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Validação da versão portuguesa e determinação do poder de resposta e significância clínica do Life-Space Assessment (LSA)
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Abstract(s)
Introdução: A mobilidade é um componente fundamental para a realização das AVD e para a participação social. O Life-Space Assessment (LSA) permite avaliar os níveis de mobilidade no espaço quotidiano, em idosos com 65 ou mais anos de idade. Objetivo: Determinar as principais propriedades psicométricas de versão portuguesa do LSA. Métodos: No momento inicial (T0), foi administrado um questionário de caracterização sociodemográfica, o SF-12v2, LSA e CEEA, a um total de 520 participantes (74±7anos). Para avaliação da fiabilidade teste-reteste, o LSA foi novamente administrado no intervalo de 1 semana (n=103). Posteriormente, foi administrado o protocolo (T1) nos idosos que foram submetidos a Fisioterapia/Atividade Física, consistindo este no SF-12v2, LSA, CEEA e numa escala subjetiva da perceção das alterações (n=154). Resultados: A versão portuguesa do LSA possui valores aceitáveis de consistência interna (Alfa Cronbach 0,69) e boa fiabilidade teste-reteste (CCI 0,896). O LSA mostrou uma correlação forte com a dimensão da função física do SF-12v2 e com a escala de CEEA, uma correlação moderada com a idade, com a dimensão de desempenho físico e emocional e com a medida sumário física do SF-12v2, e uma correlação fraca com as restantes dimensões e com a medida sumário mental do SF-12v2. O LSA possui validade discriminante em relação ao sexo, à utilização e ao tipo de auxiliares de marcha, à presença de problemas de saúde, à ocorrência de quedas no último ano, com o tipo de residência e com o IMC (p<0,05). Quanto ao Poder de Resposta e de Significância Clínica, após intervenção em Fisioterapia/Atividade Física, o LSA revelou valores de SES 0,26, SRM 0,40, EPM 8,52, MMD 24,46 e de MMI 7,52. Conclusões: A versão portuguesa do LSA é uma medida válida, fiável, com baixo poder de resposta, e com valores de MMD a parecerem mais adequados à leitura da significância clínica. Contudo, são necessários mais estudos que permitam a reprodução e a comparação dos resultados.
Introduction: Mobility is a fundamental component in achieving ADL and in social participation. The Life-Space Assessment (LSA) allows the assessment of mobility levels in life space mobility in the elderly aged 65 or older. Objective: To determine the main psychometric properties of the Portuguese version of the LSA. Methods: In the initial stage (T0), a sociodemographic characterization questionnaire, SF-12v2, LSA and ABC, was administered to 520 participants (74±7). In order to assess test-retest reliability, the LSA was again administered within 1 week (n=103). Later the protocol (T1), consisting of SF-12v2, LSA, ABC and a subjective scale of perception of changes (n=154), was administered in the elderly who underwent Physiotherapy/Physical Activity. Results: The Portuguese version of the LSA has acceptable internal consistency values (Cronbach’s Alpha 0.69) and good test-retest reliability (ICC 0.896). The LSA showed a strong correlation with the physical function dimension of SF-12v2 and with the ABC-scale, a moderate correlation with age, the physical and emotional performance dimension and with the SF-12v2 physical summary measure, and a weak correlation with the remaining dimensions and with the SF-12v2 mental summary measure. The LSA has discriminant validity regarding sex, use and type of walking aids, presence of health problems and the occurrence of falls in the last year, type of residence, and BMI (p<0.05). As regards Responsiveness and Clinical Significance after intervention with Physiotherapy/Physical Activity the LSA showed values of SES 0.26, SRM 0.40, SEM 8.52, MDC 24.46 and MID 7.52. Conclusions: The Portuguese version of the LSA is a valid and reliable measure with poor responsiveness, and MDC values seem to be more adequate for reading clinical significance. However, further studies are required to allow reproduction and comparison of results.
Introduction: Mobility is a fundamental component in achieving ADL and in social participation. The Life-Space Assessment (LSA) allows the assessment of mobility levels in life space mobility in the elderly aged 65 or older. Objective: To determine the main psychometric properties of the Portuguese version of the LSA. Methods: In the initial stage (T0), a sociodemographic characterization questionnaire, SF-12v2, LSA and ABC, was administered to 520 participants (74±7). In order to assess test-retest reliability, the LSA was again administered within 1 week (n=103). Later the protocol (T1), consisting of SF-12v2, LSA, ABC and a subjective scale of perception of changes (n=154), was administered in the elderly who underwent Physiotherapy/Physical Activity. Results: The Portuguese version of the LSA has acceptable internal consistency values (Cronbach’s Alpha 0.69) and good test-retest reliability (ICC 0.896). The LSA showed a strong correlation with the physical function dimension of SF-12v2 and with the ABC-scale, a moderate correlation with age, the physical and emotional performance dimension and with the SF-12v2 physical summary measure, and a weak correlation with the remaining dimensions and with the SF-12v2 mental summary measure. The LSA has discriminant validity regarding sex, use and type of walking aids, presence of health problems and the occurrence of falls in the last year, type of residence, and BMI (p<0.05). As regards Responsiveness and Clinical Significance after intervention with Physiotherapy/Physical Activity the LSA showed values of SES 0.26, SRM 0.40, SEM 8.52, MDC 24.46 and MID 7.52. Conclusions: The Portuguese version of the LSA is a valid and reliable measure with poor responsiveness, and MDC values seem to be more adequate for reading clinical significance. However, further studies are required to allow reproduction and comparison of results.
Description
Keywords
Idoso Mobilidade no espaço quotidiano Instrumentos de medição Fisioterapia Atividade física