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Objective: Advancements in smartphone technology provide availability to evaluate movement in a more practical and feasible manner, improving clinicians' ability to diagnose and treat adults at risk for mobility loss. The purpose of this study was to evaluate the validity and reliability of a smartphone application to measure spatiotemporal outcomes during level (primary) and uphill/downhill (secondary) walking with and without an assistive device for older adults (OAs), Parkinson's Disease (PD) and cerebrovascular accident (CVA) populations. Methods: A total of 50 adults (OA = 20; PD = 15; CVA = 15) underwent gait analysis at self-selected gait speeds under 0-degree, 5-degree uphill and 5-degree downhill environments. The validity and reliability of the smartphone outcomes were compared to a motion-capture laboratory. Bland–Altman analysis was used to evaluate limits of agreement between the two systems. Intraclass correlation coefficients (ICCs) were used to determine absolute agreement, and Pearson correlation coefficients (r) were used to assess the strength of the association between the two systems. Results: For level walking, Bland–Altman analysis revealed relatively equal estimations of spatiotemporal outcomes between systems for OAs without an assistive device and slight to mild under- and overestimations of outcomes between systems for PD and CVA with and without an assistive device. Moderate to very high correlations between systems (without an assistive device: OA r-range, 0.72–0.99; PD r-range, 0.87–0.97; CVA r-range, 0.56–0.99; with an assistive device: PD r-range, 0.35–0.98; CVA r-range, 0.50–0.99) were also observed. Poor to excellent ICCs for reliability between systems (without an assistive device: OA ICC range, 0.71–0.99; PD ICC range, 0.73–0.97; CVA ICC range, 0.56–0.99; with an assistive device: PD ICC range, 0.22–0.98; CVA ICC range, 0.44–0.99) were observed across all outcomes. Conclusions: This smartphone application can be clinically useful in detecting most spatiotemporal outcomes in various walking environments for older and diseased adults at risk for mobility loss. [ABSTRACT FROM AUTHOR]

Primary purpose was to identify relationships between performance-based measures onto both computerized adaptive testing [Physical Function-Computer Adaptive Testing (PF-CAT)] and joint-specific legacy [Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living (KOOS-ADL)] instruments pre- and 12-month post-TKA. The PF-CAT and KOOS-ADL were identified as outcomes and performance on the 40-m fast-paced walking test, stair climb test and chair stand test were identified as predictors. Linear regression was used for all comparisons after adjusting for confounders. Sixty-eight people with TKA (56.7% male) were tested. Better scores on the 40-m fast-paced walking (KOOS-ADL, p = 0.02), stair climb (KOOS-ADL, p = 0.05) and chair stand (KOOS-ADL, p < 0.01) associated with better self-reported scores pre-TKA. Better scores on the 40-m fast-paced walking (PF-CAT, p = 0.05; KOOS-ADL, p = 0.01), stair climb (KOOS-ADL, p < 0.01), chair stand (PF-CAT, p < 0.01) and range of motion (KOOS-ADL, p = 0.02) were associated with better self-reported scores 12-month post-TKA. Decrease knee range of motion related to poorer 40-m fast-paced walking (p = 0.01) and stair climb (p = 0.03) scores pre-TKA. Quadriceps weakness related to poorer 40-m fast-paced walking (p = 0.04) score pre-TKA. Self-reported instruments are a moderate, but inconsistent surrogate to performance-based measures pre- and post-TKA. Our findings indicate that both self-reported and performance-based measures are necessary to fully characterize physical function and should be used jointly to aid in the recovery analysis of people undergoing TKA. Monitoring the trajectory of pre- to post-total knee arthroplasty (TKA) physical function is important as it directly relates to mortality, morbidity and poorer quality of life in older adults. Both self-reported and performance-based measures of physical function are used to determine progress in recovery for patients pre- and post- TKA. This study provides evidence that perceived physical function measures are a moderate, but an inconsistent, surrogate to objective physical function measures pre- and post-TKA. Joint specific deficits in knee range of motion and quadriceps strength were weakly associated with deficits in function measures pre-TKA, but no association was observed 12-month post-TKA. Our findings indicate that both self-reported and performance-based measures are necessary to fully characterize physical function and should be used jointly to aid in the complete recovery analysis of people undergoing TKA. [ABSTRACT FROM AUTHOR]