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Factors Related to Self-rated Health in Older Adults

A Clinical Approach Using the International Classification of Functioning, Disability, and Health (ICF) Model

Tiernan, Chad W., PhD1; Fleishman, Hali A., PT, DPT2; Hiscox, Meghann A., PT, DPT2; Shaver, Sarah N., PT, DPT2; Stauffer, Caitlyn M., PT, DPT2; Thibodeau, Patrick A. W., PT, DPT2

Journal of Geriatric Physical Therapy: April/June 2019 - Volume 42 - Issue 2 - p 86–97
doi: 10.1519/JPT.0000000000000130
Research Reports

Background and Purpose: A growing population of older adults will require health care professionals to become increasingly knowledgeable in geriatric care. Patient ratings, functional measures, and emphasis on health and wellness should be part of geriatric physical therapy practice. The purpose of the current study was to examine relationships between self-rated health (SRH) and movement-related variables in older adults using the International Classification of Functioning, Disability, and Health (ICF) as a research framework. Associations between body mass index (BMI), gait, and balance confidence were also explored.

Methods: Thirty older adults (mean age = 74.1 years; 18 women and 12 men) participated in the study and completed the following questionnaires: SRH, Short Activities-specific Balance Confidence scale, Keele Assessment of Participation, and the Neighborhood Environment Walkability Scale–Abbreviated. Spatiotemporal gait parameters, BMI, and isokinetic knee extensor strength were also assessed.

Results: Bivariate results indicated significant associations between SRH and double-support time during gait (rs = −0.6, P < .001), gait speed (rs = 0.4, P = .05), step length (rs = 0.4, P = .05), BMI (rs = −0.4, P = .015), and hilliness of neighborhood (rs = −0.4, P = .015). Individual regression models, controlling for education and age, demonstrated that double-support time was the strongest predictor of SRH (R2 = 0.50, P = .001). Comparisons of the low versus high BMI groups indicated more favorable balance confidence and gait characteristics for the low BMI group, particularly in double support (t = −3.8, P = .001).

Conclusions: SRH should be considered as a quick, patient-focused assessment of health in older adults. Measures of double-support time and BMI may provide clinicians with useful information about their geriatric patients' overall health and function.

1Physical Therapy Department, University of Michigan–Flint.

2School of Physical Therapy, Husson University, Bangor, Maine.

Address correspondence to: Chad W. Tiernan, PhD, Physical Therapy Department, University of Michigan–Flint, 2157 William S. White Bldg, 303 E. Kearsley St, Flint, MI 48502 (

The authors declare no conflicts of interest.

Kevin Chui was the Decision Editor.

© 2019 Academy of Geriatric Physical Therapy, APTA
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