Ann Geriatr Med Res.  2022 Jun;26(2):125-133. 10.4235/agmr.22.0022.

Validation of a Multi-Sensor-Based Kiosk in the Use of the Short Physical Performance Battery in Older Adults Attending a Fall and Balance Clinic

Affiliations
  • 1Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
  • 2Department of Geriatric Medicine, Woodlands Health Campus, Singapore
  • 3Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
  • 4Department of Physiotherapy, Tan Tock Seng Hospital, Singapore
  • 5Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
  • 6Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore

Abstract

Background
The Short Physical Performance Battery (SPPB) is a well-established functional assessment tool used for the screening and assessment of frailty and sarcopenia. However, the SPPB requires trained staff experienced in conducting the standardized protocol, which may limit its widespread use in clinical settings. The automated SPPB (eSPPB) was developed to address this potential barrier; however, its validity among frail older adults remains to be established. Therefore, this exploratory study compared the eSPPB and manual SPPB in patients attending a tertiary fall clinic in relation to their construct validity, reliability, and agreement.
Methods
We studied 37 community-dwelling older adults (mean age, 78.5±6.8 years; mean FRAIL score, 1.2±1.0; 65% pre-frail) attending a tertiary falls clinic. The participants used the mSPPB and eSPPB simultaneously. We evaluated the convergent validity, discriminatory ability, reliability, and agreement using partial correlation adjusted for age and sex, an SPPB cutoff of ≤8 to denote sarcopenia, intraclass correlation coefficients (ICC), and Bland-Altman plots, respectively.
Results
The eSPPB showed strong correlations with the mSPPB (r=0.933, p<0.01) and Berg Balance Scale (r=0.869, p<0.01), good discriminatory ability for frailty and balance, and good to excellent reliability (ICC=0.94; 95% confidence interval, 0.88–0.97). The Bland-Altman plots indicated good agreement with the mSPPB (mean difference, -0.2; 95% confidence interval, -3.2–2.9) without evidence of systematic or proportional biases.
Conclusion
The results of our exploratory study corroborated the construct validity, reliability, and agreement of the eSPPB with the mSPPB in a small sample of predominantly pre-frail older adults with increased fall risk. Future studies should examine the scalability and feasibility of the widespread use of the eSPPB for frailty and sarcopenia assessment.

Keyword

Physical performance; Frailty; Sarcopenia
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