Translation, reliability, agreement and validity of the Turkish version of Cumulated Ambulation Score in patients with hip fracture
İlker Çolak1, Emel Mete2, Morten Tange Kristensen3, Tuğba Kuru Çolak4
1Department of Orthopedics and Traumatology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
2Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Faculty of Healthy Sciences, Istanbul, Turkey
3Departments of Physical Therapy and Orthopedic Surgery, Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
4Department of Physiotherapy and Rehabilitation, Marmara University, Faculty of Healthy Sciences, Istanbul, Turkey
Keywords: Arthroplasty, femoral neck fracture, hip, mobility
Objectives: This study aims to translate and investigate the inter- rater reliability, agreement and validity of the Turkish version of the Cumulated Ambulation Score (CAS-TR) in patients with hip fracture.
Patients and methods: This study included patients with a hip fracture of the femoral neck between July 2019 and March 2020 at the Dr. Lütfi Kırdar Kartal Training and Education Hospital, Department of Orthopedics and Traumatology, Istanbul. The CAS manual and score-sheet were translated into Turkish. An orthopedician and a physiotherapist independently administered the CAS-TR to 36 patients (12 males, 24 females; mean age 78.7 years; range, 65 to 90 years) at postoperative days one, two, three and 30. Weighted Cohen's kappa coefficient was used to measure inter-rater reliability. Turkish version of modified Barthel Index was used for analysis of validity.
Results: The majority of the patients had type III fracture (72.2%) according to Garden’s classification. The kappa value was ≥0.90 for days one-three, the total and 30th day score of CAS-TR. The observed agreement ranged between 91.6% and 100% for all assessments. Validity analysis showed a significantly positive correlation between day two and day 30 CAS-TR and Barthel scores.
Conclusion: We found almost perfect reliability, high percentage agreement and acceptable convergent validity of the CAS-TR. We recommend the CAS to be used as an easily applicable instrument to assess basic mobility status in Turkish patients with hip fracture. Orthopedic and geriatric patients and patients undergoing any type of surgery can be assessed with CAS for early evaluation of mobility status.
Citation: Çolak İ, Mete E, Kristensen MT, Kuru Çolak T. Translation, reliability, agreement and validity of the Turkish version of Cumulated Ambulation Score in patients with hip fracture. Jt Dis Relat Surg 2020;31(2):346-352.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.