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

Authors Sven Geelen , Karin Valkenet , Cindy Veenhof
Published in Disability and Rehabilitation
Publication date 2018
Research groups Innovation of Movement Care
Type Article


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 (r¼ 0.408, p¼0.001), but not between the “6-clicks” and age (r¼ 0.180, 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.

On this publication contributed

  • Cindy Veenhof | Professor | Research group Innovation of Movement Care
    Cindy Veenhof
    • Professor
    • Research group: Innovation of Movement Care

Language English
Published in Disability and Rehabilitation
Year and volume 41 21
Key words hospitalization, mobility, Physiotherapy, validity, reliability, measuring tool
Page range 2563-2569

Innovation of Movement Care