Single-leg squats identify independent stair negotiation ability in older adults referred for a physiotherapy mobility assessment at a rural hospital.

OBJECTIVES: To determine whether single-leg squats identify ability to negotiate stairs in older adults at a rural hospital. DESIGN: Cross-sectional analytical study. SETTING: Acute wards and emergency department of a rural hospital in Australia. PARTICIPANTS: A systematic sample of 143 older adults (72 men, 71 women, 80.0 ± 6.8 years) from the emergency department or acute wards of Shoalhaven Hospital referred for a physiotherapy mobility assessment. MEASUREMENTS: Ability to complete up to three single-leg squats and negotiate up to three steps were measured. Covariates and demographic variables were collected. RESULTS: The squat test had 86% sensitivity, 100% specificity, 100% positive predictive value, and 49% negative predictive value in correctly identifying stair negotiation ability. Participants who could complete single-leg squats were 57 times more likely to be able to independently negotiate stairs than participants who could not complete squats. Multivariate regression analysis indicated that walker use, pain severity and whether participants lived alone were significant and independent predictors of ability to negotiate stairs independently. CONCLUSION: Single-leg squats may be an accurate identifier of stair negotiation ability in older adults admitted to the hospital for an acute illness or injury. A traditional stairs assessment would be required if older adults were unable to complete the squat test or had moderate to severe pain, used a walker to ambulate, or did not live alone. The squat test is a potentially more-efficient assessment tool than traditional stair assessments in determining an individual's ability to negotiate stairs and suitability for discharge where poor mobility is a problem.

A systematic review of the predictive ability of the Orebro Musculoskeletal Pain Questionnaire.

STUDY DESIGN: Systematic review. OBJECTIVE: To establish the ability of the Orebro Musculoskeletal Pain Questionnaire (OMPQ) to predict outcome in patients with recent onset spinal pain. SUMMARY OF BACKGROUND DATA: Psychosocial factors are believed to play a significant role in the development of a chronic pain problem. The OMPQ is a self-administered screening questionnaire that was developed to identify those patients with acute or subacute musculoskeletal pain who are at risk of delayed recovery. Clinical guidelines recommend its use, despite its predictive ability never having been systematically reviewed. METHODS: Searches of electronic databases were undertaken. Eligible studies were those that enrolled subjects with acute or subacute spinal pain, administered the OMPQ at baseline and measured outcomes in terms of pain, disability, sick leave, and/or global recovery. Ratings of study quality and data extraction were conducted by 2 independent assessors. RESULTS: Seven publications (5 discreet data sets) of variable methodologic quality were included. Baseline OMPQ scores were shown to have moderate ability in predicting long-term pain, disability, and sick leave outcomes. For example, the area under the curve values for predicting persisting pain ranged from 0.62 to 0.75 and for persisting disability from 0.68 to 0.83. CONCLUSION: The OMPQ has moderate predictive ability in identifying patients with spinal pain at risk of persisting pain and disability. This evidence supports clinical guidelines recommending its use as an assessment tool for identifying psychosocial risk factors. Further research is needed to confirm the predictive ability of individual items in different populations and settings, to enhance its usefulness.