Do functional mobility tests predict the risk of falls in community-dwelling elderly?
Moreira, Ana Carolina Silva de Souza; Mazo, Giovana Zarpellon; Hauser, Eduardo; Paiva, Paula Bertolini de; Menezes, Enaiane; Cardoso, Fernando Luiz
ntroduction: The falls are associated with morbidity and mortality in the elderly. Numerous of functional mobility clinical tests have been created to identify older adults with potential for risk of falls. Objective: The purpose of this systematic review was to determine the predictive validity of functional mobility tests to predict the risk of falls in community-dwelling elderly. Method: Articles in English were searching in MEDLINE, SCOPUS and CINAHL. We found 18,520 documents and, after applying the inclusion and exclusion criteria, 11 articles were part of the final analysis. All articles analyzed included subjects over 60 years old. Results: The results showed that the TUG Test has good discriminative validity for elderly non-institutionalized, but it does not provide an adequate predictive validity. The TUG Test may not be enough as a unique basic screening tool to detect the risk of elderlies´ falling. Conclusion: It is suggested that the TUG Test should be used in combination with other predictors of falling risk tools or should it be reconfigured for the different levels of elderly physical active functionality.
1. Silvestre JA, Costa Neto MM. Abordagem do idoso em programas de saúde da família. Cad Saúde Pública. 2003;19(3):839-47.
2. Perracini MR, Ramos LR. Fatores associados a quedas em uma coorte de idosos residentes na comunidade. Rev Saúde Pública. 2002; 36(6): 709-16.
3. Datasus. Banco de dados do Sistema Único de Saúde. 2010
4. Aschkenasy MT, Rothenhaus TC. Trauma and falls in the elderly. Emerg Med Clin North Am, 2006; 24: 413-32.
5. Englander F. Economic dimensions of slip and fall injuries. J Forensic Sci. 1996; 41(5): 733-46.
6. Zuckerman D. Hype in health reporting: “checkbook science” buys distortion of medical news. Int. J. Health Serv. 2003; 33(2): 383-89.
7. Georg AE, Duncan BB, Toscano CM, Schmidt MI, Mengue S, Duarte C, Polanczyk CA. Análise econômica de programa para rastreamento do diabetes mellitus no Brasil. R. Saúde Públ. 2005; 39(3): 452-60.
8. Pasquali L. Instrumentação psicológica: Fundamentos e práticas. Porto Alegre, Brasil: Artmed, 2010.
9. Pasquali L. Psicometria. Rev. Esc. Enferm. 2009; 43: 992-99.
10. Newton R. Balance screening of an inner city older adult population. Arch Phys Med Rehabil. 1997; 78: 587-91.
11. Muir SW; Berg K; Chesworth B; SPEECHLEY M. Use of the Berg Balance Scale for predicting multiple falls in community-dwelling elderly people: a prospective study. Phys Ther. 2008; 88(4): 449-59.
12. Santos GM, Souza ACS, Virtuoso JF, Tavares GMS, Mazo GZ. Valores preditivos para o risco de quedas em idosos praticantes e não praticantes de atividade física por meio do uso da Escala de Equilíbrio de Berg. Braz J Phys Ther. 2011, 15(2): 95-101.
13. Alzayer L, Beninato M, Portney LG. The accuracy of individual Berg Balance Scale items compared with the total Berg score for classifying people with chronic stroke according to fall history. J Neurol Phys Ther. 2009, 33(3): 136-43.
14. Morris R, Harwood RH, Baker R, Sahota O. Armstrong S Masud T. A comparison of different balance tests in the prediction of falls in older women with vertebral fractures: a cohort study. Age Ageing. 2007, 36(1): 78-83.
15. Thrane G, Joakimsen RM, Thornquist E. The association between timed up and go test and history of falls: the Tromsø study. BMC Geriatr 2007, 12(7): 1.
16. Chiu AY, Au-Yeung SS, Lo SK. A comparison of four functional tests in discriminating fallers from non-fallers in older people. Disabil Rehabil. 2003, 25(1): 45-50.
17. Pardasaney PK, Latham NK, Jette AM, Wagenaar RC, Ni P, Slavin MD, Bean JF. Sensitivity to change and responsiveness of four balance measures for community-dwelling older adults. Phys Ther. 2012, 92(3): 388-97.
18. Farrell MK, Rutt RA, Lusardi MM, Williams AK. Are scores on the physical performance test useful in determination of risk of future falls in individuals with dementia? J Geriatr Phys Ther. 2011, 34(2): p57-63.
19. Oliveira MRF, Gomes AC, Toscano C M. QUADAS e STARD: Avaliação da qualidade de estudos de acurácia de testes diagnósticos Rev Saude Publica, 2011, 45(2): 416-22.
20. Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults Arch Phys Med Rehabil. 2002, 83(11): 1566-71.
21. Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults Arch Phys Med Rehabil. 2006, 87(11): 1478-85.
22. Wrisley DM, Kumar NA. Functional gait assessment: concurrent, discriminative, and predictive validity in community-dwelling older adults. Phys Ther. 2010, 90(5): 761-73.
23. Trueblood PR, Hodson-Chennault N, McCubbin A, Youngclarke D. Performance and impairment-based assessments among community dwelling elderly: sensitivity and specificity. Aging (Albany NY) 2001, 24(1):2–6
24. Greene BR, O’Donovan A, Romero-Ortuno R. Quantitative falls risk assessment using the timed up and go test. Biomed Tech (Berl) 2010, 57(12): 2918-26.
25. Tsutsumimoto K, Doi T, Misu S, Ono R, Hirata S. Can the Ordered MultiStepping Over Hoop test be useful for predicting fallers among older people? A preliminary 1 year cohort study Aging Clin Exp Res. 2013, 25(4): 427-32.
