Functional Assessment Tools

[chp4211]

Hi All,

I'm trying to get my hands on:

The Modified Elderly Mobility Scale (MEMS) - I'd settle for the Elderly Mobility Scale (EMS)

and

The Timed up and Go (TUG) Test

I'm specifically after the tests themselves and any background info on their validity. I've done some searches and pulled together bits and pieces but nothing that gives me a complete tool to use.

Can anyone help?

Thanks & regards,
Ray

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[sanagupta]

Hello!
I came across this scale some time back...see if this can be of any help to u?This one is modified scale
Regards
Sana


MODIFIED ELDERLY MOBILITY SCALE

DIAGNOSIS: PMH: History of falls over 1 year: Yes/No * If yes, state no. No. of medications: ³ 4 / < 4 * Impaired hearing / vision *Date :
1. Lying – SittingPatient is asked to sit over the edge of the bed from supine position 2 Independent 1 Needs x 1 assist 0 Needs x 2 assist 2. Sitting – LyingPatient is asked to lie down to a supine position from sitting over the edge of the bed 2 Independent 1 Needs x 1 assist 0 Needs x 2 assist
3. Sitting - StandingPatient is asked to stand from chair of height 43cm. Timing starts when patient begins task. 3 Independent in £ 3 sec 2 Independent in > 3 sec 1 Needs x1 assist (verbal or physical) 0 Needs x2 assist 4. StandingPatient is required to stand still and reach forward and sideways. 3 Stands without support and able to reach front/side 2 Stands without support but needs support to reach 1 Stands but need support 0 Needs assistance to stand * Support means needs to use upper limbs to steady self
5. GaitPatient is required to walk, turn, change direction, stop and start. Patient may use walking aids if required. 3 Independent and safe (incl. use of stick) 2 Independent with frame/quad stick 1 Amb with aid but unsafe turning (req occasional supervision) 0 Req assistance to walk/needs constant supervision 6. Timed WalkPatient is required to walk over 5m as fast as possible. Time when patient steps over the starting line. Walking aids may be used. 3 Completes in £ 15 sec 2 Completes in 16-30 sec 1 Completes in > 30 sec 0 Unable to cover the distance
7. Functional ReachPatient is required to reach forward as far as possible without losing balance. 4 Reaches > 8” (20cm) 2 Reaches bet. 4” – 8” (10-20cm) 0 Reaches under 4” (10cm) or unable Distance: cm 8. Timed Up and Go TestPatient is asked to get up from the chair, walk at normal pace to 3 m mark. Turn and walk back to the chair to sit. Walking aids may be used. Time Taken: sec
TOTAL SCORE: / 20
Physiotherapist: Signature / Date
* Pls delete accordingly Adapted from Janet Simpson
SCORING:
EMS (Tests 1 -7) FR and TUG (Tests 7 & 8)
FR TUG
Low risk > 20 cm < 15 sec
Med risk 10 – 20 cm 15 – 30 sec
High risk < 10 cm > 30 sec
Independent and Safe = ³ 14
Supervision or minimal assistance = 10 – 13
High level of assistance = < 10


Falls efficacy as a measure of fear of falling.

Tinetti ME, Richman D, Powell L.

Department of Medicine, Yale University School of Medicine.

We developed the Falls Efficacy Scale (FES), an instrument to measure fear of falling, based on the operational definition of this fear as "low perceived self-efficacy at avoiding falls during essential, nonhazardous activities of daily living." The reliability and validity of the FES were assessed in two samples of community-living elderly persons. The FES showed good test-retest reliability (Pearson's correlation 0.71). Subjects who reported avoiding activities because of fear of falling had higher FES scores, representing lower self-efficacy or confidence, than subjects not reporting fear of falling. The independent predictors of FES score were usual walking pace (a measure of physical ability), anxiety, and depression. The FES appears to be a reliable and valid method for measuring fear of falling. This instrument may be useful in assessing the independent contribution of fear of falling to functional decline among elderly people.
Arch Phys Med Rehabil. 1996 Oct;77(10):1025-9. Related Articles, Links

Fear of falling revisited.

Hill KD, Schwarz JA, Kalogeropoulos AJ, Gibson SJ.

National Ageing Research Institute, Parkville, Victoria, Australia.

