| dc.description.abstract | ABSTRACT
Aim: A high proportion of hospitalized patients experience limitations in mobility. To identify a loss in
mobility, it is important to use an objective, standardized and valid measurement tool. The Activity
Measure for Post-Acute Care ‘6-clicks’ Basic Mobility (AM-PAC BM) is an easy-to-use, quick English
measuring tool and has been found valid and reliable in a hospital population. Therefore, the study
aims were: (1) to translate the AM-PAC BM to Dutch, and (2) to determine the construct validity and
(3) inter-rater reliability in patients hospitalized in a Dutch medical center.
Methods: First, the AM-PAC BM was translated from English to Dutch by using a backward-forward
translation protocol. Secondly, to determine the validity physiotherapists assessed patients admitted
to the internal medicine wards to test six hypotheses regarding the construct ‘mobility’. Thirdly, to
determine the inter-rater reliability, pairs of physiotherapists independently scored hospitalized
patients using the Dutch AM-PAC BM.
Results: Five of the six hypotheses (83.33%) were confirmed. Better mobility scores as measured with
the AM-PAC BM relate to less restrictive pre-admission living situations (p=0.011), less restrictive
discharge locations (p=0.001), more independence in activities of daily living (p=0.001), and less
physiotherapy visits (p=0.000). There is a correlation between a patient’s AM-PAC BM score and length
of stay (r=-0.408, p=0.001), but not between the patient’s AM-PAC BM and age (r=-0.180, p=0.528).
Three Intraclass Correlation Coefficients were found between 0.919 (95% CI: 0.862-0.953) to 0.920
(95% CI: 0.828 – 0.964). The Kappa Coefficients for the individual items ranged between 0.649 (walking
stairs) to 0.841 (sit to stand).
Conclusion: This study provides evidence for the construct validity of the Dutch AM-PAC BM when
physiotherapists use it to assess the mobility of hospitalized patients, and also demonstrates a
moderate to excellent inter-rater reliability.
Clinical Relevance Not only does the newly translated AM-PAC BM offer the Dutch physiotherapist an
easy way to measure the mobility more validly, it also offers the Dutch physiotherapists a way to
improve the validity of their clinical recommendations regarding post-acute care and discharge
planning. | |
