Tuesday, 11 October 2011

The timed "up and go": A test of basic functional mobility for frail elderly persons. Podsialdo.D & Richardson.S.

The aim of the study was to assess physical mobility in the elderly, using a reliable method. Many other tests had already been developed, yet there seemed to be problems in terms of validity and reliability.

The method used was to see how long it took a frail elderly patient to stand up from an armchair (approximately 45cm), walk 3 metres, turn round, walk back and sit again. 60 patients were observed from a Geriatric Hospital in Montreal. 23 men and 37 women took part, and the mean age of the subjects was 79.5. All participants were aged between 60 and 90. 10 were considered healthy and active, and were aged over 70. The rest were affected by one of the following; A cerebral vascular accident, Parkinson's disease, rheumatoid osteoarthritis, cerebellar degeneration, post surgical hip fractures or general deconditioning.

The results showed that all the 'healthy' participants performed the test in 10 seconds or less. Time scores ranged between 10 and 240 seconds in 57 patients, as 3 were unable to even perform the test. 7 participants began the test but didn't have the stamina to finish. The results showed no relationship between the scores of the test and their diagnosis.
The hypothesis was supported by the results, in the fact that the timed "up and go" score correlated with patients scores on balance, gait speed and functional capacity.
The patients were divided in to 3 groups depending on their score. Those who took less than 20 seconds were considered independent, and could do everyday task without help, climb stairs, and leave the house alone. The second group consisted of those who took between 20 and 29 seconds to complete the task , who were considered mostly independent, needing help in areas such as getting off the toilet etc. The final group was those who took 30 seconds or more to complete the task, and these were considered dependant as they struggled getting up and walking without assistance.

The test proved to be practical, in the sense that it was simple to carry out, no special equipment was needed and it was quick. It was also reliable, as it gave a good indication of an individuals physical mobility, correlating with scores for gait speed and balance tests.
Those who scored lower than 30 and more than 20 were harder to categorize into a certain group, as such variation was seen in their tests for balance gait speed and functional capacity, so further assessment was needed to clarify their functional level.
If this test were to be used at the beginning of an examination, they could save a lot of professional time as irrelevant questions and tests could be eliminated and can focus on the specific area causing the issue.
As a descriptive tool it is good at describing level of functional capacity, it is quick and easy to carry out and has been proven to be reliable and valid.

1 comment:

  1. This is pretty good! You've covered the paper well, and with a sensible level of detail.

    What I'd like to see you do now is take this fairly detailed summary and turn it into a 200 word summary. This means you will have to think about which bits are the critical pieces of information, and how to express them quickly. Use full sentences, no bullet points or anything. Post that revision with a link to this version so people can see the progression.

    Nice job! A summary with this level of detail is a good place to start, so that you've covered all the bases; but sometimes you can then find ways to express just the key points.