Assessing the measurement properties of life-space mobility measures in community-dwelling older adults: a systematic review.

BACKGROUND: Preserving and enhancing mobility is an important part of healthy ageing. Life-space mobility is a construct that captures actual mobility within the home and the community. The objective of this systematic review was to synthesise the measurement properties and interpretability of scores produced by life-space mobility measures in community-dwelling older adults. METHODS: This systematic review followed Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Multiple databases were searched to identify potentially relevant articles. Data extraction and assessment of methodological quality was conducted by two independent reviewers. When possible, results were quantitatively pooled for each measurement property. If studies could not be combined quantitatively, then findings were summarised qualitatively using means and percentage of confirmed hypothesis. Synthesised results were assessed against the COSMIN criteria for good measurement properties. RESULTS: A total of 21 full text articles were included in the review. The University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA) was the most evaluated life-space mobility measure. The LSA demonstrated content validity, internal consistency (Cronbach's alpha 0.80-0.92), reliability [intra-class correlation value 0.89 (95% confidence interval (CI): 0.80, 0.94)] and convergent validity with measures of physical function in community-dwelling older adults. CONCLUSION: This systematic review summarised the measurement properties of life-space mobility measures in community-dwelling older adults following COSMIN guidelines. The LSA has been translated into multiple languages and has sufficient measurement properties for assessing life-space mobility among community-dwelling older adults.

Frailty assessment in emergency medicine using the Clinical Frailty Scale: a scoping review.

BACKGROUND: Frailty is a common condition present in older Emergency Department (ED) patients that is associated with poor health outcomes. The Clinical Frailty Scale (CFS) is a tool that measures frailty on a scale from 1 (very fit) to 9 (terminally ill). The goal of this scoping review was to describe current use of the CFS in emergency medicine and to identify gaps in research. METHODS: We performed a systemic literature search to identify original research that used the CFS in emergency medicine. Several databases were searched from January 2005 to July 2021. Two independent reviewers completed screening, full text review and data abstraction, with a focus on study characteristics, CFS assessment (evaluators, timing and purpose), study outcomes and statistical methods. RESULTS: A total of 4818 unique citations were identified; 34 studies were included in the final analysis. Among them, 76% were published after 2018, mainly in Europe or North America (79%). Only two assessed CFS in the pre-hospital setting. The nine-point scale was used in 74% of the studies, and patient consent was required in 69% of them. The main reason to use CFS was as a main exposure (44%), a potential predictor (15%) or an outcome (15%). The most frequently studied outcomes were mortality and hospital admission. CONCLUSION: The use of CFS in emergency medicine research is drastically increasing. However, the reporting is not optimal and should be more standardized. Studies evaluating the impact of frailty assessment in the ED are needed. REGISTRATION: https://doi.org/10.17605/OSF.IO/W2F8N.

Psychometric properties of life-space mobility measures in community-dwelling older adults: a systematic review protocol.

INTRODUCTION: Mobility is one of the most important contributors to healthy aging and is traditionally measured through performance-based tests. Measuring life-space mobility is a holistic way to measure the spaces individuals visited over a period of time versus what they are physically able to do. However, before a measure of life-space mobility can be widely used in research and clinical settings, it must have robust psychometric properties. The objective of this review is to summarize the psychometric properties of existing life-space mobility measures in community-dwelling older adults. INCLUSION CRITERIA: The construct is life-space mobility and the instruments are: The Nursing Home Life Space Diameter, the Life-Space Questionnaire, and the Life-Space Assessment. The population is community-dwelling older adults (age > 65). The outcome of the review includes all psychometric properties (reliability, validity, responsiveness) as well as feasibility and interpretability data. METHODS: Following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and JBI guidelines, a search strategy will be piloted and then translated to multiple databases. Two independent reviewers will conduct title/abstract screening, full-text screening, data extraction, and assess the methodological quality of the studies. A narrative synthesis will be compiled for all collected data. A meta-analysis will be conducted for each psychometric property if there are enough studies with sufficiently low heterogeneity. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019121855.

Intervention-related factors associated with physical activity maintenance among post-stroke patients: a protocol for a systematic review with meta-analysis and meta-regression.

OBJECTIVE: The aim of this review is to i) evaluate the effectiveness of current rehabilitation interventions in promoting short-, moderate-, and long-term physical activity maintenance among patients post-stroke, and ii) to investigate the intervention characteristics associated with the promotion of physical activity maintenance among patients post-stroke. INTRODUCTION: Physical activity and exercise can positively impact post-stroke recovery. However, few patients participate in the recommended levels of physical activity after a stroke. To design better post-stroke programs, the characteristics of current interventions that promote physical activity maintenance need to be identified. INCLUSION CRITERIA: Randomized controlled trials including adults (age ≥ 18) post-stroke, assessing physical activity via subjective or objective measures with a minimum three-month follow-up, and published in English will be considered for inclusion. METHODS: Literature searches will be conducted using MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials. The quality of the randomized controlled trials will be assessed using Cochrane's risk of bias tool. Interventions will be coded using the Behaviour Change Technique Taxonomy version 1. Standardized mean differences of physical activity levels between intervention and control groups will be calculated using study-specific measures and interpreted as small (<0.40), medium (0.40-0.70), or large (>0.70). Meta-analysis of effect sizes will be conducted for short- (three months), moderate- (six months), and long-term (≥12 months) follow-ups. Univariable and multivariable random effects meta-regression using intervention characteristics (setting, delivery method, delivery type, duration, outcome measure, and behavior change techniques) will be conducted to identify predictors of maintenance. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019131056.