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Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease

Published online by Cambridge University Press:  14 April 2011

Plaiwan Suttanon ,
Keith D. Hill ,
Karen J. Dodd  and
Catherine M. Said
Plaiwan Suttanon*
Affiliation:
School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia Preventive and Public Health Division, National Ageing Research Institute, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Keith D. Hill
Affiliation:
Preventive and Public Health Division, National Ageing Research Institute, The Royal Melbourne Hospital, Parkville, Victoria, Australia Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia Allied Health Division, Northern Health, Bundoora, Victoria, Australia
Karen J. Dodd
Affiliation:
School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia
Catherine M. Said
Affiliation:
Physiotherapy, School of Health Science, The University of Melbourne, Parkville, Victoria, Australia Physiotherapy Department, Heidelberg Repatriation Hospital, Heidelberg West, VictoriaAustralia
*
Correspondence should be addressed to: Plaiwan Suttanon, PO Box 2127, Royal Melbourne Hospital (Royal Park Campus), VIC 3050, Australia. Phone: +61 3 8387 2383, Fax: +61 3 8387 2153. Email: p.suttanon@nari.unimelb.edu.au; psuttanon@students.latrobe.edu.au.
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Abstract

Background: To interpret changes of balance and mobility in people with Alzheimer's disease (AD), we require measures of balance and mobility that have demonstrated reliability in this population. The aim of the study was to determine the safety, feasibility and retest reliability of clinical and forceplate balance and mobility measurements in people with AD.

Methods: Relative and absolute reliabilities were examined in 14 older people with mild to moderate AD. Relative reliability was calculated using the intraclass correlation coefficient, two-way mixed model (ICC3,1). Absolute reliability was calculated using the standard error of measurement (SEM), the minimum detectable change (MDC) and the coefficient of variation (CV).

Results: All measurements were clinically feasible and could be safely administered. ICC values were excellent and CVs were less than 11% in all clinical balance and mobility measures except the Timed Up & Go test with cognitive or manual task (ICC3,1 = 0.5 and 0.7, and CV = 14% and 10%, respectively). Most balance and mobility measures tested on the Neurocom™ forceplate (modified Clinical Test of Sensory Interaction on Balance, Walk Across (step width, step length parameters), and Sit to Stand (rising index parameter)) had excellent relative reliability (ICC3,1 ranging from 0.75 to 0.91). ICC values were fair to good for the other measures.

Conclusions: Retest reliability of the balance and mobility measures used in this study ranged between fair to good, and good to excellent. Clinicians should consider retest reliability when deciding which balance and mobility measures are used to assess people with AD.

