human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Walk tests provide essential outcome information when assessing ambulation of individuals with lower-limb amputation and a prosthetic device . Existing tests have limitations such as ceiling effects or insufficient challenge . The objective of this study was to assess the reliability and validity of data for a clinical measure of basic mobility , the L Test of Functional Mobility  ( L Test ) . SUBJECTS For this method ological study , 93 people with unilateral amputations ( 74 % transtibial , 26 % transfemoral ; 78 % male , 22 % female ; mean age=55.9 years ) were consecutively recruited from an outpatient clinic . Twenty-seven subjects returned for retesting . METHODS To assess concurrent validity , subjects completed the L Test , Timed " Up & Go " Test ( TUG ) , 10-Meter Walk Test , and 2-Minute Walk Test , followed by the Activities-specific Balance Confidence scale , Frenchay Activities Index ( FAI ) , and mobility subscale of the Prosthetic Evaluation Question naire ( PEQ-MS ) . Amputation cause and level , walking aid use , automatic stepping , and age variables were used to assess discriminant validity . RESULTS Intraclass correlation coefficients were .96 for interrater reliability and .97 for intrarater reliability , and minimal bias existed upon retesting . The magnitude of concurrent validity correlations ( r ) was very high between the L Test data and data for other walk tests and fair to moderate between the L Test data and data for self-report measures . The L Test discriminated between all groups as hypothesized . DISCUSSION AND CONCLUSION The L Test is a 20-m test of basic mobility skills that includes 2 transfers and 4 turns . It demonstrated excellent measurement properties in this study Background The newly developed Brief – Balance Evaluation System Test ( Brief-BESTest ) may be useful for measuring balance and predicting falls in individuals with Parkinson disease ( PD ) . Objectives The purpose s of this study were : ( 1 ) to describe the balance performance of those with PD using the Brief-BESTest , ( 2 ) to determine the relationships among the scores derived from the 3 versions of the BESTest ( ie , full BESTest , Mini-BESTest , and Brief-BESTest ) , and ( 3 ) to compare the accuracy of the Brief-BESTest with that of the Mini-BESTest and BESTest in identifying recurrent fallers among people with PD . Design This was a prospect i ve cohort study . Methods Eighty participants with PD completed a baseline balance assessment . All participants reported a fall history during the previous 6 months . Fall history was again collected 6 months ( n=51 ) and 12 months ( n=40 ) later . Results At baseline , participants had varying levels of balance impairment , and  Brief-BESTest scores were significantly correlated with  Mini-BESTest  ( r=.94 , P<.001 ) and  BESTest  ( r=.95 , P<.001 ) scores . Six-month retrospective fall prediction accuracy of the Brief-BESTest was moderately high ( area under the curve [AUC]=0.82 , sensitivity=0.76 , and specificity=0.84 ) . Prospect i ve fall prediction accuracy over 6 months was similarly accurate ( AUC=0.88 , sensitivity=0.71 , and specificity=0.87 ) , but was less sensitive over 12 months ( AUC=0.76 , sensitivity=0.53 , and specificity=0.93 ) . Limitations The sample included primarily individuals with mild to moderate PD . Also , there was a moderate dropout rate at 6 and 12 months . Conclusions All versions of the BESTest were reasonably accurate in identifying future recurrent fallers , especially during the 6 months following assessment . Clinicians can reasonably rely on the Brief-BESTest for predicting falls , particularly when time and equipment constraints are of concern Background Falling is a common problem in the fast-growing elderly population .  