Download PDF
Arthritis und Rheuma 2009; 29(01): 7-13
DOI: 10.1055/s-0037-1620141
Altersmedizin
Schattauer GmbH

Körperliche Funktionsmessung bei geriatrischen Patienten

Sinn und UnsinnAssessment of physical functionSense and nonsense
M. D. Denkinger
1   Bethesda Geriatrische Klinik der Universität Ulm
,
Th. Nikolaus
1   Bethesda Geriatrische Klinik der Universität Ulm
,
A. Lukas
1   Bethesda Geriatrische Klinik der Universität Ulm
› Author Affiliations
Further Information

Publication History

Publication Date:
24 December 2017 (online)

  PDF Download  Permissions and Reprints

Zusammenfassung

Körperliche Funktionsmessungen bieten zahlreiche Vorteile. So lassen sich aus den Testergebnissen gezielte Interventionen ableiten, nicht beachtete (geriatrische) Syndrome erkennen, Vergleiche zwischen den Patienten ziehen, den Verlauf einzelner Patienten dokumentieren und Effekte von Interventionen nachweisen. Letzteres ist bei zunehmender „Beweislast“ gegenüber den Kassen nicht zu unterschätzen. Zudem erlaubt die Möglichkeit einer objektiven Verlaufsmessung mit passenden Instrumenten eine frühzeitige Diagnostik von Gebrechlichkeit, Funktionsverlust und Behinderung im Alltag sowie die Erfolgskontrolle bei entsprechenden Interventionen. In diesem selektiven Übersichtsartikel werden einige geriatrische Funktionstests vor dem geschichtlichen und theoretischen Hintergrund vorgestellt. Die pragmatische Unterteilung der Assessments nach benötigtem Zeitaufwand gestattet eine praxisnahe Auswahl.

Summary

Physical function measures have ample advantages. Test-results allow for the derivation of focused interventions, the acknowledgement of neglected (geriatric) syndromes, comparisons between patients, documentation of the development of individuals and verification of the effects of certain interventions. With an increasing burden of proof concerning health insurance companies the last aspect should be taken seriously. Additionally the option of an objective measurement of change allows for the early detection of frailty, functional decline and disability, as well as it allows for the efficiency control of certain interventions. In this selective literature review, a variety of geriatric assessments of physical function will be presented on a historical and theoretical background. The pragmatic allotment of assessments according to the time needed for administration provides options for a practical and “real life” choice.

