Evaluation of the Measurement Properties of a 5 Time Repeated Instrumented Timed Up and Go (5iTUG)
Condition: Measurement Properties of 5iTUG; Physical Disability; Balance; Cognitive Impairment; Leg Strength; Gait Disorder, Sensorimotor; Activity of Daily Living
MeSH terms: Gait Disorders, Neurologic
Study type: Observational

Summary: 
      In order to tailor interventions, objective assessments of physical function is needed. A
      limitation of several of today's clinical assessments is that they require too much time
      and/or space. The Timed Up and Go (TUG) is a commonly used clinical test of physical function
      in older populations. The TUG is particularly useful due to its short administration time and
      the little space that is required. The TUG is however of limited value when used in
      higher-functioning older adults due to ceiling effects. Instrumented versions of TUG (iTUG)
      computes several outcome measures in addition to the traditional outcome measure which is the
      total duration. The aim of this study is to evaluate the construct- and discriminative
      validity of outcomes derived from sensor signals recorded with a smartphone during a five
      times repeated iTUG (5iTUG).
    

Detailed description: 
      At "Robert-Bosch-Krankenhaus" (RBK) in Stuttgart the investigators aim to recruit a sample
      consisting of 60 geriatric participants. The sample will recruited from a mix of health care
      settings in order to allow for cohort specific analysis.

      The first 20 participants will be recruited from the inpatient rehabilitation ward at RBK.
      The treating medical doctor and Prof Dr Clemens Becker will inform potentially eligible
      participants about the possibility of being involved in this study. Should participants
      confirm their interest a research assistant will complete a detailed information session and
      obtain written informed consent prior enrolment.

      Further 20 participants will be recruited through the outpatient rehabilitation clinic at
      RBK. The treating doctor will again inform the potential participant about the study and
      invite them to 6 participate. A research assistant will complete a detailed information
      session and written informed consent will be obtained prior enrolment.

      Lastly 20 community dwelling older adults will be invited to participate. Recruitment will
      occur through advertisement at a locally run seniors fitness group, conducted every Thursday
      at RBK. Older adults who are interested in being involved will be invited to receive
      additional information about the study and the involved procedures before providing written
      informed consent and being enrolled.

      All participation is entirely voluntary. Participants are free to withdraw at any time
      without stating a reason. Withdrawal or non-participation will not impact the care and
      services they are receiving or will receive from RBK now or in the future.

      The following inclusion criteria will be used: community-dwelling, aged between 60 and 80
      years and are able to walk 30m independently. Participants will be excluded if they report
      any severe cardiovascular, pulmonary, neurological, or mental diseases.

      In Trondheim researchers will recruit and include 20 healthy seniors, men and women, from
      senior exercise groups in local fitness centres and the municipality of Trondheim. They will
      approach leaders or instructors of the exercise groups and ask them to contact the
      participants in their exercise groups to ask whether they want to take part in this study.
      Those who are willing will be contacted by a research coordinator. Written informed consent
      will be obtained prior enrolment.

      Participants will be randomized to start with either the five times repeated instrumented
      Time up an Go Test (5iTUG) or clinical tests. The clinical tests include seven tests: the
      Community Balance and Mobility Scale (CBMS) (only the group of healthy participants), 8-level
      Balance Scale, 30s Chair stand (CS), Five times sit-to-stand (STS), Short Physical
      Performance Battery (SPPB), fast and habitual gait speed over 7 meters. Participants will
      complete the clinical tests according to the current standard clinical procedures. For the
      5iTUG, participants will be instructed to do the Time up and Go Test (TUG) five times with 30
      seconds rest between each repetition. The assessor will tell the participant when they should
      start walking. Participants will wear a smartphone attached with a belt to their lower back
      during the entire test sequence, both during the clinical tests and the 5iTUG. The assessor
      will demonstrate each test before the participants start. Participants can take breaks
      between tests or trials if needed. The assessor is experienced with testing of physical
      function in older adults, and will stand close to participants during all tasks especially
      where balance is challenged. At the end of the test-session, the assessor will administer one
      questionnaire about activities of daily living (ADL) function (the Late Life Function and
      Disability (LLFDI) questionnaire) and cognitive impairment based on screening via the
      Montreal Cognitive Assessment (MoCA).
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The first 20 participants will be recruited from the inpatient rehabilitation ward at
        Robert-Bosch-Hospital.

        Further 20 participants will be recruited through the outpatient rehabilitation clinic at
        Robert-Bosch-Hospital.

        Lastly 20 community dwelling older adults will be invited to participate.
      
Keywords: Time up and Go Test