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Nepal GM1, Basaula M2
1Kathmandu University School of Medical Sciences, Department of Physiotherapy, Dhulikhel, Nepal, 2Grande International Hospital, Department of Physiotherapy, Kathmandu, Nepal
Background: Falls and decreased mobility in older people are a major public health concern in terms of morbidity, mortality and health socioeconomic. About 28-35% of people aged 65 and over suffer falls related injuries annually in Nepal. The older patient with decreased mobility has less accessibility to the hospital due to geographical circumstances and other infrastructures. Involving caregivers in health care services is thus important to provide essential support for older patients.
Purpose: There is need for reliable outcome measure which can be used by caregivers to assess rehabilitation outcomes in older patients at home. Timed up and go test (TUG) is a simple tool to assess functional mobility, balance, walking ability and risk of fall in older adults. TUG is easy to administer, not time consuming and is cost-effective. Thus, we examined the inter-rater reliability of TUG in older adults measured by physiotherapist and caregivers. We also measured the duration of care, footwear, assistive device and instrument used during administration of TUG to see the effect of these variables in TUG score.
Methods: The main study was conducted in 100 older adults and their primary caregivers in the community settings. The primary caregivers were trained prior and were instructed to use the available local resources for administrating TUG. The standard instruction of the test was translated into Nepali and the same instruction was given to all the participants. Informed consent was taken from the elderly and their caregivers in verbal and written form.
Timed Up and Go test (TUG) was then administered to the older adults by the therapist and the caregivers with the time interval of 5 minutes. The first one to administer the test was chosen by the lottery method.
The inter-rater reliability of Timed Up and Go test (TUG) between caregivers of older adults and physiotherapist was evaluated using two-way mixed model and absolute agreement intra-class correlation coefficient. The association of duration of care, footwear, assistive device and instrument used were analyzed using Pearson chi square test.
Results: The inter rater reliability of TUG test between the physiotherapist and caregivers was found to be excellent (ICC 0.93). The TUG score was not associated with duration of care (p=0.65), footwear (p=0.51), assistive device (p=0.15) and instrument used (p=0.38).
Conclusion(s): The inter-rater reliability of the Timed Up and Go test measured by PTs and caregiver of older adults was found to be excellent. The study results suggest that the TUG can be administered by the caregivers in home settings with basic training.
Implications: The healthcare centers in Nepal are not accessible to most of the populations and the availability of healthcare professionals are also few in remote areas. The TUG scores measured by caregivers from a distant remote area can particularly be used for further decision making process.
Keywords: Inter-rater reliability, Timed Up and Go test, Caregiver
Funding acknowledgements: None
Purpose: There is need for reliable outcome measure which can be used by caregivers to assess rehabilitation outcomes in older patients at home. Timed up and go test (TUG) is a simple tool to assess functional mobility, balance, walking ability and risk of fall in older adults. TUG is easy to administer, not time consuming and is cost-effective. Thus, we examined the inter-rater reliability of TUG in older adults measured by physiotherapist and caregivers. We also measured the duration of care, footwear, assistive device and instrument used during administration of TUG to see the effect of these variables in TUG score.
Methods: The main study was conducted in 100 older adults and their primary caregivers in the community settings. The primary caregivers were trained prior and were instructed to use the available local resources for administrating TUG. The standard instruction of the test was translated into Nepali and the same instruction was given to all the participants. Informed consent was taken from the elderly and their caregivers in verbal and written form.
Timed Up and Go test (TUG) was then administered to the older adults by the therapist and the caregivers with the time interval of 5 minutes. The first one to administer the test was chosen by the lottery method.
The inter-rater reliability of Timed Up and Go test (TUG) between caregivers of older adults and physiotherapist was evaluated using two-way mixed model and absolute agreement intra-class correlation coefficient. The association of duration of care, footwear, assistive device and instrument used were analyzed using Pearson chi square test.
Results: The inter rater reliability of TUG test between the physiotherapist and caregivers was found to be excellent (ICC 0.93). The TUG score was not associated with duration of care (p=0.65), footwear (p=0.51), assistive device (p=0.15) and instrument used (p=0.38).
Conclusion(s): The inter-rater reliability of the Timed Up and Go test measured by PTs and caregiver of older adults was found to be excellent. The study results suggest that the TUG can be administered by the caregivers in home settings with basic training.
Implications: The healthcare centers in Nepal are not accessible to most of the populations and the availability of healthcare professionals are also few in remote areas. The TUG scores measured by caregivers from a distant remote area can particularly be used for further decision making process.
Keywords: Inter-rater reliability, Timed Up and Go test, Caregiver
Funding acknowledgements: None
Topic: Outcome measurement; Older people; Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: Kathmandu university school of medical sciences (KUSMS)
Ethics committee: Institutional review committee KUSMS
Ethics number: 60/17
All authors, affiliations and abstracts have been published as submitted.
