A dual-task dynamic measure for identifying individuals who are at risk for falls.
1
Less than 3 minutes
Initially reviewed by Irene Ward, PT, DPT, NCS and the TBI EDGE taskforce of the Neurology Section of the APTA in 6/2012, Reviewed for the VestEDGE task force of the Vestibular section of the APTA by Elizabeth Dannenbaum MscPT in 2013; Updated with references from the PD population by Rosemary Gallagher, PT, DPT, GCS and the PD EDGE Taskforce of the Neurology Section of the APTA in 4/2013
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
Abbreviations: |
|
HR | Highly Recommend |
R | Recommend |
LS / UR | Reasonable to use, but limited study in target group / Unable to Recommend |
NR | Not Recommended |
Recommendations Based on Parkinson Disease Hoehn and Yahr stage:
| I | II | III | IV | V |
PD EDGE | HR | HR | HR | HR | LS/UR |
Recommendations based on level of care in which the assessment is taken:
| Acute Care | Inpatient Rehabilitation | Skilled Nursing Facility | Outpatient Rehabilitation | Home Health |
MS EDGE | HR | HR | HR | HR | HR |
TBI EDGE | LS | LS | LS | LS | LS |
Recommendations for use based on ambulatory status after brain injury:
| Completely Independent | Mildly dependant | Moderately Dependant | Severely Dependant |
TBI EDGE | LS | LS | NR | NR |
Recommendations based on EDSS Classification:
| EDSS 0.0 – 3.5 | EDSS 4.0 – 5.5 | EDSS 6.0 – 7.5 | EDSS 8.0 – 9.5 |
MS EDGE | HR | HR | HR | NR |
Recommendations for entry-level physical therapy education and use in research:
| Students should learn to administer this tool? (Y/N) | Students should be exposed to tool? (Y/N) | Appropriate for use in intervention research studies? (Y/N) | Is additional research warranted for this tool (Y/N) |
MS EDGE | Yes | Yes | Yes | No |
PD EDGE | Yes | Yes | Yes | Not reported |
TBI EDGE | No | Yes | No | Not reported |
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Community dwelling elderly:
(Shumway-Cook et al, 2000)
Community dwelling elderly:
(Hofheinz et al, 2010, n = 120 healthy older adults between the ages 60-87)
(Shumway-Cook et al 2000)
(Caixeta et al, 2012)
Community dwelling elderly:
(Hofheinz et al, 2010, n = 120 healthy older adults between the ages 60-87)
Community dwelling elderly:
(Shumway-Cook et al, 2000)
Community dwelling elderly:
(Hofheinz et al, 2010, n = 120 healthy older adults between the ages 60-87)
Concurrent validity:
Community dwelling elderly:
(Hofheinz et al, 2010, n = 120 healthy older adults between the ages 60-87)
(Caixeta et al, 2012, Vestibulopathic elderly (n = 76), without a control group)
Predictive validity:
Community dwelling elderly:
(Shumway-Cook et al, 2000; n = 30; 15 fallers and 15 non-fallers; mean age of fallers= 86.2(6.4) years; mean age of non-fallers= 78.4 (5.8)
Parkinsons Disease:
(Maranhao-Filho et al, 2011)
Parkinson’s Disease:
(Campbell et al 2003, n = 19 older adults: 9 with PD and self-reported problems with mobility (6M/3F, 8 (89%)reporting falls past 6 months, mean age 74.3 + 7yrs, range 61-84) and 10 older adults without PD (4M/6F, 1 (10%) reporting falls past 6 months, mean age 76.4 + 7 yrs, range 68-86)
Time to complete (seconds) by group and task.(mean/SD):
Healthy Older | PD | |
Tug baseline | 9.85 (1.44) | 16.4 (3.8) |
TUG low | 10.77 (2.11) | 16.5 (3.6) |
TUG high | 11.58 (2.63) | 21.5 (7.9) |
Concurrent validity:
Parkinson's Disease:
Maranhao-Filho et al (2011)
Caixeta, G. C. d. S., Doná, F., et al. (2012). "Cognitive processing and body balance in elderly subjects with vestibular dysfunction." Brazilian Journal of Otorhinolaryngology 78(2): 87-95.
Campbell, C. M., Rowse, J. L., et al. (2003). "The effect of cognitive demand on timed up and go performance in older adults with and without Parkinson disease." Journal of Neurologic Physical Therapy 27(1): 2-7.
Hofheinz, M. and Schusterschitz, C. (2010). "Dual task interference in estimating the risk of falls and measuring change: a comparative, psychometric study of four measurements." Clin Rehabil 24(9): 831-842.
Lundin-Olsson, L., Nyberg, L., et al. (1998). "Attention, frailty, and falls: the effect of a manual task on basic mobility." J Am Geriatr Soc 46(6): 758-761.
Maranhao-Filho, P. A., Maranhao, E. T., et al. (2011). "Rethinking the neurological examination II: dynamic balance assessment." Arq Neuropsiquiatr 69(6): 959-963.
Rockwood, K., Awalt, E., et al. (2000). "Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging." Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 55(2): M70-73.
Shumway-Cook, A., Brauer, S., et al. (2000). "Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test." Phys Ther 80(9): 896-903.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.