60 | Chapter 4 to be correlated, functional status could not only be determined with the SPPB in a clinical setting, but could also be monitored remotely using sensor-based daily life gait quality and quantity. We hypothesized moderate to strong correlations between the SPPB and daily-life gait quality and quantity (183, 193). METHODS Study design and setting This observational cross-sectional study included 229 community-dwelling adults of 65 years or older. Data were collected between August 2021 and January 2023 as baseline data within a randomized controlled trial that aimed to investigate the (cost-)effectiveness of the ‘In Balance’ fall prevention program, which is described in more detail elsewhere (198). Ethical approval was obtained from the Medical Ethical Committee Brabant (project number P2055) on 10 February 2021. This study was conducted according to the principles of the Declaration of Helsinki (7th revision, October 2013) and Good Clinical Practice. All participants provided informed consent and were aware that participation is voluntary. Participants Recruitment was done via flyers, advertisements in local papers and via the network of the fall prevention program therapists participating in the randomized controlled trial. The participants had an increased risk of falls (i.e., two or more self-reported falls in the past 12 months, and/or having difficulties with moving, walking or balancing). All participants were able to independently execute basic activities of daily living (e.g. going to the bathroom and dress themselves) and walk 100 meters, with walking aid if needed. Older adults were included if they were classified as non-frail or pre-frail based on the phenotype concept by Fried and colleagues (29). Potential participants were excluded if they participated in a fall prevention intervention in the past 6 months, if they were unable to read and understand Dutch, if they had cognitive impairment, indicated by a score lower of 18 or lower on the Mini-Mental State Examination (199), or if they had any self-reported uncontrolled comorbid conditions or contraindications (e.g. cardiovascular, neurological and orthopaedic problems). Functional status SPPB outcomes The SPPB consists of three functional tests: Three Stage Balance Test, Four Meter Walk Test, and Five Times Sit to Stand test (183). The Three Stage Balance Test consists of standing in three progressively difficult postures for a maximum of ten seconds per posture. The postures are 1) feet side by side, 2) semi-tandem with one foot placed so that it touches the big toe
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