Sensor-based monitoring of sit-to-stand performance is indicative of objective and self-reported aspects of functional status in older adults
Introduction
With aging functional status may decline, therefore it is important to monitor functioning in older adults and to timely initiate interventions to prevent loss of functional abilities. Methods for the monitoring of motor functioning have been developed using body-fixed motion sensors [1]. Sensor-based measurement of leg power may be a relevant addition to existing sensor-based methods. Leg power is a determinant of mobility (changing basic body position, i.e. getting into and out of a body position and moving from one location to another [2]) and an important parameter for measuring intervention effects [3], [4], [5], [6]. Motion sensors can be used to estimate vertical peak power during the STS transfer [7] with adequate reliability and sensitivity to change [8], [9], [10].
However, it is unclear how sensor-based STS peak power and other STS measures (e.g. maximal velocity) relate to the functional status of older adults. Therefore, the aim of this study was to investigate the associations between sensor-based STS measures and standard clinical measures of functional status in older adults. STS measures were calculated from an individual sensor, because from a practical perspective a single sensor is preferred over multiple sensors. Studies show that leg power is associated with mobility, leg strength, self-reported measures of activities and mobility [3], [4], [5], [6]. Therefore, we hypothesized that sensor-based STS peak power is associated with mobility, leg strength, self-reported measures of limitations in activities and frailty. In addition, we hypothesized that STS peak power is more strongly associated with the aforementioned aspects of functional status than other STS measures. As part of the study aim, we also investigated the ability of STS peak power to discriminate between higher and lower functioning individuals.
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Participants
Participants were 36 older adults (24 females, 12 males; age: 72–94 years (mean ± SD: 82.2 ± 5.4 years); mass: 48.0–104.4 kg (79.3 ± 14.1 kg); height: 1.46–1.89 m (1.66 ± 0.10 m)). Inclusion criteria were: Age≥70 years, being able to perform STS movements and walk ≥10 m (with or without a wheeled walker or cane). Recruitment took place in a health care center, residential care home and sheltered houses. Exclusion criteria were: lower extremity orthopedic surgery or a stroke within the six months before the
Results
Table 1 shows the measurement outcomes. As a result of physical limitations not all participants were able to perform all clinical measurements (Table 1). The hip sensor data of one participant, and the chest sensor data of two other participants, were not analyzed due to missing samples. Scaled peak power and maximal velocity demonstrated multicollinearity (rs = 0.99) at both sensor locations.
Discussion
This study investigated the associations between sensor-based STS measures and standard clinical measures of functional status in older adults. In general, chest STS measures showed a larger number of significant associations and stronger associations with clinical measures than hip STS measures. Chest maximal velocity, chest peak power, chest scaled peak power and chest stabilization phase SD demonstrated significant associations (weak to strong) with all six clinical measures. Noteworthy is
Conflict of interest statement
All authors made substantial contributions to the conception and design of the study, data acquisition, data analysis, data interpretation, drafting the article or revising it critically for important intellectual content. Each of the authors has read and concurs with the content in the final manuscript. The authors have no conflicts of interest.
Acknowledgement
This study was supported by a grant from ZonMw (program ‘Diseasemanagement Chronische Ziekten’; project number 40-00812-98-09014). The sponsor was not involved in the study design, data collection, data analysis, data interpretation, writing of the manuscript and the decision to submit the manuscript for publication.
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