26. Stel VS, Smit JH, Plujim SMF. Balance and mobility performance as treatable risk factors for recurrent falling in older persons. J Clin Epidemiol. 2003, 56(7): 659-68.
27. Greene BR, Doheny EP, Walsh C. Evaluation of falls risk in communitydwelling older adults using body-worn sensors. Gerontology 2012, 58(5): 472-80.
28. Shumway-Cook A, Brauer S, et al. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000, 80(9): 896-903.
29. Murphy SL, Dubin JA, Gill TM. The development of fear of falling among community-living older women: predisposing factors and subsequent fall events. J Gerontol A Biol Sci Med Sci. 2003, 58(10): M943-M947.
30. Matsushima M, Yabe I, Uwatoko H, Shirai S, Hirotani M, Sasaki H. Reliability of the Japanese version of the Berg balance scale. Intern Med. 2014, 53(15): 1621-4.
31. Salavati M, Negahban H, Mazaheri M, Soleimanifar M, Hadadi M, Sefiddashti L, Zahraee MH, Davatgaran K, Feizi A. The Persian version of the Berg Balance Scale: inter and intra-rater reliability and construct validity in elderly adults Disabil Rehabil. 2012, 34(20): 1695-98.
32. De Figueiredo KM, De Lima KC, Cavalcanti MAC, Guerra RO. Interobserver reproducibility of the Berg Balance Scale by novice and experienced physiotherapists Physiother Theory Pract. 2009, 25(1):30-6
33. Sahin F, Yilmaz F, Ozmaden A, Kotevolu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale J Geriatr Phys Ther. 2008, 31(1): 32-37.
34. Wang CY, Hsieh CL, Olson SL, Wang CH, Sheu CF, Liang CC. Psychometric properties of the Berg Balance Scale in a community-dwelling elderly resident population in Taiwan. J Formos Med Assoc. 2006, 105(12): 992-1000.
35. Miyamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale Braz J Med Biol Res. 2004, 37(9): 1411-21.
36. Muir SW, Berg K, Chesworth B. Balance impairment as a risk factor forfalls in community-dwelling older adults Who are high functionin: a prospective study Phys Ther. 2010, 90(3): 338-47.
37. Holbein-Jenny MA, Billek-Sawhney B, Beckman E, Smith T. Balance in personal care home residents: a comparison of the Berg Balance Scale, the Multi-Directional Reach Test, and the Activities-Specific Balance Confidence Scale J Geriatr Phys Ther. 2005, 28(2): 48-53.
38. Riddle DL, Stratford PW. Interpreting validity indexes for diagnostic tests: an illustration using the Berg balance test. Phys Ther. 1999, 79(10); 939-48.
39. Souza ACS, Santos GM. Sensibilidade da Escala de Equilíbrio de Berg em indivíduos com osteoartrite Motriz: Rev Educ Fis. 2012, 18(2): 307-18.
40. Reider NC, Naylor PJ, Gaul C Sensitivity and specificity of the minimal chair height standing ability test: a simple and affordable fall-risk screening instrument. J Geriatr Phys Ther. 2015, 38(2):90-5.
41. Hirase T, Inokuchi S, Matsusaka N, Nakahara K, Okita M. A modified fall risk assessment tool that is specific to physical function predicts falls in community-dwelling elderly people. J Geriatr Phys Ther. 2014, 37(4): 159-65.
42. Buatois S, Perret GC, Gueguen R, Miget P, Vançon G, Perrin P, Benetos A. A simple clinical scale to stratify risk of recurrent falls in communitydwelling adults aged 65 years and older. Phys Ther. 2010, 90(4); 550-60.
43. Tiedemann A, Shimada H, Sherrington C, Murray S, Lord S. The comparative ability of eight functional mobility tests for predicting falls in community -dwelling older people Age Ageing. 2008, 37(4): 430-35.
44. Buatois S, Miljkovic D, Manckoundia P, Gueguen R, Miget P, Vançon G, Perrin P, Benetos A. Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. J Am Geriatr Soc. 2008, 56(8):1575-77.
45. Schaubert KL, Bohannon RW. Reliability and validity of three strength measures obtained from community-dwelling elderly persons J Strength Cond Res. 2005, 19(3): 717-20.
46. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994, 49(2): M85-94.
47. Ward RE, Leveille SG, Beauchamp MK, Travison T, Alexander N, Jette AM, Bean JF. Functional performance as a predictor of injurious falls in older adults. J Am Geriatr Soc. 2015, 63(2): 315-20.
48. Cheng YY, Wei SH, Chen PY, Tsai MW, Cheng IC, Liu DH, Kao CL. Can sitto-stand lower limb muscle power predict fall status? Gait Posture 2014, 40(3): 403-7.
49. Zhang M, Kim JC, Li Y, Shapiro BB, Porszasz J, Bross R, Feroze U, Upreti R, Martin D, Kalantar-Zadeh K, Kopple JD. Relation between anxiety, depression, and physical activity and performance in maintenance hemodialysis patients J Ren Nutr. 2014, 24(4): 252-60.
50. Nakazono T, Kamide N, Ando M. The Reference Values for the Chair Stand Test in Healthy Japanese Older People: Determination by Meta-analysis. J Phys Ther Sci. 2014, 26(11):1729-31.
51. Noronha APP, Alchieri JC. Reflexões sobre os instrumentos de avaliação psicológica Em R Primi (Org) Temas em avaliação psicológica. Campinas: Impressão Digital do Brasil 2002.
52. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010, 21(5): 658-68.