title: Community mobility assessment for adolescents with an acquired brain injury: preliminary inter-rater reliability study.
abstract: BACKGROUND
  The Community Mobility Assessment (CMA) is an observational assessment that evaluates safety of an adolescent with an acquired brain injury (ABI) during a community outing. It consists of a 3-point level of accomplishment scale for 40 functional items, divided into two components (physical and cognitive). The CMA identifies areas of strength and weakness and facilitates development of compensating strategies. This study was undertaken to determine how reliably therapists rate a client's performance using the CMA on a community outing.
  
  
  METHODS
  Eight adolescents between the ages of 12 and 18 participated. All had an ABI and were involved in rehabilitation either as a day-patient or inpatient.
  
  
  METHODS
  Each teen was independently evaluated by one expert rater and one of two student raters (A or B), using the CMA during a standard 2-h community outing.
  
  
  METHODS
  Descriptive statistics were computed for physical and cognitive component summary scores. Inter-rater reliability analyses used weighted Kappa statistics. A minimum Kappa score >0.70 was hypothesized a priori to indicate good reliability.
  
  
  RESULTS
  The mean score for the physical component = 92% (min = 82%, max = 100%), and for the cognitive component = 77% (min = 58%, max = 97%). Minimum weighted Kappa scores for the two rater pairings were 0.80 for the physical component and 0.70 for the cognitive component.
  
  
  CONCLUSIONS
  An acceptable Kappa score was reached for both components, indicating that with appropriate rater training, the CMA has good inter-rater reliability. Construct validity and responsiveness to change over a clinically meaningful follow-up period should now be evaluated.
authors.affiliation: Brain Injury Rehabilitation Team and Bloorview Research Institute, Toronto, Ontario, Canada.
authors.forename: K D
authors.initials: KD
authors.lastname: Moody
authors.forename: F V
authors.initials: FV
authors.lastname: Wright
authors.forename: K M
authors.initials: KM
authors.lastname: Brewer
authors.forename: P E
authors.initials: PE
authors.lastname: Geisler
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001930:Brain Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D002648:Child; D003071:Cognition / Q000502:physiology; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009949:Orientation; D011597:Psychomotor Performance / Q000502:physiology*; D015203:Reproducibility of Results; D012449:Safety; D014186:Transportation; D016138:Walking / Q000502:physiology