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NM de Vries, JB Staal, MG Olde Rikkert and MW Nijhuis-van der Sanden
BACKGROUND: Physical activity is assumed to be important in the prevention and treatment of frailty. It is however unclear to what extent frailty can be influenced, because an outcome instrument is lacking. OBJECTIVES: An Evaluative Frailty Index for Physical activity (EFIP) was developed based on the Frailty Index Accumulation of Deficits and clinimetric properties were tested. DESIGN: The content of the EFIP was determined in a written Delphi procedure. Intra-rater reliability, inter-rater reliability, and construct validity were determined in an observational study (n=24) and to determine responsiveness, the EFIP was used in a physical therapy intervention study (n=12). METHOD: Intra-rater reliability and inter-rater reliability were calculated using Cohen’s kappa, construct validity was determined by correlating the score on the EFIP with those on the Timed Up &Go Test (TUG), the Performance Oriented Mobility Assessment (POMA), and the Cumulative Illness Rating Scale for geriatrics (CIRS-G). Responsiveness was calculated by means of the Effect Size (ES), the Standardized Response Mean (SRM), and a paired sample t-test. RESULTS: Fifty items were included in the EFIP. Inter-rater (Cohen’s kappa: 0,72) and intra-rater reliability (Cohen’s kappa: 0,77 and 0,80) were good. A moderate correlation with the TUG, POMA, and CIRS-G was found (0,68 -0,66 and 0,61 respectively, P< 0.001). Responsiveness was moderate to good (ES: -0.72 and SRM:-1.14) for an intervention with a significant effect (P< 0.01). LIMITATIONS: The clinimetric properties of the EFIP have been tested in a small sample and anchor based responsiveness could not be determined. CONCLUSIONS: The EFIP is a reliable, valid, and responsive instrument to evaluate the effect of physical activity on frailty in research and clinical practice.
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Scientific method, Inter-rater reliability, Fleiss' kappa, Cohen's kappa, Student's t-test, Jacob Cohen, Reliability, Psychometrics
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