Spanish Translation, Cross-Cultural Adaptation, and Psychometric Evaluation of the Inpatient Mobility Measurement Tools

Objectives: This study had 2 objectives: (1) translate to Spanish and cross-culturally adapt the Activity Measure for Post-Acute Care (AM-PAC) Inpatient Mobility Short Form, the AM-PAC Inpatient Activity Short Form, and the Johns Hopkins Highest Level of Mobility (JH-HLM) tools; and (2) assess the reliability, validity, and responsiveness of the translated and cross-culturally adapted tools. Design: After an expert committee approved a forward-backward translation of the tools, we evaluated the interrater reliability, concurrent validity, and responsiveness of the translated tools. Reliability was assessed by a team of 2 physical therapists and 1 nurse who independently scored 59 patients at admission and discharge. Concurrent validity was evaluated via the assessment of convergent validity with other measures of function. Responsiveness was assessed by quantifying the minimally important difference with 1 anchor-based and 2 distribution-based methods. Results: The interrater reliability (intraclass correlation coefficient) was larger than 0.95 at admission and discharge. Evidence for concurrent validity (correlations) ranged from 0.64 to 0.95. AM-PAC minimally important difference ranged between +3.13 and −6.75 for improvement and decline, respectively, and JH-HLM minimally important difference ranged between +0.73 and −1.07. Conclusions: The Spanish AM-PAC and JH-HLM tools have excellent interrater reliability, measure constructs of mobility and function, and detect clinically meaningful changes in patients’ mobility.