Validity and Responsiveness of Floor Sitting-Rising Test in Post–Total Knee Arthroplasty: A Cohort Study

Test-retest reliability of Latin American Group for Maturity (GDLAM) protocol in older women

Functional autonomy (FA) is a critical factor in determining the quality of life of older adults (OA), especially in the case of older women (OW), as they face a decline in FA in their later years of life. FA should be assessed early, using valid, reliable, and low-cost tests. This study evaluated the test-retest reliability of GDLAM and GDLAM autonomy index (GI) in OW. Thirty-nine OW (71.2 ± 6.50 years) participated in the study. A repeated measures design was used to compare the interday test-retest reliability of the five GDLAM tests (seconds) and the GI (points). The five tests represent activities of daily living, such as dressing or wandering around the house, while the GI provides a weighting of the results of the five tests. The analysis consisted of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). A CV ≤ 10% and an ICC ≥ 0.80 were considered acceptable reliability, whereas a CV ≤ 5% and an ICC ≥ 0.90 were considered high reliability. The outcome of the five tests, represented by the GI, showed high interday test-retest reliability (CV = 6.00% and ICC = 0.91). The results of this study demonstrate that the five tests of the GDLAM protocol and the GI have high interday test-retest reliability and good interday reproducibility. From a practical point of view, the GDLAM protocol allows the assessment of FA of community-dwelling OW, providing background for early diagnosis and, with it, the possibility of developing an individualized physical exercise prescription.

Floor-hugging Intervention: A Perspective on Floor Exposure and After-Fall Contingency Intervention

The fear of falling is a pressing public health issue, yet current interventions often fall short in addressing it effectively. As a result, there is a need for innovative interventions that go beyond symptom relief to address the underlying causes. From this standpoint, we propose that limited exposure to floors and a lack of post-fall contingencies may contribute to the uncertainty that amplifies the fear of falling, particularly in fall prone populations. We explore the theoretical underpinnings of this hypothesis and propose a framework based on the Uncertainty and Anticipation model to elucidate potential connections. Building upon this, we introduce the Floor-hugging intervention-a two-part strategy designed to confront these challenges. Firstly, we propose gradual exposure to different floor scenarios through guided imagery to diminish fear by familiarizing individuals with such situations. Secondly, we advocate for the adoption of evidence-based ways to get up from the floor for developing after fall contingencies. We delve into the theoretical framework supporting our approach and its potential to reduce the fear of falling while improving physical, social, and psychological well-being. Additionally, we outline prospective outcome measures to comprehensively assess the impact of the intervention across biopsychosocial domains. This perspective aims to stimulate discussion on the potential role of floor exposure and post-fall strategies in reducing the fear of falling, while also advocating for innovative interventions to empower and protect fall-prone populations.

Reproducibility and Convergent Validity of the Sitting-Rising Test in People With Multiple Sclerosis

OBJECTIVE

To evaluate the test-retest reproducibility and convergent validity of the sitting-rising test (SRT) in people with multiple sclerosis (PwMS).

DESIGN

Observational study comprising a test-retest design.

SETTING

Multiple Sclerosis Center, Rehabilitation Hospital at Sheba Medical Center, Tel-Hashomer, Israel.

PARTICIPANTS

A total of 50 PwMS (32 women, 18 men, N=50), mean age 44.8±7.6 years and mean disease duration of 13.8±8.5 years since diagnosis, were enrolled in the study. The median Expanded Disability Status Scale score was 4.5, indicating a mild-moderate neurologic disability.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

SRT, posturography measures, 10-repetion sit-to-stand test (10STS), timed Up and Go (TUG) test, hand grip strength, strength of hip flexion/extension/abduction, knee flexion/extension, and Fall Status Questionnaire.

RESULTS

The intraclass correlation coefficient value for the intrarater test-retest reproducibility (7- to 10-day interval between tests) of the SRT test, was 0.931 (95% confidence interval, 0.796-0.977). Strong correlations were found between the SRT, TUG test (ρ=-0.709), and 10STS (ρ=-0.719), and moderate correlations were found between the SRT and postural control measures (ρ∼0.4). Moderate correlations were found between the SRT and the hip and knee strength (combined) of the weaker limb (ρ=0.344). No differences were found in the SRT score between fallers and nonfallers.

CONCLUSIONS

The current study supports the convergent validity and test-retest reproducibility of the SRT in PwMS.