Physiotherapy Across the Lifespan

(Older Adults)
Dr Cuisle Forde

Assessments and outcome measures

Walking Speed – a vital sign
Predicts
– Response to rehabilitation
– Functional dependence
– Frailty
– Mobility disability
– Cognitive decline
– Falls
– Hospitalizations
– Mortality

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Walking Speed

Complex interplay of structures and functions

– Proactive and reactive postural control
– Lower extremity strength
– Aerobic capacity
– Proprioception
– Vision

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Suitable for use in many locations and for many patients/diagnosis
Many protocols
– Consider length of walkway (3m to 40m have been used)
– No turn
– Pace (consider both self selected and maximal)
– Static or Dynamic start (acceleration of 2-3 m needed for self selected pace whereas
over 3m needed for maximal walking
– Standardisation is key!
Responsive
– Can be used to measure change over time
– Note trajectory (ie rate of change) as well as absolute change

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Middleton et al 2016

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Previously described tools

https://www.cgakit.com/
https://www.sralab.org/
http://www.comet-initiative.org/

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The senior fitness test

Measuring several aspects of fitness with population norms for

comparison.
No overall score
Takes up to 40 minutes to complete
Can inform an individualised exercise rehabilitation programme

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Tips for most measurements

What are you measuring and why?

How will you use your results?
How accurate are your tools?
Calibration
Environment (NB for older patients)
Is patient in “steady state”?

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Psycometric properties

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Are you hitting the bullseye!

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 If tools are not appropriate valid and
reliable you have a greater chance of error

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 Heterogeneity
Watch out for ceiling and floor effects in this population!

Comparison of Three Tools to Measure Improvements in

Upper-Limb Function With Poststroke Therapy

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Thank You