A comparison of mobility assessments in a geriatric day hospital

Objective: To assess the sensitivity of the Elderly Mobility Scale (EMS) to detect improvements in mobility after physiotherapy in comparison with the Barthel Index (BI) and Functional Ambulation Category (FAC) in routine cli nical day hospital practice. Subjects: Eighty-three patients who completed a course of physiotherapy wer e studied. Methods: Each was assessed by an independent physiotherapist before and aft er a programme of physio therapy, using the EMS, BI and FAC. Results: The mean age was 79 years (SD 7.7). Fifty-three out of 83 (64%) pa tients were female and 92% were community dwelling. The median number of ph ysiotherapy sessions undergone by each patient was 9 (range 3-51). All thre e scales detected an improvement in mobility with physiotherapy (p < 0.001) . However, using the EMS, 68 out of 82 (83%) patients had a detectable impr ovement in mobility compared with only 34 out of 80 (42%) using the BI and 28 out of 81 (35%) using the FAC. Using a matched-pairs comparison, the EMS was significantly more likely to detect an improvement in mobility followi ng physiotherapy within the study group than the BI (p < 0.001) or the FAC (p < 0.001). Conclusion: Although all three scales detected improvements in mobility, th e EMS detected mobility improvements in a significantly greater number of p atients.