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Clinimetric properties of the performance-oriented mobility assessment.
Marjan J Faber1, Ruud J Bosscher, Piet C W van Wieringen
1Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, PO Box 9101, 117 KWAZO, 6500 HB Nijmegen, the Netherlands. m.faber@kwazo.umcn.nl
Physical Therapy
|July 4, 2006
Summary
The Performance-Oriented Mobility Assessment (POMA) shows good reliability and validity for assessing older adult mobility. However, its accuracy in predicting falls is poor, and individual score changes need to be at least 5 points to be considered reliable.
Area of Science:
- Gerontology
- Rehabilitation Science
- Clinical Biomechanics
Background:
- The Performance-Oriented Mobility Assessment (POMA) is a standard tool for evaluating balance and gait in older adults.
- Its clinical utility relies on robust clinimetric properties, particularly responsiveness to change.
- Understanding the POMA's psychometric performance is crucial for accurate mobility assessment and intervention evaluation.
Purpose of the Study:
- To determine the clinimetric properties, specifically reliability, validity, and responsiveness, of the POMA.
- To assess the POMA's ability to detect meaningful changes in mobility in older adults.
- To evaluate the POMA's predictive validity for falls in elderly populations.
Main Methods:
- The study involved 245 older adults (78% female, mean age 84.9 years) residing in care facilities.
- Reliability and responsiveness were assessed in a subsample (n=30) using test-retest and interrater assessments.
- Validity was evaluated against reference tests, and fall prediction was assessed using sensitivity and specificity analyses.
Main Results:
- The POMA-T and POMA-B demonstrated good interrater and test-retest reliability (R=.74-.93).
- Satisfactory concurrent validity was found for POMA-T and POMA-B (R=|.64|- |.68|), but gait subscale (POMA-G) validity was less convincing (R=|.52|- |.56|).
- Minimal detectable change for reliable individual score changes in POMA-T was 5 points; fall prediction accuracy was poor (62.5%-66.1%).
Conclusions:
- The POMA-T and POMA-B possess adequate reliability and validity for assessing older adult mobility.
- The POMA-T is suitable for demonstrating intervention effects at a group level.
- Clinicians should interpret individual POMA-T score changes of less than 5 points cautiously, and its fall prediction capability is limited.