Multitasking or engaging in two or more activities at the same time is common in daily living . Objective To determine the usefulness of the  trail-walking test ( TWT ) for predicting a fall in community-dwelling elderly individuals . Methods This was a prospect i ve study in which the TWT was used to evaluate the risk of falling among a group of community-dwelling elderly individuals ( n = 171 ) with a mean age of 80.5 ± 5.6 years . The following tests were conducted :  TWT , trail-making test ( TMT ) , timed-up- and -go test ( TUG ) , functional reach ( FR ) test , one-leg st and ing ( OLS ) test , and 10-m walking time test . Test – retest reliability was assessed by repeating the TWT within 2 weeks of the first trial , and there was a 1-year follow-up . Stepwise logistic regression analysis was used to analyze whether the TWT , TMT , TUG , FR , OLS , or 10-m walking tests predicted falling . Results The test – retest reliability  of TWT was high ( intraclass correlation coefficient 0.945 , p < 0.001 ) . Fifty-nine participants ( 34.5 % ) had reported a fall during the year preceding the 1-year follow-up . The stepwise logistic regression analysis revealed that only the TWT was significantly related to falling ( odds ratio 1.160 , 95 % confidence interval 1.107–1.214 ; p < 0.001 ) . In total , 77.8 % of cases were correctly classified . Conclusion When reliability and validity were considered , the TWT was most useful test of those evaluated for assessing the risk of fall among our elderly cohort Over the ensuing seven months she had three more clinical relapses , each accompanied by reappearance in the stools of either the organism or its cytotoxin , or both . Each improvement after vancomycin ( eight to 14-daycourses ) was accompanied by disappearance of the organism . At one point she was given cholestyramine , but she was unable to tolerate it . Her illness was punctuated by malnutrition and episodes of heart failure . She was given no other antibiotics . After the sixth relapse maintenance treatment with oral vancomycin 125 mg eight-hourly was begun . With this regimen diarrhoea was controlled and stools over the next 10 weeks remained negative for C difficile and its cytotoxin . There was no adverse reaction to vancomycin throughout Background and Purpose — The modified Emory Functional Ambulation Profile ( mEFAP ) is an easily administered test that measures the time to ambulate through 5 common environmental terrains with or without an assistive device or manual assistance . The mEFAP was evaluated for its interrater reliability , test-retest reliability , concurrent validity , and sensitivity to change during outpatient rehabilitation for poststroke gait dysfunction . Methods — Twenty-six poststroke patients were followed up prospect ively in a rehabilitation day-treatment program . The  mEFAP , Berg Balance Test ( BBT ) , and 7-item mobility subsection of the Functional Independence Measure + Functional Assessment Measure ( FAMm ) were completed at admission and discharge . Results — mEFAP interrater reliability ( intraclass coefficient [ ICC ] 0.999 ) and test-retest reliability ( ICC 0.998 ) were high . The BBT demonstrated high interrater ( ICC 0.992 ) but poor test-retest ( ICC 0.605 ) reliability . Initial and final scores comparing the mEFAP with the BBT ( r = −0.735 , r = −0.703 ) and the mEFAP with the FAMm ( r = 0.685 , r = −0.775 ) were strongly correlated . Improvement on the mEFAP correlated with improved BBT performance ( r = −0.524 ) . There was no correlation between overall change observed on the FAMm and change on the mEFAP ( r = −0.145 ) . Total mEFAP and all mEFAP subtask scores improved over time ( P < 0.0001 ) . Conclusions — The mEFAP is a reliable gait- assessment tool for patients with stroke and is sensitive to change in ambulation speed BACKGROUND numerous tests have been suggested as fall risk indicators . However , the validity of these assessment s has not been demonstrated in large representative sample s of community-dwelling older people . OBJECTIVE the objective of this study was to examine the comparative ability and clinical utility of eight mobility tests for predicting multiple falls in older community-dwelling people . METHODS design -- prospect i ve cohort study ; subjects--362 subjects aged 74 - 98 years ; measurements --the sit-to-st and test with one and five repetitions , the pick-up-weight test , the half-turn test , the alternate-step test ( AST ) , the six-metre-walk test ( SMWT )  and  stair ascent and descent tasks . Falls were monitored for 1 year with fall calendars . RESULTS in the 12-month follow-up period , 80 subjects ( 22.1 % ) suffered two or more falls . Multiple fallers performed significantly worse than non-multiple fallers in the sit-to-st and test with five repetitions ( STS-5 ) , the AST , the  half-turn test  , the  SMWT  and the stair-descent test .  