The analysis of our outcomes illustrates the similarities and differences between the identified tests
Assessment s of gait , balance , and transfer in elderly people play a valuable role in maintaining healthy aging and preventing a decline in mobility .
Several evaluation tools have been proposed ; however , clinicians should select the most accurate ones wisely , based on numerous criteria .
This systematic review aims to identify all applicable elderly mobility assessment tests and show their measurement properties with as much detail as possible .
Clinimetric properties of the performance-oriented mobility assessment.
BACKGROUND AND PURPOSE The Performance-Oriented Mobility Assessment ( POMA ) is a widely used instrument that provides an evaluation of balance and gait . It is used clinical ly to determine the mobility status of older adults or to evaluate changes over time . To support the use of the POMA for these purpose s , the clinimetric properties ( in particular , responsiveness ) were determined . SUBJECTS Participants ( 78 % female ; mean age=84.9 years ) were living in either self-care or nursing-care residences .  Concurrent and discriminant validity were assessed with the total group ( N=245 ) , whereas reliability and responsiveness were determined with a sub sample ( n=30 ) . Fall-related predictive validity was assessed with a sub sample of 72 participants . METHODS In addition to the POMA , several reference performance tests were administered . The POMA was assessed on 2 consecutive days by 2 raters ( observers ) . The analyses included the calculation of Spearman rank correlation coefficients ( R ) , limits of agreement ( LOA ) with Bl and -Altman plots , minimal detectable changes at the 95 % confidence level ( MDC(95 ) ) , and sensitivity and specificity with regard to predicting falls . When possible , findings for the total scale ( POMA-T ) were complemented by findings for its balance subscale ( POMA-B ) and its gait subscale ( POMA-G ) . RESULTS The interrater and test-retest reliability for the POMA-T and the POMA-B were good ( R=.74-.93 ) , whereas for the POMA-G , the reliability values , although high as well , were systematic ally slightly lower ( R=.72-.89 ) . The Spearman correlations with the reference performance tests ( R=|.64|- |.68| ) indicated satisfactory concurrent validity for the POMA-T and the POMA-B , but the corresponding findings for the POMA-G ( R=|.52|- |.56| ) were less convincing . The discriminant validity values of the 3 scales were about the same . The LOA for the POMA-T were on the order of -4.0 to 4.0 for test-retest agreement and -3.0 to 3.0 for interrater agreement . On the basis of the MDC(95 ) values , it was concluded that changes in POMA-T scores at the individual level should be at least 5 points and that those at the group level ( n=30 ) should be at least 0.8 point to be considered reliable . Even when optimal cutoff points were used , sensitivity and specificity values ( varying between 62.5 % and 66.1 % ) for the POMA-T as well as for its 2 subscales indicated poor accuracy in predicting falls . DISCUSSION AND CONCLUSION The POMA-T and its subscale POMA-B have adequate reliability and validity for assessing mobility in older adults . The POMA-T is useful for demonstrating intervention effects at the group level . Changes within subjects , however , should be at least 5 points before being interpreted as reliable changes . The accuracy of the POMA-T in predicting falls is poor
The analysis of our outcomes illustrates the similarities and differences between the identified tests
Assessment s of gait , balance , and transfer in elderly people play a valuable role in maintaining healthy aging and preventing a decline in mobility .
Several evaluation tools have been proposed ; however , clinicians should select the most accurate ones wisely , based on numerous criteria .
This systematic review aims to identify all applicable elderly mobility assessment tests and show their measurement properties with as much detail as possible .