Preliminary Validation of the Acute Care Mobility Assessment as a Measure of Hospital Mobility
Abstract
BACKGROUND: Despite heighted interest, measurement of hospital mobility remains challenging. Available assessment tools lack patient input regarding level and frequency of hospital mobility. The purpose of this study was to validate a brief self-reported mobility assessment to measure out-of-bed activity during hospitalization. METHODS: We recruited cognitively intact hospitalized adults (age ≥ 65 years) who walked prior to admission, to wear an accelerometer for 24 hours and to complete the Acute Care Mobility Assessment (ACMA), a self-report of mobility that ranges from bed rest to walking off the hospital unit in the prior 24 hours. For each mobility level from sitting in a chair to walking off the unit, patients reported frequency of the activity and need for help from another person or equipment. Spearman correlation coefficients were calculated using several scoring algorithms to compare ACMA to accelerometer data. RESULTS: Fifty-one patients (mean age 74.3 (SD 6.2) years, 63% female, 39% Black) had complete data. Steps taken in 24 hours ranged from 10 - 2831. Correlation analyses identified strong associations between ACMA scores and total steps, and moderate correlations with total time walking using all algorithms. However, the unweighted frequency count using the three ambulation levels only (walking in room, in hall and off ward) had the highest correlation with total steps (r=0.84; p < 0.001) and total time walking (r = 0.66; p < 0.001). CONCLUSION: ACMA is a valid measure of mobility among cognitively intact hospitalized older adults. The ACMA may add value to our current armamentarium of tools by adding patient report of hospital mobility.