When dichotomised using cut-off points from receiver-operated characteristics ( ROC ) curve analyses , these tests demonstrated reasonable sensitivity and specificity in identifying multiple fallers . A principal components analysis identified only one factor underlying the mobility tests . Poor performances in two mobility tests , however , increased the risk of multiple falls more than poor performance in one test alone ( ORs = 3.66 , 95 % CI = 1.44 , 9.27 and 1.61 , 95 % CI = 0.62 , 4.16 respectively ) . CONCLUSIONS the mobility tests appear to be measuring a similar ' mobility ' construct . Based on feasibility and predictive validity , the AST , STS-5 and SMWTs were the best tests Background : With the increasing incidence of Alzheimer disease ( AD ) , determining the validity and reliability of outcome measures for people with this disease is necessary . Objective : The goals of this study were to assess test-retest reliability of data for the Timed “ Up & Go ” Test ( TUG ) , the  Six-Minute Walk Test  ( 6MWT ) , and gait speed and to calculate minimal detectable change ( MDC ) scores for each outcome measure . Performance differences between groups with mild to moderate AD and moderately severe to severe AD ( as determined by the Functional Assessment Staging [ FAST ] scale ) were studied . Design : This was a prospect i ve , nonexperimental , descriptive method ological study . Methods : Background data collected for 51 people with AD included : use of an assistive device , Mini-Mental Status Examination scores , and FAST scale scores . Each participant engaged in 2 test sessions , separated by a 30- to 60-minute rest period , which included 2 TUG trials , 1 6MWT trial , and 2 gait speed trials using a computerized gait assessment system . A specific cuing protocol was followed to achieve optimal performance during test sessions . Results : Test-retest reliability values for the TUG , the 6MWT , and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately ( intraclass correlation coefficients ≥.973 ) ; however , individual variability of performance also was high . Calculated MDC scores at the 90 % confidence interval were : TUG=4.09 seconds , 6MWT=33.5 m ( 110 ft ) , and gait speed=9.4 cm/s . The 2 groups were significantly different in performance of clinical tests , with the participants who were more cognitively impaired being more physically and functionally impaired . Limitations : A single research er for data collection limited sample numbers and prohibited blinding to dementia level . Conclusions : The TUG , the 6MWT , and gait speed are reliable outcome measures for use with people with AD , recognizing that individual variability of performance is high . Minimal detectable change scores at the 90 % confidence interval can be used to assess change in performance over time and the impact of treatment Background : The  ‘ timed up and go ’ test ( TUG ) is a simple , quick and widely used clinical performance-based measure of lower extremity function , mobility and fall risk . We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults . Objective : To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test ( BBT ) and the Dynamic Gait Index ( DGI ) . Methods : The  TUG , DGI and BBT  were assessed in 265 healthy older adults ( 76.4 ± 4.3 years ; 58.3 % women ) who participated in a 3-year prospect i ve study . The  Mini-Mental State Examination , digit span and verbal fluency measured cognitive function . The one- sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson ’s correlation coefficients quantified associations . Results : The mean scores of the BBT , DGI and TUG were : 54.0 ± 2.4 , 22.8 ± 1.5 , 9.5 ± 1.7 s , respectively . The BBT and the DGI were not normally distributed ( p < 0.001 ) , but the TUG was ( p = 0.713 ) . The TUG times were mildly associated ( p < 0.01 ) with digit span and verbal fluency and were related to future falls , while the BBT and the DGI were not . Conclusions : The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults . It does not suffer from ceiling effect limitations , is normally distributed and is apparently related to executive function . The BBT 
    Output:
    
agent
