Validity of measures for life space mobility and physical activity in older adults with lower-limb amputation

Abstract

Background: Older adults with lower-limb amputations (LLAs) often experience lack of confidence and poor balance, which limits their mobility. There are few validated measures for assessing these outcomes in the LLA population. Objectives: To assess the validity of the Life Space Assessment (LSA) and the Physical Activity Scale for the Elderly (PASE) for older adults with LLA. Study design: Secondary analyses of cross-sectional data. Methods: Sixty-eight older adults with LLA across Canada were recruited to complete the LSA and the PASE. Validity was assessed via correlations with the Activities-specific Balance Confidence (ABC), Four-Square Step Test (FSST), and Two-Minute Walk Test (2-MWT).Results: As hypothesized, the LSA was positively correlated with the ABC (r 5 0.36, 95% confidence interval [CI] [0.17, 0.62]) and 2-MWT (r 5 0.49, 95% CI [0.27, 0.70]) and negatively correlated with FSST (r 5 20.39, 95% CI [20.56, 20.10]). The PASE was positively correlated with the ABC (r 5 0.34, 95% CI [0.10, 0.56]) and 2-MWT (r 5 0.32, 95% CI [0.05, 0.52]), and negatively correlated with FSST (r 5 20.36, 95% CI [20.53, 20.07]). Conclusions: The LSA has validity in measuring life space mobility. The PASE captures the physical activity with weaker support of validity in older adults with LLA. Clinical relevance: The LSA and PASE are quick low-cost tools for clinicians to assess mobility-related functional health and physical activity, respectively, in older adults with LLA. However, the PASE may contain activities that are not common among older adults with LLA.

2023 Carol B. Lewis Distinguished Lecture Address to the APTA Geriatrics Membership Combined Sections Meeting, February 23, 2023 Key Words & Challenges: Defining Our Role in Caring for Older Adults

“…104,105 Comparing TUG single-task times to manual (carrying a full glass of water) and cognitive (counting backward serial 3's) may indicate the costs of divided attention on efficacy of movement. 106 The Four-Square Step Test has been used to assess balance in persons at risk of falls, 107 with amputation, 108 frailty, 109 stroke, 110,111 Parkinson's disease, 112 osteoporosis, 113 and joint replacement. 114 Normative data and evidence of responsiveness are minimal, however, requiring further investigation.…”