title: Cross-cultural validation of the Italian version of the Cumulated Ambulation Score.
abstract: Hip fractures are common in elderly patients, and walking impairment is a frequent complication. The Cumulated Ambulation Score (CAS) is a validated functional scale used to monitor easily three basic mobility activities in patients with hip fracture. The aim of this study was to translate, cross-cultural adapt, and validate the CAS in the Italian language (CAS-I). The translation was carried out according to recommended guidelines. The final version of the CAS-I was administered to 80 geriatric patients with hip fracture admitted to a Traumatology Unit, and allowed full weight-bearing after treatment with hemiarthroplasty. Two raters evaluated each patient 2 days after surgery and then after 3 months. Statistical methods included Cronbach's α coefficient for the scale's internal consistency; the total agreement; and the κ coefficient for the inter-rater reliability. The concurrent validity of the scale was determined by comparing the total CAS-I (0-6 points) with the Index of Independence in Activities of Daily Living score (0-4 points). Internal consistency and inter-rater reliability of the CAS, evaluated with Cronbach's α and κ, respectively, were above 0.84 and 0.94. The SE of measurement for the total CAS-I (0-6 points) 2 days and 3 months after surgery were 0.03 and 0.13 points, respectively. The CAS-I showed a significant correlation with the first four items of the Activities of Daily Living score scale (r≥0.85, P<0.001). This study confirms the validity of the CAS-I for patients with a hemiarthroplasty after hip fracture and provides additional evidence of the psychometric properties of the scale. We suggest that the official CAS-I version be used in other settings to evaluate the basic mobility in patients with hip fracture.
authors.affiliation: aDepartment of Health Sciences, University of Eastern Piedmont 'A. Avogadro', Novara bUnit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation, Scientific Institute of Veruno, Veruno, Italy cDepartment of Physical Medicine and Rehabilitation, Hamad Medical Corporation, Doha, Qatar dPhysical Medicine and Rehabilitation Research - Copenhagen (PMR-C), Department of Physical Therapy and Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark.
authors.forename: Elisa
authors.initials: E
authors.lastname: Grana
authors.forename: Simone
authors.initials: S
authors.lastname: Verzellotti
authors.forename: Federico A
authors.initials: FA
authors.lastname: Grassi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ferriero
authors.forename: Morten T
authors.initials: MT
authors.lastname: Kristensen
authors.forename: Carlo
authors.initials: C
authors.lastname: Cisari
authors.forename: Marco
authors.initials: M
authors.lastname: Invernizzi
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D004185:Disability Evaluation; D005260:Female; D062785:Hemiarthroplasty / Q000534:rehabilitation; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data*; D014175:Translating; D000070857:Walk Test / Q000706:statistics & numerical data*