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Simoes M.D.S.M.P.1, Garcia I.F.F.2, Costa L.D.C.M.2, Lunardi A.C.1,2
1Universidade de São Paulo, Speech, Physical Therapy and Occupational Therapy, São Paulo, Brazil, 2Universidade Cidade de Sao Paulo, Master's and Doctoral Programs in Physical Therapy, São Paulo, Brazil
Background: Mobility is an important component of functionality, necessary for performance of activities of daily living. The questionnaire The University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA) evaluates mobility from the spaces that older adults go, the frequency and independence that they move through these spaces. The LSA is one among few instruments that evaluate mobility in the context of participation. In addition, the questionnaire is simple and may be applied in person or by telephone. There are already validated versions of the LSA for use in other countries and, in the absence of a validated version of the LSA for Brazil, it is necessary to adapt cross-culturally and to analyze the measurement properties of the adapted version, in order to increase the options for mobility evaluation of older adults.
Purpose: The purpose of this study was to perform the cross-cultural adaptation of the LSA into Brazilian-Portuguese, and to analyze its measurement properties.
Methods: This cross-cultural adaptation and clinimetric study was conducted in two phases.
Phase I: we performed a cross-cultural adaption of the questionnaire and its instructions for application, following international guidelines. The adapted version was pretested with 10 health professionals and 30 community-dwelling older adults. Data were analyzed using descriptive analysis.
Phase II: we included 80 community-dwelling older adults. The adapted LSA was applied and we assessed physical mobility through accelerometry. After seven days, the accelerometer was removed and the questionnaire was reapplied. Reliability was analyzed by the Cronbach´s alpha (internal consistency), intraclass correlation coefficients (ICC2,1) and 95% confidence interval (95%CI) (reproducibility), and standard error of measurement (measurement error). The construct validity was analyzed by Pearsons correlation between the scores of LSA and accelerometry data (time in sedentary activities and time in moderate and vigorous activities). Interpretability was analyzed by histograms, minimal detectable change (MDC), and determination of floor and ceiling effects.
Results: We obtained a Brazilian-Portuguese version of the LSA. This version met the criteria for content validity adopted in this study. Internal consistency (Cronbach´s alpha) was 0.92 and reproducibility (ICC2,1) was 0.97 (95%CI 0.95 to 0.98). The standard error of measurement was calculated in 4.12 points (3%). The LSA score showed negative correlation with time in sedentary activities
(r= -0.63; p 0.001), and positive correlation with time in moderate and vigorous activities
(r= 0.49; p 0.001). The MDC was 0.36 points, and we observed no floor or ceiling effects.
Conclusion(s): The Brazilian-Portuguese version of the LSA reproduces the original version with adequate reliability, validity and interpretability. A genuine difference in LSA score was set at 4.48 points. We recommend the use of this version to evaluate life-space mobility of Brazilian older adults.
Implications: More than life-space mobility assessment for clinical setting, this validated version of the LSA enables the beginning of research on life-space mobility in Brazil. Also, this version allows the development of other validation studies of the LSA for different population, like older adults with specific conditions.
Funding acknowledgements: Not applicable.
Topic: Older people
Ethics approval: :The work was approved by the Ethics Comitee of the School of Medicine, University of Sao Paulo (CAAE 17653013.2.0000.0065).
All authors, affiliations and abstracts have been published as submitted.
