Examining Associations of Locomotor Capacity with Perceived and Actual Mobility

Research Objectives: The WHO’s Unified Framework for Measurement of Mobility proposes three domains that reflect a comprehensive mobility assessment; perceived, actual, and locomotor capacity. Given the breadth required to assess all three, understanding how these are associated may identify the most comprehensive measures that reflect mobility. Thus, the aim was to examine the association between measures of locomotor capacity and measures of perceived and actual mobility in community-dwelling older adults.

Design: This was a baseline analysis of a prospective cohort study, where participants underwent a comprehensive mobility assessment.

Setting: Participants were recruited from the community using newspaper and social media advertisements, along with random phone calls.

Participants: Eligible participants were 1) 65 years or older; 2) community dwelling; 3) able to walk 10-metres without physical assistance from another person; 4) able to attend an in-person assessment at McMaster University, Canada; and 5) capable of providing informed consent. Non-English speakers were excluded.

Interventions: NA

Main Outcome Measures: Locomotor capacity was assessed via balance (Brief Best-Test, Single Leg Stance, TUG-fast pace, TUG-usual pace), muscle power (5-Repetition Chair Rise), and walking ability (Gait Speed). Perceived mobility was assessed with the function component of the Late Life Disability & Function instrument (LLFI). Actual mobility was assessed with the Physical Activity Scale for the Elderly (PASE).

Results: Baseline assessments were conducted on 511 participants, with complete data available for 493 participants. The sample had a mean age of 76.2 (±6.7 SD) years, was 63% female (n=314), 16% having high school education or less, and 25% (n=123) reported using a gait aid. Mean scores on the locomotor measures were: TUG-usual pace = 11.6s (±3.7s SD), TUG-fast pace = 9.2s(±3.3s SD), TUG-dual task = 14.0s (±5.8s SD), Chair Rise = 12.5s (±4.3s SD), Brief Bestest score = 16.1 (±5.2 SD), Single Leg stance= 22.0s (±20.7s SD). Correlations with perceived mobility (LLFI) were strongest for Brief BESTEST (r=0.46, 95%CI=0.4 to 0.5, p< 0.001) and TUG-usual pace (r=-0.45, 95%CI=-0.5 to -0.4, p< 0.001), while they were weakest with Tug-Dual task (r=-0.32, 95%CI=-0.4 to -2, p< 0.001). Correlations with actual mobility (PASE) were strongest with Brief BESTEST (r=0.34, 95%CI=0.3 to 0.4, p< 0.001) and weakest with Chair Rise (r=-0.20, 95%CI=-0.3 to -0.1, p< 0.001).

Conclusions: The Brief BESTEST was the locomotor capacity measure with the strongest correlation with both perceived and actual mobility measures. A performance-based measure that comprehensively assesses all three mobility domains may be useful for clinical and/or research assessments.

Author(s) Disclosures: No conflicts of interest to declare.