Archives of physical medicine and rehabilitation · 2013
Using the Timed Up & Go test in a clinical setting to predict falling in Parkinson's disease.
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Nocera Joe R, Stegemöller Elizabeth L, Malaty Irene A, Okun Michael S, Marsiske Michael, Hass Chris J, National Parkinson Foundation Quality Improvement Initiative Investigators
Аннотация
OBJECTIVE: To investigate the ability of the Timed Up & Go test to identify patients with Parkinson's disease at risk for a fall.
DESIGN: Cross-sectional cohort study.
SETTING: Sixteen participating National Parkinson's Foundation Centers of Excellence.
PARTICIPANTS: A query yielded a total of 2985 records (1828 men and 1157 women). From these, 884 were excluded because of a lack of crucial information (age, diagnosis, presence of deep brain stimulation, disease duration, inability of performing the Timed Up & Go test without assistance) at the time of testing, leaving 2097 patients included in the analysis.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: The primary outcome measure for this study was falls. The chief independent variable was the Timed Up & Go test.
RESULTS: The initial model examined the prediction of falls from the Timed Up & Go test, adjusting for all study covariates. The estimated models in the imputed data sets represented a significant improvement above chance (χ(2) range [df=17], 531.29-542.39, P<.001), suggesting that 74% of participants were accurately classified as a faller or nonfaller. The secondary model in which the question of whether the effect of Timed Up & Go test was invariant across disease severity demonstrated 75% of participants were accurately classified as a faller or nonfaller. Additional analysis revealed a proposed cut score of 11.5 seconds for discrimination of those who did or did not fall.
CONCLUSIONS: The findings suggest that the Timed Up & Go test may be an accurate assessment tool to identify those at risk for falls.
DESIGN: Cross-sectional cohort study.
SETTING: Sixteen participating National Parkinson's Foundation Centers of Excellence.
PARTICIPANTS: A query yielded a total of 2985 records (1828 men and 1157 women). From these, 884 were excluded because of a lack of crucial information (age, diagnosis, presence of deep brain stimulation, disease duration, inability of performing the Timed Up & Go test without assistance) at the time of testing, leaving 2097 patients included in the analysis.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: The primary outcome measure for this study was falls. The chief independent variable was the Timed Up & Go test.
RESULTS: The initial model examined the prediction of falls from the Timed Up & Go test, adjusting for all study covariates. The estimated models in the imputed data sets represented a significant improvement above chance (χ(2) range [df=17], 531.29-542.39, P<.001), suggesting that 74% of participants were accurately classified as a faller or nonfaller. The secondary model in which the question of whether the effect of Timed Up & Go test was invariant across disease severity demonstrated 75% of participants were accurately classified as a faller or nonfaller. Additional analysis revealed a proposed cut score of 11.5 seconds for discrimination of those who did or did not fall.
CONCLUSIONS: The findings suggest that the Timed Up & Go test may be an accurate assessment tool to identify those at risk for falls.