Schlüsselwörter

Körperliche Funktionsmessung - Altersmedizin

Keywords

Assessment of physical function - geriatrics
 

  • Literatur

  • 1 Bellamy N, Buchanan WW, Goldsmith CH. et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15 (12) 1833-1840.
    Google Scholar
  • 2 Brooks D, Parsons J, Hunter JP. et al. The 2-minute walk test as a measure of functional improvement in persons with lower limb amputation. Arch Phys Med Rehabil 2001; 82 (10) 1478-1483.
    CrossrefPubMedGoogle Scholar
  • 3 Cohen ME, Marino RJ. The tools of disability outcomes research functional status measures. Archives of Physical Medicine and Rehabilitation 2000; 81 12PB 21-29.
    CrossrefPubMedGoogle Scholar
  • 4 Denkinger M, Igl W, Coll-Planas L. et al. Evaluation of the Short Form of the Late Life Function and Disability Instrument in Geriatric Inpatients – Validity, Responsiveness, and Sensitivity to Change. Journal of the American Geriatrics Society 2008. Published online 2008 Dec 11; DOI: 10.1111/j.1532-5415. 2008.02095.x
    PubMedGoogle Scholar
  • 5 Denkinger M, Weyerhäuser K, Nikolaus T, Coll-Planas L. Reliability of the abbreviated version of the Late Life Function and Disability Instrument – a meaningful and feasible tool to assess physical function and disability in the elderly. Z Gerontol Geriatr 2008 May 18 (epub ahead of print); DOI: 10.1007/s00391-008-0550-y
    PubMedGoogle Scholar
  • 6 Ferrucci L, Guralnik J, Studenski S. et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc 2004; 52 (04) 625-634.
    CrossrefPubMedGoogle Scholar
  • 7 Gilgen R, Garms-Homolová V. Resident Assessment Instrument (RAI): a system for client evaluation and documentation in long-term care – an overview. Z Gerontol Geriatr 1995; 28 (01) 25-28.
    PubMedGoogle Scholar
  • 8 Gray DB, Hendershot GE. The ICIDH-2: Developments for a new era of outcomes research. Archives of Physical Medicine and Rehabilitation 2000; 81 12PB 10-14.
    CrossrefPubMedGoogle Scholar
  • 9 Guralnik J, Simonsick E, Ferrucci L. et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J. Gerontol 1994; 49 (02) M85-M94.
    Google Scholar
  • 10 Haley S, Jette A, Coster W. et al. Late Life Function and Disability Instrument: II. Development and evaluation of the function component. J Gerontol A Biol Sci Med Sci 2002; 57 (04) M217-M222.
    Google Scholar
  • 11 Jette A, Haley S, Coster W. et al. Late life function and disability instrument: I. Development and evaluation of the disability component. J Gerontol A Biol Sci Med Sci 2002; 57 (04) M209-M216.
    CrossrefPubMedGoogle Scholar
  • 12 Katz S, Ford A, Moskowitz R. et al. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA 1963; 185: 5914-5919.
    Google Scholar
  • 13 Keitel W, Hoffmann H, Weber G, Krieger U. Ermittlung der prozentualen Funktionsminderung der Gelenke durch Bewegungsfunktionstest in der Rheumatologie. Dtsch Ges.-wesen. 1971; 26: 191-193.
    PubMedGoogle Scholar
  • 14 Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil 1987; 1: 6-18.
    PubMedGoogle Scholar
  • 15 Kempen G, Suurmeijer T. The development of a hierarchical polychotomous ADL-IADL scale for noninstitutionalized elders. Gerontologist 1990; 30 (04) 497-502.
    CrossrefPubMedGoogle Scholar
  • 16 Mahoney F, Barthel D. Functional Evaluation: The Barthel-Index. Md State Med J 1965; 14: 61-65.
    PubMedGoogle Scholar
  • 17 McDowell I, Newell C. Measuring health a guide to rating scales and questionnaires. New York: Oxford Univ. Press; 1996
    Google Scholar
  • 18 Nikolaus T, Specht-Leible N. Das geriatrische Assessment. Schriftenreihe Geriatrie Praxis. München: MMV. 1992
    PubMedGoogle Scholar
  • 19 Podsiadlo D, Richardson S. The timed „ Up & Go“: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39 (02) 142-148.
    CrossrefPubMedGoogle Scholar
  • 20 Saliba D, Orlando M, Wenger N. et al. Identifiying a short functional disability screen for older persons. J Gerontol A Biol Sci Med Sci 2000; 55 (12) M750-M756.
    CrossrefPubMedGoogle Scholar
  • 21 Lynn Snow A, Cook KF, Lin P. et al. Proxies and Other External Raters: Methodological Considerations. Health Serv Res 2005; 40 5 Pt 2 1676-1693.
    CrossrefPubMedGoogle Scholar
  • 22 Spector WD, Katz S, Murphy JB, Fulton JP. The hierarchical relationship between activities of daily living and instrumental activities of daily living. J Chronic Dis 1987; 40 (06) 481-489.
    CrossrefPubMedGoogle Scholar
  • 23 Thuriaux MC. The ICIDH: evolution, status, and prospects. Disabil Rehabil 1995; 17 3–4 112-118.
    CrossrefPubMedGoogle Scholar
  • 24 Verbrugge L, Jette A. The disablement process. Soc Sci Med 1994; 38 (01) 1-14.
    CrossrefPubMedGoogle Scholar
  • 25 Tinetti M, Williams T, Mayewski R. Fall Risk Index for Elderly Patients based on Number of Chronic Disabilities. Am J Med 1986; 80: 429-434.
    CrossrefPubMedGoogle Scholar
  • 26 Warren MW. Care of Chronic Sick. Br Med J 1943; 2 4329 822-823.
    CrossrefPubMedGoogle Scholar
  • 27 World Health Organization. International classification of functioning, disability and health ICF. Geneva: World Health Organization; 2001
    Google Scholar