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      Comparative analysis of functional mobility among Hungarian community-living and institutionalized elderly individuals

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          Abstract

          Purpose

          Reduced functional mobility is a risk factor for falls. The Timed Up and Go test is a complex measurement tool for functional mobility. Our aims were to assess the functional mobility of: (a) community-living elderly who were participating in an exercise programme ( n = 40; mean age = 73.7 years), (b) community-living elderly who were physically inactive ( n = 40; mean age = 74.1 years), and (c) institutionalized elderly ( n = 40; mean age = 73.5 years) and to compare the results with cut-off values for risk of fall.

          Materials and methods

          After measuring functional mobility, one-way independent ANOVAs and sample t-tests were used for analysis.

          Results

          The functional mobility of the active participants was better than that of the inactive ( p < .001) and institutionalized participants ( p < .001). There was no significant difference between the inactive and institutionalized participants ( p = .990). The functional mobility of the active participants was better, whereas the functional mobility of the inactive participants was worse than the cut-off value of 13.5 s for risk of fall for community-living elderly. The functional mobility of the institutionalized participants did not differ from the 15-s reference value for predicting risk of fall.

          Conclusion

          The results indicate that regular physical activity has a positive effect on maintaining functional mobility among both community-living and institutionalized elderly individuals.

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          Most cited references18

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          Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test.

          Anne Shumway-Cook, Sandy Brauer, Marjorie Woollacott (2000)
          This study examined the sensitivity and specificity of the Timed Up & Go Test (TUG) under single-task versus dual-task conditions for identifying elderly individuals who are prone to falling. Fifteen older adults with no history of falls (mean age=78 years, SD=6, range=65-85) and 15 older adults with a history of 2 or more falls in the previous 6 months (mean age=86.2 years, SD=6, range=76-95) participated. Time taken to complete the TUG under 3 conditions (TUG, TUG with a subtraction task [TUGcognitive], and TUG while carrying a full cup of water [TUGmanual]) was measured. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. The TUG was found to be a sensitive (sensitivity=87%) and specific (specificity=87%) measure for identifying elderly individuals who are prone to falls. For both groups of older adults, simultaneous performance of an additional task increased the time taken to complete the TUG, with the greatest effect in the older adults with a history of falls. The TUG scores with or without an additional task (cognitive or manual) were equivalent with respect to identifying fallers and nonfallers. The results suggest that the TUG is a sensitive and specific measure for identifying community-dwelling adults who are at risk for falls. The ability to predict falls is not enhanced by adding a secondary task when performing the TUG.
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            Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review.

            David Oliver, Fergus Daly, Finbarr C Martin … (2004)
            To identify all published papers on risk factors and risk assessment tools for falls in hospital inpatients. To identify clinical risk assessment tools or individual clinical risk factors predictive of falls, with the ultimate aim of informing the design of effective fall prevention strategies. Systematic literature review (Cochrane methodology). Independent assessment of quality against agreed criteria. Calculation of odds ratios and 95% confidence intervals for risk factors and of sensitivity, specificity, negative and positive predictive value for risk assessment tools (with odds ratios and confidence intervals), where published data sufficient. 28 papers on risk factors were identified, with 15 excluded from further analysis. Despite the identification of 47 papers purporting to describe falls risk assessment tools, only six papers were identified where risk assessment tools had been subjected to prospective validation, and only two where validation had been performed in two or more patient cohorts. A small number of significant falls risk factors emerged consistently, despite the heterogeneity of settings namely gait instability, agitated confusion, urinary incontinence/frequency, falls history and prescription of 'culprit' drugs (especially sedative/hypnotics). Simple risk assessment tools constructed of similar variables have been shown to predict falls with sensitivity and specificity in excess of 70%, although validation in a variety of settings and in routine clinical use is lacking. Effective falls interventions in this population may require the use of better-validated risk assessment tools, or alternatively, attention to common reversible falls risk factors in all patients.
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              Falls and their prevention in elderly people: what does the evidence show?

              Laurence Rubenstein, Karen R Josephson (2006)
              A large proportion of falls and fall injuries in older people is due to multiple risk factors, many of which probably can be modified or eliminated with targeted fall prevention interventions. These interventions must be feasible, sustainable, and cost effective to be practical for widespread use. The most promising prevention strategies involve multidimensional fall risk assessment and exercise interventions. Incorporating these intervention strategies whenever feasible into a fall prevention program seems to be the most effective means for fall prevention in older adults.
              Article 0 comments Cited 105 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (pmc): dhs
                Journal ID (publisher-id): 2066
                Title: Developments in Health Sciences
                Abbreviated Title: DHS
                Publisher: Akadémiai Kiadó (Budapest )
                ISSN (Electronic): 2630-936X
                ISSN (Print): 2630-9378
                Publication date (Electronic, epub): 11 September 2019
                Publication date (Print, ppub): September 2019
                Volume: 2
                Issue: 2
                Pages: 46-50
                Affiliations
                [ 1 ]Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University , Budapest, Hungary
                [ 2 ]Department of Physiotherapy, Faculty of Health Sciences, Semmelweis University , Budapest, Hungary
                [ 3 ] Old Age Home of the Municipality of Budapest , Budapest, Hungary
                [ 4 ]Department of Nursing, Faculty of Health Sciences, Semmelweis University , Budapest, Hungary
                Author notes
                [* ]Corresponding author: Dr. Éva Kovács; Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Vas Str. 17, Budapest H-1088, Hungary; E-mail: kovacse@ 123456se-etk.hu
                Article
                DOI: 10.1556/2066.2.2019.007
                SO-VID: f54a7d66-f326-4d86-a494-3b278e9a2a65
                Copyright © © 2019 The Author(s)
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated. (SID_1)

                History
                Date received : 24 April 2019
                Date revision received : 20 June 2019
                Date accepted : 14 July 2019
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 29, Pages: 5
                Categories
                Subject: ORIGINAL ARTICLE

                ScienceOpen disciplines: Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                Keywords: older adults,physical activity,functional mobility
                Data availability:
                ScienceOpen disciplines: Medicine, Immunology, Health & Social care, Microbiology & Virology, Infectious disease & Microbiology
                Keywords: older adults, physical activity, functional mobility

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