refer to the testing centre usability, 4+5 refer to whether it’s useful to the participant

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20
Q

When considering exercise testing, what do psychometric properties refer to?

A

The DEGREE the test will meet SPECIFIC and ESTABLISHED test construction guidelines.

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21
Q

What are FOUR established exercise test construction guidelines?

A
  1. Reliability
  2. Validity
  3. Discrimination Power
  4. Performance Standards
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22
Q

What psychometric property refers to the degree that TWO test scores are SIMILAR when tested under identical conditions?

A

RELIABILITY

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23
Q

What should the test – re-test reliability be when discussing the test results taken by the same tester?

A

The test re-test reliability should be >0.80 or >80%

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24
Q

What types of exercise tests are appropriate, can the tester create their own criteria?

A

The tests used must originate form a published protocol

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25
Q

What does inter-rater reliability refer to in psychometric properties?

A

When scores obtained from MULTIPLE TESTERS are very similar / have a high correlation.

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26
Q

What psychometric property refers to the test having shown to measure what it is intended to measure and is the most important characteristic of any test?

A

VALIDITY

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27
Q

What is Criterion-related validity?

A

When developing a new test, Criterion-related validity refers to evaluating a test’s validity by comparing its scores with other scores already found to be valid.

(ex. 30 sec chair stand test vs. lab-based measure such as the 1-RM leg press or BIodex etc.)

28
Q

What are acceptable correlation values of VALIDITY between tests?

A

> 0.70 or >70%

29
Q

When discussing psychometric properties, what does content validity refer to (2)?

A
  1. Degree to which a test measures the domain of interest
  2. Determined by experts in the field (no stat tests needed)

Ex: The domain of interest of the Fullerton advanced balance scale is balance. I.e. Static and dynamic balance

30
Q

What psychometric property refers to the ability of a test to predict the future outcome of the test, with research data showing a strong statistical prediction to the future outcome?

A

PREDICTIVE VALIDITY

ex. does the test predict something useful? Like: ≤25 on Fullerton Balance Scale = high risk of falls.

31
Q

What psychometric property refers to the ability of the test to detect changes in performance over time?

A

DISCRIMINATION POWER

32
Q

When discussing the psychometric property of Discrimination Power, what TWO effects would prevent the detection in changes in performance over time and why?

A
  1. FLOOR EFFECT: The test is too difficult for specific subjects being tested
  2. CEILING EFFECT: Test is too easy for specific subjects being tested
33
Q

When using the Berg Balance Scale, what score (on most test items) would result in the floor effect or the ceiling effect and why?

A

The participants would experience the floor effect if they mostly scored 0’s because the Berg test is too difficult for them.

The participants would experience the ceiling effect if they mostly scored 4’s because the berg test is too easy for them.

34
Q

Which test items are considered VERY difficult for most hemiparetic participants and elderly with balance problems?

A

Items 12-14

  1. Placing alternate. Foot on step or stool while standing unsupported
  2. Standing unsupported one foot in front
  3. Standing on one leg.
35
Q

What type of data can have ceiling or floor effects?

A

ORDINAL data

36
Q

What tests would NOT experience a ceiling or floor effect?

A

SFT, Arm reach, continuous measure (time etc..) distance, force, reach measures…

37
Q

What are Norms, or Norm-referenced standards?

A

Evaluation by comparing others to the same sex and age.

38
Q

How can we provide feedback to participants after doing the exercise tests?

A

Interpretation of the scores using:

  • Norm-referenced standards
  • Criterion- referenced standards.
39
Q

What are Criterion -referenced standards?

A

Evaluated performance in relation to a particular reference point or specific goal such as:

Fitness level to climb stairs or to remain functionally independent

40
Q

What is the minimal VO2 in men and women. To remain function and independent at age 85?

A

15 – 18 ml/kg/ min

41
Q

What are TWO recommended field-based Assessment tools designed to measure physical impairments and functional limitations in OA?

A
  1. The Senior Fit Test (SFT)

2. Fullerton Advanced Balance (FAB) Scale

42
Q

What are the Five Good reasons to use the Senior Fit Test?

A
  1. Meets PSYCHOMETRIC properties (reliable, valid, discriminative)
  2. PRACTICAL & CONVENIENT (equipment, training space, time)
  3. NORM-REFERENCED standards for INTERPRETABILITY of results (ex: 5-year age group norms for independent living men and women, aged 60 to 94)
  4. SAFE for OAs- usually no need for medical release (sub-max effort)
  5. Evaluates a wide range of PHYSICAL ABILITIES and FUNCTIONS (strength, cardio-respiratory, flexibility, agility & balance)
43
Q

Can you experience the ceiling or floor effect in the SFT?

