Objective: To investigate the inter-rater reliability and validity of the Swedish version of the Modified Elderly Mobility Scale (Swe M-EMS).
Design: A correlation study.
Setting: A stroke unit which provides acute care and rehabilitation for all stroke admissions in Northern Alvsborg County Hospital, Sweden.
Subjects: Thirty consecutive patients with an acute first-time stroke. Seventeen were women and 13 were men, with a median age of 79 years (41-92) and with a median hospital stay of 21 days (8-35).
Intervention: The patients were assessed twice with the Swe M-EMS on admission and at discharge, before and after midday, by two independent physiotherapists. They were assessed by an independent physiotherapist using the three evaluation instruments on admission, once a week during their hospital stay and at discharge.
Main outcome measures: The primary evaluation instrument was the Swe M-EMS. The two other evaluation instruments were the Modified Motor Assessment Scale of Uppsala Akademiska Sjukhus-95 (M-MAS UAS-95) and the Berg Balance Scale (BBS).
Results: The Swe M-EMS was a reliable instrument (ICC 0.98-0.99). It correlated well with both the M-MAS UAS-95 (rs=0.69-0.88) and the BBS (rs=0.86-0.94). The Swe M-EMS was sensitive to change over time, but the patients obtained the maximum score quickly.
Conclusion: The instrument shows a high inter-rater reliability. The Swe M-EMS correlates well with both the M-MAS UAS-95 and the BBS and is sensitive to change. However, it is not sensitive enough to use as a single instrument in evaluating the improvement of a patient with acute stroke.
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References
1.
Socialstyrelsen (Swedish Board of Health and Welfare). Nationella riktlinjer för strokesjukva°rd. Version för hälso- och sjukva°rdspersonal. Modin Tryck, 2000 (in Swedish).
2.
Wang C-H, Hsieh C-L, Dai M-H, Chen C-H, Lai Y-F. Inter-rater reliability and validity of the stroke rehabilitation assessment of movement (stream) instrument. J Rehabil Med2002; 34: 20-24.
3.
Gibbon M. Measuring stroke recovery. Nurs Times1991; 87: 32-34.
4.
Loewen S, Anderson B. Predictors of stroke outcome using objective measurement scales. Stroke1990; 21: 78-81.
5.
Langton Hewer R. Assessment of stroke. Scand J Rehabil Med1992; suppl 26: 91-96.
6.
Barkelius K, Johansson A, Kõrm K, Lindmark B. Reliabilitetsoch validitetsprövning av modifierad Motor Assessment Scale enligt Uppsala Akademiska sjukhus-95. Nordisk Fysioterapi1997; 1: 121-126.(in Swedish).
7.
Collin C, Wade D. Assessing motor impairment after stroke: a pilot reliability study. J Neurol Neurosurg Psychiatry1990; 53: 576-597.
8.
Lindmark B, Hamrin E. Evaluation of functional capacity after stroke as a basis for active intervention. Scand J Rehabil Med1988; 20: 175-180.
9.
Berg K, Wood-Dauphinee S, Williams JI. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med1995; 27: 27-36.
10.
Podsiadlo D, Richardson S. The Timed ‘Up & gO’: A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc1991; 39: 142-148.
11.
Squires A, Hastings M. Rehabilitation of older people. A handbook for the multidisciplinary team. Chapman and Hall, 2002.
12.
Smith R. Validation and reliability of the Elderly Mobility Scale. Physiotherapy1994; 80: 744-747.
13.
Prosser L, Canby A. Further validation of the Elderly Mobility Scale for measurement of mobility of hospitalized elderly people. Clin Rehabil1997; 11: 338-343.
14.
Spilg EG, Martin B, Mitchell S, Aitchinson T. A comparison of mobility assessments in a geriatric day hospital. Clin Rehabil2001; 15: 296-300.
15.
Asplin G. Inter-rater reliability of the Swedish version of the modified Elderly Mobility Scale(Swe M-EMS). Research thesis in physiotherapy, advanced level 1 (C), 10 credits. Sahlgrenska Academy at Göteborg University, Autumn 2002; 1-23.
16.
Duncan P, Weiner D, Chandler J, Studenski S. Functional Reach: a new clinical measure of balance. J Gerontol 1990; 45: 192-197.
17.
Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health1992; 83: suppl (2): S7-S11.
18.
Carr J, Shepherd R. Neurological rehabilitation. Optimizing motor performance. Butterworth-Heinemann, 1998.
19.
Davies P. Steps to follow. Springer-Verlag, 1985.
20.
Friedman P. Gait recovery after hemiplegic stroke. Int Disabil Stud1990; 12: 119-122.
21.
Salbach NM, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards C. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil2001; 82: 1204-1212.
22.
Simpson JM, Valentine J, Worsfold C. The Standardized Three-metre Walking Test for elderly people (WALK3m): repeatability and real change. Clin Rehabil2002; 16: 843-850.
23.
Duncan PW, Studenski S, Chandler J, Prescott B. Functional Reach: Predictive Validity in a Sample of Elderly Male Veterans. J Gerontol1992; 47: M93-M98.
