Research On The Measurement And Application Of The Dynamic Balance Ability In Older Adults In Community Based On 8-Foot Up-and-Go Test

Purposes: Decreased balance ability is an important modifiable fall-related risk factor.It has been proved that targeted interventions based on the scientific measurement of balance ability can effectively improve the balance ability of older adults and prevent falling.The 8-Foot Up-and-Go test(8UG)is a measurement of dynamic balance ability and agility in older adults,which included in Senior Fitness Test(SFT)system.The 8UG test together with other measurements in SFT system are widely applied to measure and evaluate the physical functions in older adults abroad.In China,although scholars have introduced the SFT system,including the 8UG test into China and carried out research,the reliability and validity,and application value of 8UG test in older adults in community of China remains to be verified.This research examined the reliability and validity of the 8UG test in older adults in community in China,and then explored its application value to predict risk of falling in older adults in community.This research provides theoretical support for scientific measurement of dynamic balance in older adults in China by using the 8UG test.In addition,this research also provides a theoretical basis for the promotion and application of the 8UG test as a fall risk assessment tool for older adults in community in China.Methods: This study recruited 424 eligible 60~79-year-old older adults in community in Shanghai.Demographic information,history of falling were collected,and height,weight,the 8UG test and other fall-related physical function tests were measured.Substudy sample recruitment and measurement were conducted as well.The whole research is divided into three parts.(1)In the first part,the reliability of the 8UG test as a measurement of dynamic balance ability in older adults in community in Shanghai is examined.For consistent reliability,48 older adults were recruited to complete the 8UG test three times in the same day,with an interval of 1 minute among each test.For the stability reliability,44 older adults completed the first 8UG test and the retest after two days.(2)In the second part,the validity of the 8UG test as a measurement of dynamic balance ability in older adults in community in Shanghai is examined.Firstly,99 older adults were recruited to examine the criterion validity between the 8UG test and the Timed Up and Go test(TUG),which is a commonly used measurement of dynamic balance ability in China.Secondly,424 older adults were recruited.They were divided into different groups according to gender(male and female),age(60~64 years old,65-69 years old,70~74 years old,and 75~79 years old),and Body Mass Index(BMI)(normal,overweight,and obesity).And the discriminant validity of the 8UG test was analyzed by these groups respectively.(3)In the third part,the application value of the 8UG test as a measurement of dynamic balance ability to assess risk of falling in older adults in community is explored.The sample of this part is as same as that in the discriminative validity part.Based on the measurement results of the 8UG test,history of falling,and other fall-related physical function test,the correlation between the 8UG test and falls was analyzed.Besides,the accuracy and predictive cut-off value of the 8UG test used to assess risk of falling was analyzed.Results:(1)In study 1,the results of consistent reliability analysis found that,regardless of males and females,the measurement results of three retests on the same day of the 8UG test were not statistically significant,the intraclass correlation coefficient(ICC)of the first test and the second test,the second test and the third test,and the first test and third test results on the same day was 0.966,0.975 and 0.979,respectively.The stability reliability analysis found that there was no significant statistical difference between the results of the first test of the 8UG test and the retest two days later,and the ICC was 0.846.(2)In study 2,the results of the criterion validity analysis showed that the 8UG test and the TUG test had a high correlation(r=0.777,P<0.05),and the correlation coefficient between the 8UG test and the TUG test in each age group was between 0.643 and 0.836,and the correlation coefficient of the 8UG test and the TUG test in males and females were 0.792 and 0.749 respectively.The results of the discriminative validity study showed that the time of males to complete the 8UG test(5.08±0.77 seconds)was significantly faster than that of females(5.36±0.81 seconds,P<0.05).As age grows,the time for males and females to complete the 8UG test would be prolonged.Compared the results with older population,the time of completing the 8UG test in younger older adults was shorter,and there was a significant statistical difference.Compared with the time of completing the 8UG test in older adults in normal weight group(5.12±0.71 seconds)and overweight group(5.20±0.80 seconds,P=0.003),those older adults in obese group(5.49±0.93 seconds,P=0.023)had a significant statistical difference.(3)In study 3,the time of completing the 8UG test in older adults in the fall group(6.32±1.02 seconds)and the non-fall group(5.08±0.64 seconds)had significant differences(P<0.05).There was a correlation between fall-related physical function tests,such as the 8UG test and the TUG test,4-meter gait speed test,reaction time test,30-s Chair-Stand test and the times of falling(r=-0.309~0.888).The Area Under the ROC Curve(AUC)of the 8UG test to assess risk of falling was 0.890,the males and females were 0.917 and 0.863 respectively.The best cut-off values to predict risk of falling risk in males and females were 5.38 seconds and 5.52 seconds.Conclusions:(1)The 8UG test is a reliable measurement to assess the dynamic balance ability in older adults in community,with good consistent reliability and stable reliability;(2)The 8UG test is an effective measurement to assess the dynamic balance ability in older adults in community,and it is highly correlated with the TUG test.It has a good discrimination effectiveness in people of different genders,ages and BMI groups;(3)The 8UG test has good application values in assessment of risk of falling in older adults in community.It can distinguish the difference between the fall and the non-fall group of older adults,and the accuracy of the assessment of risk of falling is high.Those male older adults who completed the 8UG test ≥5.38 seconds and those female older adults who completed the 8UG test ≥5.52 seconds have higher risk of falling.