The analysis of our outcomes illustrates the similarities and differences between the identified tests
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Walk tests provide essential outcome information when assessing ambulation of individuals with lower-limb amputation and a prosthetic device . Existing tests have limitations such as ceiling effects or insufficient challenge . The objective of this study was to assess the reliability and validity of data for a clinical measure of basic mobility , the L Test of Functional Mobility  ( L Test ) . SUBJECTS For this method ological study , 93 people with unilateral amputations ( 74 % transtibial , 26 % transfemoral ; 78 % male , 22 % female ; mean age=55.9 years ) were consecutively recruited from an outpatient clinic . Twenty-seven subjects returned for retesting . METHODS To assess concurrent validity , subjects completed the L Test , Timed " Up & Go " Test ( TUG ) , 10-Meter Walk Test , and 2-Minute Walk Test , followed by the Activities-specific Balance Confidence scale , Frenchay Activities Index ( FAI ) , and mobility subscale of the Prosthetic Evaluation Question naire ( PEQ-MS ) . Amputation cause and level , walking aid use , automatic stepping , and age variables were used to assess discriminant validity . RESULTS Intraclass correlation coefficients were .96 for interrater reliability and .97 for intrarater reliability , and minimal bias existed upon retesting . The magnitude of concurrent validity correlations ( r ) was very high between the L Test data and data for other walk tests and fair to moderate between the L Test data and data for self-report measures . The L Test discriminated between all groups as hypothesized . DISCUSSION AND CONCLUSION The L Test is a 20-m test of basic mobility skills that includes 2 transfers and 4 turns . It demonstrated excellent measurement properties in this study Background The newly developed Brief – Balance Evaluation System Test ( Brief-BESTest ) may be useful for measuring balance and predicting falls in individuals with Parkinson disease ( PD ) . Objectives The purpose s of this study were : ( 1 ) to describe the balance performance of those with PD using the Brief-BESTest , ( 2 ) to determine the relationships among the scores derived from the 3 versions of the BESTest ( ie , full BESTest , Mini-BESTest , and Brief-BESTest ) , and ( 3 ) to compare the accuracy of the Brief-BESTest with that of the Mini-BESTest and BESTest in identifying recurrent fallers among people with PD . Design This was a prospect i ve cohort study . Methods Eighty participants with PD completed a baseline balance assessment . All participants reported a fall history during the previous 6 months . Fall history was again collected 6 months ( n=51 ) and 12 months ( n=40 ) later . Results At baseline , participants had varying levels of balance impairment , and  Brief-BESTest scores were significantly correlated with  Mini-BESTest  ( r=.94 , P<.001 ) and  BESTest  ( r=.95 , P<.001 ) scores . Six-month retrospective fall prediction accuracy of the Brief-BESTest was moderately high ( area under the curve [AUC]=0.82 , sensitivity=0.76 , and specificity=0.84 ) . Prospect i ve fall prediction accuracy over 6 months was similarly accurate ( AUC=0.88 , sensitivity=0.71 , and specificity=0.87 ) , but was less sensitive over 12 months ( AUC=0.76 , sensitivity=0.53 , and specificity=0.93 ) . Limitations The sample included primarily individuals with mild to moderate PD . Also , there was a moderate dropout rate at 6 and 12 months . Conclusions All versions of the BESTest were reasonably accurate in identifying future recurrent fallers , especially during the 6 months following assessment . Clinicians can reasonably rely on the Brief-BESTest for predicting falls , particularly when time and equipment constraints are of concern Background Falling is a common problem in the fast-growing elderly population .  