Towards an instrument targeting mobility-related participation: Nordic cross-national reliability.

OBJECTIVE To investigate test-retest reliability and internal consistency of a new instrument for evaluation of mobility device interventions. MATERIAL AND METHODS The instrument comprised 4 scales and one summed index. Two test-retest interviews involved 147 mobility device users (mean age 60 years) with a broad range of functional limitations, living at home. RESULTS For 2 scales and the summed index the reliability was substantial or almost perfect (kappa 0.71/ kappaW 0.76/intraclass correlation coefficient = 0.93; confidence interval = 0.90-0.95). The reliability of one scale was moderate (kappaW 0.41), but after reduction of grades and combination with another scale, it was substantial (kappaW 0.66). The reliability of the fourth scale was moderate (kappaW 0.55). The internal consistency of 3 scales varied from alpha 0.63 to 0.76. CONCLUSION Even though the test-retest reliability of all but one of the scales of the new instrument was substantial to almost perfect, this study demonstrated that revision is required. The challenges identified were probably due to the highly complex relationship between outdoor participation while using mobility devices and accessibility to the outdoor physical environment. Thus, based on the results of this study the instrument will be revised and subsequently launched as the "Nordic mobility-related participation outcome evaluation of assistive device intervention" (NOMO instrument). More research on the concept of mobility-related participation and the psychometric qualities of the instrument is required.

[1]  J. Carlin,et al.  Bias, prevalence and kappa. , 1993, Journal of clinical epidemiology.

[2]  T Mills,et al.  Development and consumer validation of the Functional Evaluation in a Wheelchair (FEW) instrument , 2002, Disability and rehabilitation.

[3]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[4]  C. Vincent,et al.  The LIFE-H: Assessment of the quality of social participation , 2002 .

[5]  J J Bartko,et al.  ON THE METHODS AND THEORY OF RELIABILITY , 1976, The Journal of nervous and mental disease.

[6]  Črt Marinček Assistive technology - added value to the quality of life : AAATE'01 , 2001 .

[7]  G St-Michel,et al.  Social consequences of long term impairments and disabilities: conceptual approach and assessment of handicap , 1998, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[8]  Renzo Andrich,et al.  IPPA, a user-centred approach to assess effectiveness of assistive technology provision , 2001 .

[9]  A. Feinstein,et al.  High agreement but low kappa: I. The problems of two paradoxes. , 1990, Journal of clinical epidemiology.

[10]  Roger O. Smith,et al.  Assistive Technology in the Measurement of Rehabilitation and Health Outcomes: A Review and Analysis of Instruments , 2005, American journal of physical medicine & rehabilitation.

[11]  L. Rajmil Health measurement scales. A practical guide to their development and use, 3rd ed , 2005 .

[12]  Linamara Rizzo Battistella,et al.  Classificação Internacional de Funcionalidade (CIF) , 2002, Acta Fisiátrica.

[13]  A M Jette,et al.  How measurement techniques influence estimates of disability in older populations. , 1994, Social science & medicine.

[14]  G. Whiteneck,et al.  Quantifying handicap: a new measure of long-term rehabilitation outcomes. , 1992, Archives of physical medicine and rehabilitation.

[15]  Åse Brandt Outcomes of Rollator and Powered Wheelchair Interventions - User Satisfaction and Participation , 2005 .

[16]  P. Fayers,et al.  Quality of Life: Assessment, Analysis, and Interpretation , 2000 .

[17]  D. Streiner,et al.  Health Measurement Scales: A practical guide to thier development and use , 1989 .

[18]  C. Fox,et al.  Applying the Rasch Model: Fundamental Measurement in the Human Sciences , 2001 .

[19]  Jiro Okochi,et al.  Health and Quality of Life Outcomes , 2005 .

[20]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[21]  S. Laditka,et al.  Difficulty or Dependency? , 2001, Journal of health & social policy.

[22]  P. Prescott,et al.  Issues in the Use of Kappa to Estimate Reliability , 1986, Medical care.

[23]  L H Kraskowsky,et al.  Factors affecting older adults' use of adaptive equipment: review of the literature. , 2001, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[24]  Å. Brandt,et al.  Older people's use of powered wheelchairs for activity and participation. , 2004, Journal of rehabilitation medicine.

[25]  G. A. van den Bos,et al.  The development of a handicap assessment questionnaire: the Impact on Participation and Autonomy (IPA) , 1999, Clinical rehabilitation.

[26]  Alan Woodside,et al.  The vital role of street design and management in reducing barriers to older peoples' mobility , 1996 .

[27]  S Iwarsson,et al.  Physical Housing Environment: Development of a Self-Assessment Instrument , 1999, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.