A

NO

44
Q

What are the 7 components of the Senior Fit Test?

A
  1. 30- sec Chair stand
  2. 30 sec arm curl
  3. 6-minute walk
  4. 2- minute Step test
  5. Chair sit and reach test
  6. Back scratch
  7. 8 foot up and go
45
Q

How many 6- minute walk tests need to be performed before obtaining a stable measurement? Why?

A

2 tests will make a stable measure because of learning curve.

46
Q

The Fullerton Advanced Balance (FAB) Scale is a series of ________ functional tests which assess both ____________ and. ____________ balance under varied ______________ conditions.

A

The Fullerton Advanced Balance (FAB) Scale is a series of TEN functional tests which assess both STATIC and. DYNAMIC balance under varied SENSORY conditions.

47
Q

What type scale (how many points) does the FAB scale use to measure the outcome of the test, and what is the maximum points?

A

The Fullerton Advanced Balance Scale is a 4-point scale . maximum 40 points.

48
Q

Can the FAB scale have a ceiling or floor effect?

A

YES

49
Q

The Fullerton Advanced Balance scale is known to have high (4):

A
  1. Predictive validity
  2. Content validity
  3. Intra- and inter-rater reliability
  4. Test-re-test reliability
50
Q

What was the objective stated in the paper “Predicting which older adults will or will not fall using the Fullerton Advanced Balance scale” by Hernandez D, and Rose DJ, 2008?

A

The purpose was to determine if the FAB scale can predict “faller status” in a group of independently functioning older adults

51
Q

in the paper “Predicting which older adults will or will not fall using the Fullerton Advanced Balance scale” by Hernandez D, and Rose DJ, 2008, what is a “faller”?

A

A faller is classified as an older adult with a history of TWO OR MORE falls in the previous 12 months.

52
Q

How many Older adults were included in the study?

A

N=192 mean age 77 SD+/- 6.5 years

53
Q

What were the main outcome measures stated in the paper “Predicting which older adults will or will not fall using the Fullerton Advanced Balance scale” by Hernandez D, and Rose DJ, 2008?

A

FAB scale, a retrospective history of falls.

54
Q

in the paper “Predicting which older adults will or will not fall using the Fullerton Advanced Balance scale” by Hernandez D, and Rose DJ, 2008, what are the results?

A

Regression analysis indicated that the total FAB scale score could be used to predict faller status. the probability of falling increased by 8% with each 1-point decrease in total FAB scale score. Cut-off score 25/40 produced highest sensitivity in predicting faller status

55
Q

What were the conclusions in the paper “Predicting which older adults will or will not fall using the Fullerton Advanced Balance scale” by Hernandez D, and Rose DJ, 2008?

A

The FAB scale is a predictive measure of faller status when used with independently functioning older adults. 7/10 cases that older adult who scores 25 or lower on the FAB scale is at high risk for falls and in need of immediate intervention

56
Q

Who is the Fullerton Advanced Balance (FAB) scale for?

A

Excellent test for OA with NO MAJOR BALANCE ISSUES

57
Q

For the OA with balance issues, or chronic disease and disability like stroke, frailty and Parkinson’s, what balance test would be recommended?

A

The Berg Balance scale

58
Q

When using the Fullerton Advanced Balance (FAB) scale, how many items is the long form, and how many items are used in the short form? What are the corresponding cut-off scores?

A

Long form: 10 items –> ≤25/ 40 = HIGH RISK

Short form: 4 items: items, 4, 5 , 6 and 7 –> ≤9/16= HIGH RISK

59
Q

On assessment day, what forms must be completed before the tests by the client (3)?

A
  1. A health and PA questionnaire
  2. Informed consent form
  3. Medical clearance, if required
60
Q

On assessment day, participants must be advised (3):

A
  1. To avoid heavy exertion and alcohol used for 24 hours before testing
  2. To eat a light meal one hour before testing
  3. To wear appropriate clothing for exercise
61
Q

Are OA stressed out before there assessments?

A

YES. They want to do well.

62
Q

When interpreting the test results for the Senior Fit Test, are there different norms depending on the gender?

A

Yes!

63
Q

When interpreting the test results for the SFT, what are the performance norms based on?

A

Over 7000 community dwelling OA between 60 and 94 years of age.

64
Q

How is “normal” defined when interpreting the results for the SFT?

A

‘Normal’ is defined as the middle 50% of the population.

65
Q

When interpreting the test results for the SFT, what are the Criterion standards based on?

A

Scores compared to a threshold score:

  • Can be used to identify participants at risk for mobility problems, falls or disability
  • Ex: 8-foot up-and-go.

EXCI 455 (13 decks)

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