OBJECTIVE: To evaluate the measurement properties of an expanded version of the Falls Efficacy Scale (FES)-a measure of fear of falling. The original FES measures fear on almost exclusively indoor activities, which may limit the usefulness of the scale in identifying early stages of fear of falling in active community-dwelling older people. DESIGN: Two-group convenience sample. SETTING: An outpatient referral clinic, and community-dwelling older people recruited from various sources. SUBJECTS: A volunteer sample of 111 healthy community-dwelling elderly (mean age 74.0 years) and a sample of 68 older people referred to a Falls and Balance Clinic (FBC) (mean age 79.2). Twenty-one subjects (9 healthy elderly and 12 FBC patients) were tested twice 1 week apart to investigate retest reliability. MAIN OUTCOME MEASURES: A 14-activity questionnaire (the Modified Falls Efficacy Scale [MFES]) was used that incorporated the original 10-activity FES and four additional activities. Falls efficacy was rated on a 10-point visual analogue scale for each activity. RESULTS AND CONCLUSIONS: The MFES demonstrated high internal consistency (Cronbach's alpha.95) and less skew than the original FES (-2.4 and -3.3, respectively). Factor analysis of the MFES revealed two factors accounting for 75% of the sample variance, grouping into an "indoor type activity" factor and an "outdoor type activity" factor. Retest reliability for the MFES was high (intraclass correlation coefficients = .93). Significant differences were evident between the FBC group and the healthy older group on all items of the MFES and on the total MFES score (p < .05). On the basis of these preliminary findings, the MFES appears to be a reliable and valid measure of falls self-efficacy, and could be a useful addition in the comprehensive assessment of older people with balance disturbance or falls.

MeSH Terms:
· Accidental Falls*
· Aged
· Factor Analysis, Statistical
· Fear/classification*
· Female
· Humans
· Male
· Questionnaires*
· Reproducibility of Results

MeSH Terms:
· Accidental Falls*
· Activities of Daily Living
· Aged/psychology*
· Aged, 80 and over
· Fear*
· Female
· Humans
· Male
· Research Support, U.S. Gov't, P.H.S.
· Self Concept

Hip protectors improve falls self-efficacy
I Cameron, B Stafford, RG Cumming, C Birks, SE … - Age and Ageing, 2000 - ageing.oupjournals.org
... on hip fractures, participants recruited at home completed an assessment of fear
of falling and falls efficacy as measured by the Falls Efficacy Scale and the ...
Cited by 35 - Web Search - ingentaconnect.com - ingentaconnect.com - ncbi.nlm.nih.gov - all 5 versions »

: J Outcome Meas. 1997;1(1):34-55. Related Articles, Links

Development of a scale to assess concern about falling and applications to treatment programs.

Lusardi MM, Smith EV Jr.

University of Oklahoma, Department of Educational Psychology, Norman 73019, USA.

This study used Rasch methodology to pursue three goals. First, we sought to demonstrate the psychometric limitations of the Falls Efficacy Scale (Tinetti, Richman, & Powell, 1990). Second, we addressed these limitations using a simultaneous calibration of the Falls Efficacy Scale and Mobility Efficacy Scale items. Third, we review previous explorations of the self-efficacy construct in relationship to health behaviors and discuss a possible treatment program based on the simultaneous calibrated items and Social Cognitive Theory. Results indicate that responses from the Falls Efficacy Scale fail to assess the higher ends of the self-efficacy continuum. Simultaneous calibration of items improved this lack of scale definition. This initial work in assessing self-efficacy perceptions provides a theoretical framework for planning treatment programs that may be more cost effective than collecting performance measures.

[chp4211]

Thanks Sana - I'll print that out and take a look at it.

Cheers,
Ray

[rgerken]

Hello-
I am also looking for the Modified Elderly Mobility scale. Can you tell me where I can download a copy of it?


RG

[Fyzzio]

Hi,
at the risk of sounding a bit sarcastic: why don't you Google it?
The first hit gets you onto the CSP website with a full description, evidence base, literature references and the actual scale/ form.
It's a PDF document.

Cheers,
Andrea

[rgerken]

Hi,
at the risk of sounding a bit sarcastic: why don't you Google it?
The first hit gets you onto the CSP website with a full description, evidence base, literature references and the actual scale/ form.
It's a PDF document.

Cheers,
Andrea

Thanks Andrea

I have googled and binged and you will see that that scale on CSP is for the Elderly Mobility Scale. I am looking for the Modified Elderly Mobility Scale.

[Fyzzio]

Sorry, you are right, the Scale is the EMS.

You can download the MEMS on ebookbrowse; see here: Free Download

First hit when you google it.