RELIABILITY, VALIDITY, AND MINIMAL DETECTABLE CHANGE IN FOUR STEP STAIR CLIMB POWER TEST IN COMMUNITY-DWELLING OLDER ADULTS

Review written by Dr Mariana Wingood info

BACKGROUND & OBJECTIVE

For an older adult lower extremity muscle power is an important component of fall prevention and functional mobility. However, many clinicians do not incorporate it into their assessment/interventions strategies. This could be due to limited clinical feasibility of current assessment tools, which is why this study aimed at determining the reliability, validity, and minimal detectable change of a clinically feasible tool – the 4 stair climb power test (4SCPT). The tool requires a scale, stopwatch, and 4 stairs (similar to figure 1) compared to the reliable and valid stair climb power test (SCPT) which requires a full flight of stairs.

Image Figure 1: 4-step training staircase

METHODS

The researchers included older adults (age > 65 years and older) with self-reported mobility difficulties, defined as difficulty with walking ½ mile and/or climbing a flight of stairs. Additionally participants had to be able to score > 4 on the Short Physical Performance Battery (SPPB), finish a 400 meter walk test within 15 min, and have a Mini-Mental Status Exam (MMSE) score of <18. These specific inclusion and exclusion criteria raise a caution flag when it comes to generalizability of results, however, it does examine the type of patient population most encountered in an out-patient clinic.

The research recorded a baseline MMSE, comprehensive history, SPPB, and 6 min walk. Followed by a second day of testing (average of 10.9 days apart), including the SCPT, 4SCPT, and single leg power (SLP) test at 2 intensities – 40% and 70% 1 rep max. The SCPT and 4 SCPT was performed 2 times each with the mean being used for analysis. To limit muscle fatigue rest periods were offered between every test, however, rest time was not specified.

RESULTS

The participants had an average of 8.6 SPPB score (classifying them as a moderate risk for adverse health outcome) and habitual gait speed of 0.86 m/sec (classifying them at increased risk for falls and frailty) with 76% using the railing

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