LAUSR

Background The Short Physical Performance Battery (SPPB) is a well-established functional assessment tool used for the screening and assessment of frailty and sarcopenia. However, the SPPB requires trained staff experienced in conducting the standardized protocol, which may limit its widespread use in clinical settings. The automated SPPB (eSPPB) was developed to address this potential barrier; however, its validity among frail older adults remains to be established. Therefore, this exploratory study examined the construct validity, reliability, and agreement of the eSPPB as compared to manual SPPB (mSPPB) in patients attending a tertiary fall clinic. Methods We studied 37 community-dwelling older adults (mean age=78.5±6.8 years; mean FRAIL score=1.2±1.0; 65% pre-frail) attending a tertiary falls clinic. The participants used the mSPPB and eSPPB simultaneously. We evaluated the convergent validity, discriminatory ability, reliability, and agreement using partial correlation adjusted for age and sex, an SPPB cutoff of ≤8 to denote sarcopenia, intraclass correlation coefficients (ICC), and Bland-Altman plots, respectively. Results The eSPPB showed strong correlations with the mSPPB (r=0.933, P <0.01) and Berg Balance Scale (r=0.869, P <0.01), good discriminatory ability for frailty and balance, and good to excellent reliability (ICC=0.94, 95% CI: 0.88-0.97). The Bland-Altman plots indicated good agreement with the mSPPB (mean difference= -0.2, 95% CI: -3.2-2.9) without evidence of systematic or proportional biases. Conclusion The results of our exploratory study corroborated the construct validity, reliability, and agreement of the eSPPB with the mSPPB in a small sample of predominantly pre-frail older adults with increased fall risk. Future studies should examine the scalability and feasibility of the widespread use of the eSPPB for frailty and sarcopenia assessment.