Translation, inter-rater reliability, agreement, and internal consistency of the Spanish version of the cumulated ambulation score in patients after hip fracture

Abstract

Purpose: To translate the Cumulated Ambulation Score (CAS) into Spanish (CAS-E) and to examine the interrater reliability and agreement of the CAS-E. Materials and Methods: Two occupational therapists, independently reviewed 60 patients consecutively admitted to a traumatology service of a public hospital with a hip fracture, and rated the three CAS activities from 0 to 2, within the first post-surgery week. We determined the internal consistency of CAS-E using Cronbach’s α coefficient. To test reliability, we used weighted kappa statistics, the standard error of measurement (SEM) and the smallest real difference (SRD). We determined the systematic between-rater bias using the McNemar–Bowker test. Results: No between-rater bias was seen, and the Cronbach’s α for the CAS-E was 0.89. The weighted kappa was ≥ 0.83 for the three individual activities and the total CAS-E, while the observed agreement was ≥ 0.87. The SEM and the SRD for the total CAS-E (0-6 points) were 0.18 and 0.83 points, respectively. Conclusions: We present the CAS for use in Spanish speaking countries and provide evidence for excellent relative and absolute reliability of the CAS-E to assess basic mobility for patients with hip fracture in an acute care hospital.