Multitasking or engaging in two or more activities at the same time is common in daily living . Objective To determine the usefulness of the  trail-walking test ( TWT ) for predicting a fall in community-dwelling elderly individuals . Methods This was a prospect i ve study in which the TWT was used to evaluate the risk of falling among a group of community-dwelling elderly individuals ( n = 171 ) with a mean age of 80.5 ± 5.6 years . The following tests were conducted :  TWT , trail-making test ( TMT ) , timed-up- and -go test ( TUG ) , functional reach ( FR ) test , one-leg st and ing ( OLS ) test , and 10-m walking time test . Test – retest reliability was assessed by repeating the TWT within 2 weeks of the first trial , and there was a 1-year follow-up . Stepwise logistic regression analysis was used to analyze whether the TWT , TMT , TUG , FR , OLS , or 10-m walking tests predicted falling . Results The test – retest reliability  of TWT was high ( intraclass correlation coefficient 0.945 , p < 0.001 ) . Fifty-nine participants ( 34.5 % ) had reported a fall during the year preceding the 1-year follow-up . The stepwise logistic regression analysis revealed that only the TWT was significantly related to falling ( odds ratio 1.160 , 95 % confidence interval 1.107–1.214 ; p < 0.001 ) . In total , 77.8 % of cases were correctly classified . Conclusion When reliability and validity were considered , the TWT was most useful test of those evaluated for assessing the risk of fall among our elderly cohort Over the ensuing seven months she had three more clinical relapses , each accompanied by reappearance in the stools of either the organism or its cytotoxin , or both . Each improvement after vancomycin ( eight to 14-daycourses ) was accompanied by disappearance of the organism . At one point she was given cholestyramine , but she was unable to tolerate it . Her illness was punctuated by malnutrition and episodes of heart failure . She was given no other antibiotics . After the sixth relapse maintenance treatment with oral vancomycin 125 mg eight-hourly was begun . With this regimen diarrhoea was controlled and stools over the next 10 weeks remained negative for C difficile and its cytotoxin . There was no adverse reaction to vancomycin throughout Background and Purpose — The modified Emory Functional Ambulation Profile ( mEFAP ) is an easily administered test that measures the time to ambulate through 5 common environmental terrains with or without an assistive device or manual assistance . The mEFAP was evaluated for its interrater reliability , test-retest reliability , concurrent validity , and sensitivity to change during outpatient rehabilitation for poststroke gait dysfunction . Methods — Twenty-six poststroke patients were followed up prospect ively in a rehabilitation day-treatment program . The  mEFAP , Berg Balance Test ( BBT ) , and 7-item mobility subsection of the Functional Independence Measure + Functional Assessment Measure ( FAMm ) were completed at admission and discharge . Results — mEFAP interrater reliability ( intraclass coefficient [ ICC ] 0.999 ) and test-retest reliability ( ICC 0.998 ) were high . The BBT demonstrated high interrater ( ICC 0.992 ) but poor test-retest ( ICC 0.605 ) reliability . Initial and final scores comparing the mEFAP with the BBT ( r = −0.735 , r = −0.703 ) and the mEFAP with the FAMm ( r = 0.685 , r = −0.775 ) were strongly correlated . Improvement on the mEFAP correlated with improved BBT performance ( r = −0.524 ) . There was no correlation between overall change observed on the FAMm and change on the mEFAP ( r = −0.145 ) . Total mEFAP and all mEFAP subtask scores improved over time ( P < 0.0001 ) . Conclusions — The mEFAP is a reliable gait- assessment tool for patients with stroke and is sensitive to change in ambulation speed BACKGROUND numerous tests have been suggested as fall risk indicators . However , the validity of these assessment s has not been demonstrated in large representative sample s of community-dwelling older people . OBJECTIVE the objective of this study was to examine the comparative ability and clinical utility of eight mobility tests for predicting multiple falls in older community-dwelling people . METHODS design -- prospect i ve cohort study ; subjects--362 subjects aged 74 - 98 years ; measurements --the sit-to-st and test with one and five repetitions , the pick-up-weight test , the half-turn test , the alternate-step test ( AST ) , the six-metre-walk test ( SMWT )  and  stair ascent and descent tasks . Falls were monitored for 1 year with fall calendars . RESULTS in the 12-month follow-up period , 80 subjects ( 22.1 % ) suffered two or more falls . Multiple fallers performed significantly worse than non-multiple fallers in the sit-to-st and test with five repetitions ( STS-5 ) , the AST , the  half-turn test  , the  SMWT  and the stair-descent test .  