Clinimetric Evaluation of the Physical Mobility Scale Supports Clinicians and Researchers in Residential Aged Care

Anna L. Barker, Jennifer C. Nitz, Nancy L. Low Choy, Terry P. Haines

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Abstract

Barker AL, Nitz JC, Low Choy NL, Haines TP. Clinimetric evaluation of the Physical Mobility Scale supports clinicians and researchers in residential aged care. Objective: To investigate the interrater agreement and the internal construct validity of the Physical Mobility Scale, a tool routinely used to assess mobility of people living in residential aged care. Design: Prospective, multicenter, external validation study. Setting: Nine residential aged care facilities in Australia. Participants: Residents (N=186). Phase 1 cohort (99 residents; mean age, 85.22±5.1y); phase 2 cohort (87 residents; mean age, 81.59±10.69y). Interventions: Not applicable. Main Outcome Measures: Kappa statistics, minimal detectable change (MDC90) scores, and Bland-Altman plots were used to assess interrater agreement. Scale unidimensionality, item hierarchy, and person separation were examined with Rasch analysis for both cohorts. Results: Agreement between raters on 6 of the 9 Physical Mobility Scale items was high (κ>.60). The MDC90 value was 4.39 points, and no systematic differences in scores between raters were found. The Physical Mobility Scale showed a unidimensional structure demonstrated by fit to the Rasch model in both cohorts (phase 1: χ2=23.90, P=.16, person separation index=0.96; phase 2: χ2=22.00, P=.23, person separation index=0.96). Standing balance was the most difficult item in both cohorts (phase 1: logit=2.48, SE, 0.16; phase 2: logit=2.53, SE, 0.15). The person-item threshold map indicated no floor or ceiling effects in either cohort. Conclusions: The Physical Mobility Scale demonstrated good interrater agreement and internal construct validity with good fit to the Rasch model in both cohorts. The comparative results across the 2 cohorts indicate generality of the findings. The Physical Mobility Scale total raw scores can be converted to Rasch transformed scores, providing an interval measure of mobility. The Physical Mobility Scale may be suited to a range of clinical and research applications in residential aged care.

Original languageEnglish
Pages (from-to)2140-2145
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume89
Issue number11
DOIs
Publication statusPublished - Nov 2008

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Barker, Anna L. ; Nitz, Jennifer C. ; Low Choy, Nancy L. ; Haines, Terry P. / Clinimetric Evaluation of the Physical Mobility Scale Supports Clinicians and Researchers in Residential Aged Care. In: Archives of Physical Medicine and Rehabilitation. 2008 ; Vol. 89, No. 11. pp. 2140-2145.
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title = "Clinimetric Evaluation of the Physical Mobility Scale Supports Clinicians and Researchers in Residential Aged Care",
abstract = "Barker AL, Nitz JC, Low Choy NL, Haines TP. Clinimetric evaluation of the Physical Mobility Scale supports clinicians and researchers in residential aged care. Objective: To investigate the interrater agreement and the internal construct validity of the Physical Mobility Scale, a tool routinely used to assess mobility of people living in residential aged care. Design: Prospective, multicenter, external validation study. Setting: Nine residential aged care facilities in Australia. Participants: Residents (N=186). Phase 1 cohort (99 residents; mean age, 85.22±5.1y); phase 2 cohort (87 residents; mean age, 81.59±10.69y). Interventions: Not applicable. Main Outcome Measures: Kappa statistics, minimal detectable change (MDC90) scores, and Bland-Altman plots were used to assess interrater agreement. Scale unidimensionality, item hierarchy, and person separation were examined with Rasch analysis for both cohorts. Results: Agreement between raters on 6 of the 9 Physical Mobility Scale items was high (κ>.60). The MDC90 value was 4.39 points, and no systematic differences in scores between raters were found. The Physical Mobility Scale showed a unidimensional structure demonstrated by fit to the Rasch model in both cohorts (phase 1: χ2=23.90, P=.16, person separation index=0.96; phase 2: χ2=22.00, P=.23, person separation index=0.96). Standing balance was the most difficult item in both cohorts (phase 1: logit=2.48, SE, 0.16; phase 2: logit=2.53, SE, 0.15). The person-item threshold map indicated no floor or ceiling effects in either cohort. Conclusions: The Physical Mobility Scale demonstrated good interrater agreement and internal construct validity with good fit to the Rasch model in both cohorts. The comparative results across the 2 cohorts indicate generality of the findings. The Physical Mobility Scale total raw scores can be converted to Rasch transformed scores, providing an interval measure of mobility. The Physical Mobility Scale may be suited to a range of clinical and research applications in residential aged care.",
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Clinimetric Evaluation of the Physical Mobility Scale Supports Clinicians and Researchers in Residential Aged Care. / Barker, Anna L.; Nitz, Jennifer C.; Low Choy, Nancy L.; Haines, Terry P.

In: Archives of Physical Medicine and Rehabilitation, Vol. 89, No. 11, 11.2008, p. 2140-2145.

Research output: Contribution to journalArticleResearchpeer-review

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AB - Barker AL, Nitz JC, Low Choy NL, Haines TP. Clinimetric evaluation of the Physical Mobility Scale supports clinicians and researchers in residential aged care. Objective: To investigate the interrater agreement and the internal construct validity of the Physical Mobility Scale, a tool routinely used to assess mobility of people living in residential aged care. Design: Prospective, multicenter, external validation study. Setting: Nine residential aged care facilities in Australia. Participants: Residents (N=186). Phase 1 cohort (99 residents; mean age, 85.22±5.1y); phase 2 cohort (87 residents; mean age, 81.59±10.69y). Interventions: Not applicable. Main Outcome Measures: Kappa statistics, minimal detectable change (MDC90) scores, and Bland-Altman plots were used to assess interrater agreement. Scale unidimensionality, item hierarchy, and person separation were examined with Rasch analysis for both cohorts. Results: Agreement between raters on 6 of the 9 Physical Mobility Scale items was high (κ>.60). The MDC90 value was 4.39 points, and no systematic differences in scores between raters were found. The Physical Mobility Scale showed a unidimensional structure demonstrated by fit to the Rasch model in both cohorts (phase 1: χ2=23.90, P=.16, person separation index=0.96; phase 2: χ2=22.00, P=.23, person separation index=0.96). Standing balance was the most difficult item in both cohorts (phase 1: logit=2.48, SE, 0.16; phase 2: logit=2.53, SE, 0.15). The person-item threshold map indicated no floor or ceiling effects in either cohort. Conclusions: The Physical Mobility Scale demonstrated good interrater agreement and internal construct validity with good fit to the Rasch model in both cohorts. The comparative results across the 2 cohorts indicate generality of the findings. The Physical Mobility Scale total raw scores can be converted to Rasch transformed scores, providing an interval measure of mobility. The Physical Mobility Scale may be suited to a range of clinical and research applications in residential aged care.

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