However, we are questioning if these tools measure the same construct as the EMS. Because of validity issues, the EMS has been tested for its correlation to Barthel Index for Activities of Daily Living, Functional Independent Measure (FIM), and Modified Rivermead Mobility Index (MRMI) which have been validated for use with geriatric and stroke patients (Nolan, Remilton, & Green, 2008 Prosser & Canby, 1997 Smith, 1994). Studies have been critical of the EMS because of the observed ceiling effect however, these studies measured physical function in healthy community-dwelling older adults and not in acute hospital settings (Davenport, Paynter, & de Morton, 2008 Soh, Stuart, Raymond, Kimmel, & Holland, 2018). However, a review of the literature indicated that none of the studies has presented comprehensive data on the analysis of test–retest reliability, which would facilitate the assessment of absolute reliability, as calculated by the standard error of measurement (SEM) and minimal detectable change (MDC) (Prosser & Canby, 1997 Smith, 1994 Spilg, Martin, Mitchell, & Aitchison, 2001, 2003). Previous studies have shown that the EMS has high inter- and intra-rater reliability. The Elderly Mobility Scale (EMS) has been considered a suitable tool for assessing basic physical function in hospitalised geriatric patients (Smith, 1994). However, a clear recommendation for appropriate assessment tools for hospitalised geriatric patients is not yet available (de Morton, Berlowitz, & Keating, 2008 Smith, 1994). The assessment tools need to be appropriate for the patient population, must be easy to administer, and provide a realistic picture of the patient's functional capacity and independence level (Beyer, Magnusson, & Thorborg, 2012). From the perspective of the physical therapist, valid and reliable assessment tools are needed for evaluating and predicting physical function during hospitalisation. In CGA, an investigation of physical function is essential because decline in physical function is a hallmark of frailty in geriatric individuals (Ellis et al., 2017). ![]() The comprehensive geriatric assessment (CGA) is a multidimensional diagnostic and therapeutic process that focuses on determining frail older individuals' medical, functional, mental and social capabilities and limitations (Ellis et al., 2017). In Norway, 50% of the hospitalisations constitute older people over 70 years, and 50% of these are admitted because of acute decline in physical function (Ramm, 2012). Older geriatric adults are admitted to the hospital more often, have longer hospital stays and higher readmission rates than younger adults (Ramm, 2012). In 2012, people aged 60 and older were almost 11.5% of the total global population of 7 billion, and by 2050, the proportion is projected to nearly double (HelpAge International, 2012). EMS can safely be used as an assessment tool for hospitalised geriatric patients. DiscussionĮMS-N exhibited good internal consistency and good to very good test–retest reliability and criterion validity. The rho value was estimated as 0.75, which corresponds to a high correlation and indicated good criterion validity. Criterion validity was calculated by a correlation analysis of the EMS-N and the SPPB. The minimal detectable change (MDC) was calculated with 95 and 90% confidence intervals at 1.44 and 1.21, respectively. The standard error of measurement (SEM) reflected the absolute reliability, calculated at 0.52. Test–retest reliability: six of the seven EMS-N items showed very good consistency, and the last item showed good consistency, ICC was estimated at 0.99. Internal consistency was estimated at 0.88. The main admission diagnoses were acute functional decline (64%, n = 32) or acute infection (26%, n = 13). The mean age of participants was 82 (range 65–95). Test–retest reliability was estimated by linear weighted kappa and the intra-class correlation coefficient (ICC). Internal consistency was measured by Cronbach's alpha. EMS-N was tested for internal consistency, test–retest reliability and criterion validity by using the short physical performance battery (SPPB) as the gold standard. The original version of the Elderly Mobility Scale (EMS) was translated from English to Norwegian before initiating this study. ![]() The inclusion criteria were acute hospital admission because of medical issues, age ≥65 years and referred to a physiotherapist for a physical function review. Methodsįifty patients admitted to a medical ward in a hospital in Norway were included. ![]() The purpose of this study was to determine the reliability and validity of the Norwegian-language version of the Elderly Mobility Scale (EMS-N) for use with geriatric patients. Reliable and valid assessment tools are needed to evaluate and predict physical function in older hospitalised patients.
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