When dichotomised using cut-off points from receiver-operated characteristics ( ROC ) curve analyses , these tests demonstrated reasonable sensitivity and specificity in identifying multiple fallers . A principal components analysis identified only one factor underlying the mobility tests . Poor performances in two mobility tests , however , increased the risk of multiple falls more than poor performance in one test alone ( ORs = 3.66 , 95 % CI = 1.44 , 9.27 and 1.61 , 95 % CI = 0.62 , 4.16 respectively ) . CONCLUSIONS the mobility tests appear to be measuring a similar ' mobility ' construct . Based on feasibility and predictive validity , the AST , STS-5 and SMWTs were the best tests Background : With the increasing incidence of Alzheimer disease ( AD ) , determining the validity and reliability of outcome measures for people with this disease is necessary . Objective : The goals of this study were to assess test-retest reliability of data for the Timed “ Up & Go ” Test ( TUG ) , the  Six-Minute Walk Test  ( 6MWT ) , and gait speed and to calculate minimal detectable change ( MDC ) scores for each outcome measure . Performance differences between groups with mild to moderate AD and moderately severe to severe AD ( as determined by the Functional Assessment Staging [ FAST ] scale ) were studied . Design : This was a prospect i ve , nonexperimental , descriptive method ological study . Methods : Background data collected for 51 people with AD included : use of an assistive device , Mini-Mental Status Examination scores , and FAST scale scores . Each participant engaged in 2 test sessions , separated by a 30- to 60-minute rest period , which included 2 TUG trials , 1 6MWT trial , and 2 gait speed trials using a computerized gait assessment system . A specific cuing protocol was followed to achieve optimal performance during test sessions . Results : Test-retest reliability values for the TUG , the 6MWT , and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately ( intraclass correlation coefficients ≥.973 ) ; however , individual variability of performance also was high . Calculated MDC scores at the 90 % confidence interval were : TUG=4.09 seconds , 6MWT=33.5 m ( 110 ft ) , and gait speed=9.4 cm/s . The 2 groups were significantly different in performance of clinical tests , with the participants who were more cognitively impaired being more physically and functionally impaired . Limitations : A single research er for data collection limited sample numbers and prohibited blinding to dementia level . Conclusions : The TUG , the 6MWT , and gait speed are reliable outcome measures for use with people with AD , recognizing that individual variability of performance is high . Minimal detectable change scores at the 90 % confidence interval can be used to assess change in performance over time and the impact of treatment Background : The  ‘ timed up and go ’ test ( TUG ) is a simple , quick and widely used clinical performance-based measure of lower extremity function , mobility and fall risk . We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults . Objective : To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test ( BBT ) and the Dynamic Gait Index ( DGI ) . Methods : The  TUG , DGI and BBT  were assessed in 265 healthy older adults ( 76.4 ± 4.3 years ; 58.3 % women ) who participated in a 3-year prospect i ve study . The  Mini-Mental State Examination , digit span and verbal fluency measured cognitive function . The one- sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson ’s correlation coefficients quantified associations . Results : The mean scores of the BBT , DGI and TUG were : 54.0 ± 2.4 , 22.8 ± 1.5 , 9.5 ± 1.7 s , respectively . The BBT and the DGI were not normally distributed ( p < 0.001 ) , but the TUG was ( p = 0.713 ) . The TUG times were mildly associated ( p < 0.01 ) with digit span and verbal fluency and were related to future falls , while the BBT and the DGI were not . Conclusions : The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults . It does not suffer from ceiling effect limitations , is normally distributed and is apparently related to executive function . The BBT 
    Output:
    