Adaptação transcultural e validação do instrumento “Cumulated Ambulation Score” para o português do Brasil

Abstract

As a result of a hip fracture, basic mobility may be compromised to different degrees, which may limit the functional capacity of the elderly person to carry out their daily activities independently. The most recommended treatment is surgery, followed by mobilization in the immediate postoperative period, still in a hospital environment. There are specific instruments that can help predict mobility recovery, determine adverse outcomes, as well as direct care to groups that require more specialized attention. The Cumulated Ambulation Score (CAS) is a specific instrument for this context, as it assesses mobility, in a hospital environment, after the surgical procedure for hip fracture and predicts functionality, hospital discharge and mortality. However, the CAS has not yet been translated, adapted and validated into Brazilian Portuguese. Therefore, the objective of the study was to carry out the cross-cultural adaptation to Brazilian Portuguese and validate the psychometric properties of the “Cumulated Ambulation Score” (CAS-BR) instrument. This is a methodological study that consists of the cross-cultural adaptation of the CAS instrument to Brazilian Portuguese (translation, back-translation, review committee, approval) and, based on the adapted version, the verification of metric properties (validity and reliability) to use in Brazil. The CAS consists of three items, with scores ranging from 0 to 2. At the end of each assessment, the points are added up, with scores ranging from 0 to 6. The sample consisted of 52 elderly people aged 60 years or over, selected by convenience in two public general hospitals, in the ward and outpatient clinic, according to each stage of the study. Concurrent criterion validity and construct validity by known groups and reliability through internal consistency were analyzed. The translation and adaptation stage were carried out by two translators and after evaluation by the review committee, it was forwarded to the committee of experts made up of seven health professionals and the author of the instrument. After approval, the version was applied to verify the metric properties. The construct validity by known groups was confirmed by the difference in CAS means between elderly people who had mobility before the fracture with and without the use of devices (initial assessment: p=0.02; d=0.67; assessment after 30 days: p = 0.02; d= -0.73) and people aged 60-79 years and ≥ 80 years (assessment after 30 days: p=0.01; d= -0.69). Internal consistency was 0.76. The CAS presented acceptable validity and reliability measures. However, it is suggested that new studies be carried out with the aim of achieving inter-rater reliability.