Development and Validation of the FBIndex to Determine the Risk of Falls for Patients With Neuromuscular Disorders

Condition(s) studied

Investigational drug(s) / intervention(s)

FBIndex: There will be no intervention.

Study summary

Currently, there are no standardised fall risk scores or guidelines on when to use appropriate assistive gait devices (AGDs) for people with neuromuscular disorders (NMDs). There is a clear medical unmet need to provide a battery of appropriate locomotor gait assessments to determine the risk of falling for patients with NMDs and give clear guidelines to prescribe an appropriate AGD.

The primary goal is to confirm whether the clinical battery assessments (Heel-Rise Test (HRT), Chair-Rise Test (CRT), Semi-tandem Stand (STS), Trunk-Rise Test (TRT), Foot-Tapping Test (FTT), Timed Up and Go (TUG), 10-Meter-Walk Test (10MWT) and 6-Minute-Walk Test (6MWT) can be validated and generalized to other NMD target populations that meet broader eligibility criteria based on used clinical assessments. The second objective of this project is to provide intra- and inter-observer reliability and test-retest reliability of included clinical assessments used to determine the risk of falling for patients with NMDs. Finally, all data will be compared with norm data from the healthy population (n=15) collected retrospectively.

Eligibility

Primary outcome measure(s)

• Chair-Rise Test (CRT) — Immediately after the ICF is signed
  This is a sit-to-stand test with five repetitions. Three sets will be performed, and the fastest one will be scored. In Group A, the test uses a bench with a height of 46 cm anchored to the force plate.Only the best rise will be analyzed to collect force and power data. The main outcome parameter is the time required to perform the five repeat movements. In Group A, the examiner will assess the performance time of five sit-to-stand movements from the first to last repetition and the power data (Pmax rel. W/kg) from the force plate. In Group B, the examiner will only record the time taken to complete the test.
• Trunk Rise Test (TRT) — Immediately after the ICF is signed
  Participants slowly bend their knees with erect straight upper body until the fingertips touch their feet or lower leg on the inside and then cross the arms on their chest and grab their shoulders with their hands. The instructions will follow: "After the signal, rise as fast as possible, one time (movement compared to lifting a heavy object). You can use your arm to push yourself up on your thigh if you cannot get up without it". Three sets will be done, and the fastest result will be evaluated. In Groups A and B, the examiner will assess the performance time from the start position "forward bend 90°" to stand up straight and also assess whether participants use their arms or not to stand up straight. In Group A, time is assessed with power data (Pmax rel. W/kg) from the force plate. In Group B, the examiner will only record the time to perform the test on a solid concrete ground floor.
• Heel-Rise Test (HRT) — Immediately after the ICF is signed
  It consists of five bilateral maximal heel rises to achieve a maximal speed of upward movement. Three sets will be done, and the fastest result will be evaluated. The instructions will follow: "Rise to the tip of your toes five-times in a row as fast and high as possible. It is important that you keep your knees straight. Cross your arms on your chest and grab your shoulders with your hands. Move to your tiptoes as fast and high as possible." In Group A, the examiner will assess the performance time of five bilateral heel rises from first to last, along with the power data (P.max rel. kg- W/kg) from the force plate. In Group B, the examiner will only record the time to perform five bilateral heel rises from first to last tiptoes on a solid concrete ground floor.
• Semi-Tandem stand, eyes open (STSeo) and eyes closed (STSeo) — Immediately after the ICF is signed
  In this test, participants will be instructed to stand as still as possible in an upright position with both arms crossed in front of the upper body for starting, first with eyes open. Then eyes closed, in a Semi-Tandem stand as long as possible (for a maximum of 30 sec.). Three sets will be done. During the test, the Leonardo Mechanography system records the position of the center of pressure on the platform. In Group A, the time to the first drop or side-step is measured, up to a maximum of 30 seconds, together with power data (Ellip. Average cm) from the force plate. In Group B, the examiner records only the time to first drop or side-step, up to a maximum of 30 seconds. The Group B will do a semi-tandem stand on a solid concrete floor with a 1 cm wide line between the inside of the soles of the feet.
• Foot-Tapping Test (FTT) (sitting) — Immediately after the ICF is signed
  The FTT is designed to assess coordination and reaction time for the foot. Sitting on a 46 cm high bench, the participant\'s task is to tap ten times with the same foot (dorsal flexion, plantar flexion) as quickly as possible while keeping the heel on the ground. The participants were instructed to tap first with their right foot 10 times as quickly as possible. The same procedure will be repeated with the left feet, and three sets of left/right will be carried out. The participants need to sit straight, with 90° between the lower and upper leg and crossed arms over the chest. In Group A, the time for 10- foot tappings together with power data (max frequency and average contact time) from the force plate will be assessed. In Group B, the examiner records only the time. In Group B, participants are seated on a 46 cm high bench or chair with no backrest.
• 10-Meter Walk Test — Immediately after the ICF is signed
  Walking at maximum speed will be measured in a long corridor with an even surface over 10 meters with a still-standing start and a "flying" finish to a target 2.5 meters beyond the 10 m mark. The stopwatch started with the word "Go" ("Ready-Steady-Go").
• Six-Minute Walk test — Immediately after the ICF is signed
  For the 6MWT, the individuals will be instructed to walk 30 m between two marks on the floor. After passing either mark, they will be told to turn and walk back. They will be instructed to walk as far as possible for six minutes and were allowed to rest (only while standing) and then to continue walking. They will be informed every minute of the remaining test time.
• Time Up and Go (TUG) — Immediately after the ICF is signed
  The TUG test measures the time it takes to stand up from a chair, walk three meters, turn around and sit down in the same chair. The subjects start with arm support from a seated position in a chair of normal height (44-45 cm) with arms, walk at a comfortable and safe pace to a mark on the floor 3 meters away, turn around, walk back to the chair, turn again and sit down. Time is measured from the start of the moment until participants touch the chair backrest with their back.

Trial sites (1)

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