Walking for the Assessment of Balance in Healthy Subjects Older than 40 Years

Abstract

Background: The Berg scale and the timed ‘up and go’ test (TUG) are established measures to assess mobility in frail older adults. As an alternative to self-paced tests to assess aerobic exercise capacity, the incremental shuttle walk test (ISWT) was developed. We hypothesized that ISWT may be useful for the assessment of aerobic capacity and balance simultaneously in healthy adults. Objectives: There are 3 objectives: (1) to evaluate the intra-tester reliability of TUG in healthy subjects; (2) to compare the validity of TUG, ISWT and comfortable gait speed (GS) to evaluate balance assessed by the Berg balance scale, and (3) to evaluate the correlations among these walking tests. Methods: We studied a sample of 64 subjects (82.81% women) aged 40–84 years to assess the intra-tester reliability of TUG. Of these, 21 subjects also performed ISWT, GS and the Berg balance scale. We also assessed height, weight, body mass index, spirometry and reported physical activity. Results: The average time to complete TUG was 7.23 ± 1.27 s. The interclass correlation coefficient of TUG was excellent (0.936; 95% CI: 0.895–0.961). Age (r = 0.36), GS (r = –0.64), GS/height (r = –0.44), ISWT (r = –0.65) and the Berg score (r = –0.65) were correlated with TUG (p < 0.05). The Berg score was significantly (p < 0.05) correlated with GS (r = 0.61) and ISWT (r = 0.61). Moreover, ISWT was mutually related with GS (r = 0.68). We evaluated 2 models of linear regression, using GS and TUG as independent variables in each of them. In the 1st model, GS described 47% of the ISWT variability. In the 2nd, TUG described 42.7% of the ISWT variability. Conclusions: The capacity of walking is related to balance in healthy adults and seniors. Our results suggest the usefulness of ISWT as a new tool for the simultaneous evaluation of the aerobic capacity and balance in healthy subjects. An important part of the ISWT variation was explained by GS and TUG. Secondly, we confirmed the significant influence of age in the TUG performance and the excellent reliability of this field walking test.

Association between the occurrence of falls and the performance on the Incremental Shuttle Walk Test in elderly women

“…Additionally, it was also observed that the tests commonly used for evaluating physical mobility, such as the TUG and the BBS, showed consistent correlations with the ISWD. Spagnuolo et al 9 observed that the ISWD was significantly correlated with the TUG (r=0.65; p<0.0001) and with the BBS score (r=0.61; p=0.003) in healthy elderly. The present results suggest the usefulness of the ISWT for the simultaneous evaluation of cardiorespiratory fitness and balance in this age group.…”

“…The Incremental Shuttle Walk Test (ISWT) was developed by Singh et al 8 . Recently, Spagnuolo et al 9 observed that the distance walked on the ISWT was correlated with balance (r=0.61) evaluated through the Berg Balance Scale (BBS). This correlation was similar to the one observed between the performances of the TUG and the BBS (r=-0.65).…”

Correlação entre instrumentos de avaliação da funcionalidade e equilíbrio em pacientes com artrite reumatoide

“…Na literatura foram encontrados resultados semelhantes na população idosa como: Berg et al 34 (r = -0,76), Podsiadlo e Richardson 26 (r = -0,81), O'Sullivan et al 35 ( = -0,767, p = 0,0001), Hatch et al 36 (r = 0,810, p < 0,01), Desai et al 37 (= -0,62), Spagnuolo et al 38 (r = -0,65, p < 0,05), Silva et al 39 (r = -0,301, p = 0,005), Gazzola et al 40 (r = -0,813, p < 0,05), Brusse et al 41 em idosos com Parkinson (= -0,78, p < 0,001), Gazzola et al 42 em idosos com disfunção vestibular crônica (r = -0,709, p < 0,001). Foi encontrado apenas um estudo de Karuka et al 43 em idosas que não encontraram correlação signifi cativa entre Berg e TUG (= -0,30, p = 0,10).…”

Test timed up and go and its correlation with age and functional exercise capacity in asymptomatic women

“…It is suggested that there is a consistent correlation between TUG and another index from of balance, for example, the distance covered in the incremental shuttle walk test (ISWT) and performance on Berg Balance Scale (BBS) in adult individuals and asymptomatic elderly (3). This is due to the incremental nature of ISWT, which demands agility to execute the changes of direction, as well the association already established between performance on tests of walking and balance (3,11).…”

“…This is due to the incremental nature of ISWT, which demands agility to execute the changes of direction, as well the association already established between performance on tests of walking and balance (3,11). Individuals with a history of falls have lower performance, compared to people who did not fall (11).…”