Acceptability and utility of a broad test battery to evaluate physical functioning and frailty in community-based settings for people experiencing homelessness and addiction-Findings from the LEAP trials

Physiotherapy. 2024 Nov 7:126:101449. doi: 10.1016/j.physio.2024.101449. Online ahead of print.

Abstract

Background: Physical function deficits and frailty are commonly reported in people experiencing homelessness and addiction. Typically, geriatric, or general physical performance measures are employed to evaluate these constructs.

Objectives and setting: We aimed to investigate the feasibility of a broad test battery to evaluate physical functioning and frailty in a non-geriatric community-based population of people experiencing homelessness and addiction.

Design and methods: Physical function and the presence of frailty was evaluated using combined data from two linked low-threshold exercise pre-post intervention studies (LEAP-I and II).

Participants: Seventy-four participants attending an open-access day-service centre (18 to 65 years) were evaluated. Participants with acute confusion or behavioural issues, or major medical conditions precluding safe participation were excluded.

Intervention: A broad test battery was performed which evaluated physical functioning and frailty.

Main outcome measures: Outcome measures included were the Short Physical Performance Battery, Single Leg Stance, Chair Stand Test, 10mWT and 2 Minute Walk Tests, limb circumference, dynamometry, Clinical Frailty Scale, SHARE-Frailty Instrument, Numerical Pain Rating Scale and Short Form-12.

Results: Test completion was 100% for all outcomes except pain rating (81% and 79% for LEAP-I and II, respectively), and balance and walking tests (95% and 93% in LEAP-II). A ceiling effect was detected for the Short Physical Performance Battery.

Conclusion: High feasibility of the test batteries was demonstrated. An optimised test battery was proposed based on findings. This has important implications for clinicians working in inclusion health settings.

Clinical trial registration number: Clinical Trials.gov: NCT05700305. CONTRIBUTION OF THE PAPER.

Keywords: Addiction; Frailty; Homelessness; Outcome measures; Physical functioning.

Associated data

  • ClinicalTrials.gov/NCT05700305