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Construct validity and inter-rater reliability of the Dutch activity measure for post-acute care “6- clicks” basic mobility form to assess the mobility of hospitalized patients

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To evaluate the construct validity and the inter-rater reliability of the Dutch Activity Measure for Post-
Acute Care “6-clicks” Basic Mobility short form measuring the patient’s mobility in Dutch hospital care.
First, the “6-clicks” was translated by using a forward-backward translation protocol. Next, 64 patients
were assessed by the physiotherapist to determine the validity while being admitted to the Internal
Medicine wards of a university medical center. Six hypotheses were tested regarding the construct
“mobility” which showed that: Better “6-clicks” scores were related to less restrictive pre-admission living situations (p¼0.011), less restrictive discharge locations (p¼0.001), more independence in activities of daily living (p¼0.001) and less physiotherapy visits (p<0.001). A correlation was found between the “6-clicks” and length of stay (r¼0.408, p¼0.001), but not between the “6-clicks” and age (r¼0.180, p¼0.528). To determine the inter-rater reliability, an additional 50 patients were assessed by pairs of physiotherapists who independently scored the patients. Intraclass Correlation Coefficients of 0.920 (95%CI: 0.828–0.964) were found. The Kappa Coefficients for the individual items ranged from 0.649 (walking stairs) to 0.841 (sit-to-stand). The Dutch “6-clicks” shows a good construct validity and moderate-toexcellent inter-rater reliability when used to assess the mobility of hospitalized patients.


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