Psychometric properties of the Cumulated Ambulation Score French translation

Abstract

Objective: To examine measurement properties (inter-rater reliability, agreement, validity, and responsiveness) of the Cumulated Ambulation Score French translation in patients with hip fracture. Design: Methodological study. Setting: A 20-bed orthopedic unit and 20-bed geriatric unit. Subjects: About 140 consecutive patients with a mean (SD) age of 83 (12) years. Interventions: The English version of the Cumulated Ambulation Score used to evaluate basic mobility was translated into French following international guidelines. Two raters independently assessed all patients on postoperative days one, two, three, and 30 after a hip fracture surgery. Relative and absolute inter-rater reliability and responsiveness (effect size for improvement from postoperative day two to 30) were evaluated. Convergent validity was analyzed by Spearman’s correlation coefficient comparing the Cumulated Ambulation Score with two other measures on postoperative day two and 30. Main measure: Cumulated Ambulation Score. Results: The weighted Kappa value ranged from 0.89 to 1.0. The standard error of measurement and the smallest real difference of the Cumulated Ambulation Score ranged, respectively, from 0.12 to 0.23 and from 0.32 to 0.6 points, while the effect size reached 1.03 (95% CI 0.87–1.26). There was a strong positive correlation comparing the Cumulated Ambulation Score with the French Tinetti Assessment Tool ( r ⩾ 0.83) and the French Mini Motor Test ( r ⩾ 0.79). Conclusions: Our findings indicate that the Cumulated Ambulation Score’s French version is a reliable and valid tool to assess patients’ basic mobility with hip fractures.

Validity, Responsiveness, and Predictive Ability of the Japanese Version of the Cumulated Ambulation Score in Patients with Hip Fracture

“…The CAS-JP effect size in the present study was large at all time points and was even higher than that previously reported by Hulsbaek et al 19) They also reported a large CAS effect size (1.04) when used from POD1 to the time of discharge (mean length of stay: 8 days) in a Danish setting. The ef- fect sizes on POD14 and discharge in the current study were higher than those reported in previous studies, 19,28) which may be explained by greater mobility recovery with the longer follow-up period in the current study. The MCID of the CAS-JP in this study ranged from 0.51 to 0.69 CAS points, which is similar to the MCID of 0.8 reported in a previous study.…”

“…Previous studies have reported correlation coefficients be- tween CAS and BI of 0.33-0.60 19,24,27) and between CAS and other mobility outcomes of 0.56-0.90 19,24,28,30) ; the CAS-JP in this study showed the same or higher associations. However, there was a weaker correlation between CAS-JP and BI on POD1, a finding that corresponds to those of a previous study.…”

“…15) The CAS was developed in Denmark to evaluate mobility function after hip fracture surgery 16) and is used as a functional outcome not only in patients with hip fracture [17][18][19] but also in patients after total knee arthroplasty 20,21) or with various diseases. [22][23][24] The CAS has been translated into more than ten languages, including English, 25) Spanish, 26) Turkish, 27) and French, 28) and is recorded in the nationwide Danish Multidisciplinary Hip Fracture Registry 17,29) and the Irish Hip Fracture Database. 13) The CAS is a simple evaluation of three basic mobility activities on a three-point score, and many studies have reported its reliability, validity, responsiveness, and predictive ability for prognosis.…”

The relationship between extent of mobilisation within the first postoperative day and 30-day mortality after hip fracture surgery

“…14 At present, the CAS manual and score sheet is freely available in 18 languages. The CAS has established reliability 13,[15][16][17][18][19] and proven valid in reflecting the early post-hip fracture mobility outcome, [20][21][22] and as a strong predictor of outcome for patients after hip fracture. 14,23 The dependent variable was a binary indicator of 30-day postoperative mortality as recorded by the multidisciplinary Danish national hip fracture register.…”

No Benefit of Adductor Canal Block Compared with Anterior Local Infiltration Analgesia in Primary Total Knee Arthroplasty

“…Pain while resting, standing, and walking was assessed using an 11-point numeric rating scale (0 = no pain to 10 = maximal pain) by nurses and physiotherapists who were blinded with respect to the intervention. Functional capacity and rehabilitation were assessed daily using the Cumulated Ambulation Score (CAS) 18,19 by physiotherapists. This includes 3 activities-getting in and out of bed, sitting down in and standing up from a chair, and walking ability-rated on a 3-point scale (0 = "not able to" to 2 = "independent").…”