Spanish Linguistic Validation, Validity and Reliability Test of Frail´BESTest in Elderly Institutionalized Frail People

6 balance systems are tested, with between 2-6 tests per balance system. The balance systems tested are: A: anticipations, B: reactions, C: locomotion, D: sensorial orientation, E: biomechanical constraints and F: gait symmetry. All tests or criteria are scored dichotomously, with 0 for negative results and 1 for positive results. The highest and best possible score for the Frail'BESTest is 26 and the lowest is 0.

A. Proactive motor control anticipatory maximum score is 5 and the minimum score is 0 (equivalent to 19%).

B. Reactive motor control - reactions - maximum score 2 and minimum score 0 (equivalent to 8%).

C. Locomotion and gait - maximum score 6 and minimum score 0 (equivalent to 23%) D. Static postural control maximum score 3 and minimum score 0 (equivalent to 12%).

E. Biomechanical restrictions maximum score is 6 and the minimum score is 0 (equivalent to 23%).

F. Gait symmetry maximum score is 4 and the minimum score is 0 (equivalent to 15%).

It is a battery that evaluates functional performance in three functional activities and measures the ability to: 1) maintain three different conditions of static balance for 10 seconds, 2) the time it takes to walk 4 meters and 3) stand up and sit down from a chair 5 consecutive times. Depending on the result, each of the activities is scored from 0 to 4 points, with the maximum possible score being 12 points.

The TUG test (Timed Up and go (TUG) measures the functional mobility of the lower limbs.

The patient sits on the chair and leans back against the back of the chair; the soles of the feet must be on the floor. On the command "Go"," the patient gets up from the chair (he is not restricted when getting up from the chair, he can use his upper extremities), walks 3 m at a fast, safe pace, turns around, goes back to the chair and sits down. The patient chooses the side on which the turn is to be performed. The timing starts with the instruction "Go" and ends when the patient is seated (buttocks touching the chair).

To calculate dual-task costs of naming on gait, two tests of gait are required. Test 1. Test of single gait at comfortable speed. A test of gait speed assesses an individual's functional mobility. Gait speed is calculated with the time taken to walk 10m distance on level surfaces at their comfortable speed over the entire distance. Examinees will be time once the first foot passes path line; the time is stopped once the first foot enters the 10m path line. Two trials are given. Analysis maximum speed obtained.

Test 2. Test of gait speed dual task assesses an individual's functional mobility while naming cities from the country patients belong (cognitive activity). The procedure to record time will be the same before. Gait speed will be calculated:

• Dual task gait speed (m·s-1) = 10m /Time taken to walk 10m naming cities
• Dual Task Cost of naming on Gait Speed (DTC-GS) will be calculated using the formula:
• DTC-GS [%] = 100 · (single-task value - dual-task value)/single-task value

Quantifies subjects' ability executing two tasks concurrently (naming and walking).

Test-1: The test of single cognitive task consists of naming towns for 30 seconds. The patient will be seated on a chair. The calculation of the number of towns correctly named per second will be recorded.

DT Number of towns per seg = number of towns /10m gait dual task (seg) Test-2. Test of gait speed dual task results. While the patient performs the test it will record the time taken to walk 10m distance on level surfaces and the number of cities in the country correctly named, repeated during the 10-meter march.

The calculation of the number of towns correctly named per second will be recorded Only one trial is given Dual task cost of gait on naming (DTC-N):

• Dual-task Number of cities per sec = correct number of cities /10m gait dual task (seg)
• Dual Task Cost of Gait on Naming (DTC-N) will be calculated:
• DTC-N [%] = 100 · (single-task value - dual-task value)/single-task value

The MiniBESTest was developed, and it is having been validated as a shorter version of the original BESTest to assess complementary systems that contribute to balance function. It aims to target and identify 6 different balance control systems so that specific rehabilitation approaches can be designed for different balance deficits. The tests include functional tasks involving several high-level exercises to assess the balance function, which may be even more difficult in case of frailty 1.1. TASKS Mini BESTest is a 14-item test scored on a 3-level ordinal scale (0-2) Total score = 32 points per test directions as we will specify use of both left and right data, thus calculating data based on 32. Assesses dynamic balance, a unidimensional construct and includes 14 items addressing 4 of the 6 sections of the original BESTest: I) Anticipatory postural adjustments II) Reactive postural control III) Sensory orientation IV) Dynamic gait.

The patient can use any assistive devices during the test. The test comprises two short sections that contain one examining static balance abilities in a chair and then standing, and the other gait. Total POMA consists of 16 items: 9 balance (POMA-B) and 7 gait (POMA-G) items. A 3-point ordinal scale, ranging from 0-2, where highest score indicates independence with each test item.

2.1. TASKS POMA has 2 sections 1) Assesses balance abilities in a chair and in standing position and 2) Assesses dynamic balance during gait. Total balance score is16 and gait 12; total Test score 28.

Balance Subscale The patient is to sit in an armless chair and will be asked to rise and stay standing. The patient will then turn 360° and then sit back down. This is to test the patients' balance.

At gait sub-scale the patient will have to walk a few meters at a normal speed, followed by turning and walking back at a "fast but safe" speed. The patient will then sit back down.

Falls are defined as an unexpected event in which the participants come to rest on the ground, floor, or lower level.

The number of falls, will be obtain from medical history records of nursing homes.

Deceases and time to patient's decease will be obtain from medical history records of nursing homes.

Subjects' ability for executing two tasks concurrently (counting backwards in threes while doing a mobility test named TUG. To calculate dual-task costs of counting backwards on TUG The test is conducted single (TUG) and dual tasking, counting backwards in three (TUG-3). Two trials will be record for each condition and the best them will use for further analysis.

Test-1-TUG. The patient sits with his/her back against the chair; the soles of feet must be on the ground. On the command "Go," the patient rises from the chair, walks at fast pace safe manner for 3m, turns, walks back to the chair and sits down.

Test-2-TUG-3. Records time needed to complete TUG test while counting backward by threes. Different starting numbers will be use for the counting tasks.

Dual Task Cost of counting backwards in threes on TUG (DTC-3-TUG) will be calculate using the formula:

DTC-3-TUG [%] = 100 · ((single-task value - dual-task value)/single-task value)).