Keywords

postural controlmobilityassessmentreliabilityAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 7 , September 2011 , pp. 1152 - 1159
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Atkinson, G. and Nevill, A. M. (1998). Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Medicine, 26, 217–238.CrossRefGoogle ScholarPubMed
Bruton, A., Conway, J. H. and Holgate, S. T. (2000). Reliability: what is it, and how is it measured? Physiotherapy, 86, 94–99.CrossRefGoogle Scholar
Chong, R. K. Y., Horak, F. B., Frank, J. and Kaye, J. (1999). Sensory organization for balance: specific deficits in Alzheimer's but not in Parkinson's disease. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 54, M122–M128.CrossRefGoogle Scholar
Dubois, B., Slachevsky, A., Litvan, I., and Pillon, B. (2000). The FAB: a frontal assessment battery at bedside. Neurology, 55, 1621–1626.CrossRefGoogle ScholarPubMed
Duncan, P. W., Weiner, D. K., Chandler, J. and Studenski, S. (1990). Functional reach: a new clinical measure of balance. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 45, M192–M197.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Hill, K. D., Bernhardt, J., McGann, A. M., Maltese, D. and Berkovits, D. (1996). A new test of dynamic standing balance for stroke patients: reliability, validity, and comparison with healthy elderly. Physiotherapy Canada, 48, 257–262.CrossRefGoogle Scholar
Hopkins, W. G. (2000). Measures of reliability in sports medicine and science. Sports Medicine, 30, 1–15.CrossRefGoogle ScholarPubMed
Huxham, F. E., Goldie, P. A. and Patla, A. E. (2001). Theoretical considerations in balance assessment. Australian Journal of Physiotherapy, 47, 89–100.CrossRefGoogle ScholarPubMed
Leandri, M., Cammisuli, S., Cammarata, S., Baratto, L., Campbell, M. S. and Tabaton, M. (2009). Balance features in Alzheimer's disease and amnestic mild cognitive impairment. Journal of Alzheimer's Disease, 16, 113–120.CrossRefGoogle ScholarPubMed
Lorbach, E. R., Webster, K. E., Menz, H. B., Wittwer, J. E. and Merory, J. R. (2007). Physiological falls risk assessment in older people with Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 24, 260–265.CrossRefGoogle ScholarPubMed
Manckoundia, P., Pfitzenmeyer, P., d'Athis, P., Dubost, V. and Mourey, F. (2006). Impact of cognitive task on the posture of elderly subjects with Alzheimer's disease compared to healthy elderly subjects. Movement Disorders, 21, 236–241.CrossRefGoogle ScholarPubMed
Menant, J. C., Steele, J. R., Menz, H. B., Munro, B. J. and Lord, S. R. (2008). Optimizing footwear for older people at risk of falls. Journal of Rehabilitation Research and Development, 45, 1167–1182.CrossRefGoogle ScholarPubMed
Mitnitski, A. B., Graham, J. E., Mogilner, A. J. and Rockwood, K. (1999). The rate of decline in function in Alzheimer's disease and other dementias. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 54, M65–M69.CrossRefGoogle ScholarPubMed
NeuroCom™ International Inc. (2003). Instructions for Use: Balance Master System Operator's Manual, Version 8.1. Clackamas, OR: NeuroCom International.Google Scholar
Phillips, C. D., Chu, C. W., Morris, J. N. and Hawes, C. (1993). Effects of cognitive impairment on the reliability of geriatric assessments in nursing homes. Journal of the American Geriatrics Society, 41, 136–142.CrossRefGoogle ScholarPubMed
Podsiadlo, D. and Richardson, S. (1991). The Timed Up& Go: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142–148.CrossRefGoogle Scholar
Rolland, Y. et al. (2009). An abnormal “one-leg balance” test predicts cognitive decline during Alzheimer's disease. Journal of Alzheimer's Disease, 16, 525–531.CrossRefGoogle ScholarPubMed
Shrout, P. E. and Fleiss, J. L. (1979). Intraclass correlations: uses in assessing reliability. Psychological Bulletin, 86, 420–428.CrossRefGoogle Scholar
Shumway-Cook, A., Brauer, S. and Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy, 80, 896–903.CrossRefGoogle ScholarPubMed
Standford, P. W. (2004). Getting more from the literature: estimating the standard error of measurement from reliability studies. Physiotherapy Canada, 56, 27–30.Google Scholar
Stratford, P. (1989). Reliability: consistency or differentiating among subjects? Physical Therapy, 69, 299–300.CrossRefGoogle ScholarPubMed
Stratford, P. W. and Goldsmith, C. H. (1997). Use of the standard error as a reliability index of interest: an applied example using elbow flexor strength data. Physical Therapy, 77, 745–750.CrossRefGoogle ScholarPubMed
Tappen, R. M., Roach, K. E., Buchner, D., Barry, C. and Edelstein, J. (1997). Reliability of physical performance measures in nursing home residents with Alzheimer's disease. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 52A, M52–M55.CrossRefGoogle Scholar
Thomas, V. S. and Hageman, P. A. (2002). A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia. International Psychogeriatrics, 14, 17–23.CrossRefGoogle Scholar
van Iersel, M., Benraad, C. E. M. and Rikkert, M. G. M. O. (2007). Validity and reliability of quantitative gait analysis in geriatric patients with and without dementia. Journal of the American Geriatrics Society, 55, 632–634.CrossRefGoogle ScholarPubMed
Walter, S. D., Eliasziw, M. and Donner, A. (1998). Sample size and optimal designs for reliability studies. Statistics in Medicine, 17, 101–110.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Whitney, S. L., Wrisley, D. M., Marchetti, G. F., Gee, M. A., Redfern, M. S. and Furman, J. M. (2005). Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the five-times-sit-to-stand test. Physical Therapy, 85, 1034.CrossRefGoogle ScholarPubMed
Wittwer, J. E., Webster, K. E., Andrews, P. T. and Menz, H. B. (2008). Test-retest reliability of spatial and temporal gait parameters of people with Alzheimer's disease. Gait and Posture, 28, 392–396.CrossRefGoogle ScholarPubMed