Original article
Development and Validation of a Movement and Activity in Physical Space Score as a Functional Outcome Measure

https://doi.org/10.1016/j.apmr.2011.05.001Get rights and content

Abstract

Herrmann SD, Snook EM, Kang M, Scott CB, Mack MG, Dompier TP, Ragan BG. Development and validation of a Movement and Activity in Physical Space score as a functional outcome measure.

Objective

To develop and validate a functional measure, the Movement and Activity in Physical Space (MAPS) score, that encompasses both physical activity and environmental interaction.

Design

Observational matched-pair cohort with 2-month follow-up.

Setting

General community under free-living conditions.

Participants

Adult participants (N=18; n=9 postsurgical, n=9 matched control; mean age ± SD, 28.9±12.0y) were monitored by an accelerometer and global positioning system receiver for 3 days within 1 week (4.1±2.8d) after knee surgery (T=0) and 2 months later (T+2). The healthy controls were matched for age, sex, smoking, perceived physical activity level, and occupation of a postsurgical participant. Correlation, t test (with Bonferroni adjustment: α=.05/2), analysis of variance, and intraclass correlation coefficient were used to establish validity and reliability evidence.

Interventions

Not applicable.

Main Outcome Measure

MAPS scores.

Results

MAPS scores were moderately correlated with the Knee Injury and Osteoarthritis Outcome Score (P<.05). There was a significant group difference at T = 0 for MAPS (t9.9=–3.60; P=.01). Analysis of variance results for the MAPS indicated a time and group interaction (F1,12=4.60, P=.05). Reliability of 3 days of MAPS scores ranged from 0.75 to 0.81 (postsurgical and control), and 2-month test-retest reliability in the control group was 0.94.

Conclusions

The results provide a foundation of convergent and known-group difference validity evidence along with reliability evidence for the use of MAPS as a functional outcome measure.

Section snippets

Participants

A total of 18 (n=9 postsurgical, n=9 control) adult participants (mean age ± SD, 25.6±9.8y; height, 172.2±7.1cm; weight, 76.7±16.3kg) volunteered in this study. Prior to data collection, all participants gave informed consent as approved by the university institutional review board. A power analysis was performed based on previous physical activity data27, 28 (power=.80, α=.05, effect size=1.5), which determined the necessary minimum sample size of N equal to 14.

The postsurgical group

Results

The descriptive statistics are provided in table 2 (T=0 and T+2) for the outcome measures: 5 KOOS subscales, step count, and MAPS scores.

Discussion

Physical activity monitoring has successfully demonstrated decreases and improvements in health status and function in various illness/disease populations.23, 25, 38, 42, 43 However, these studies have focused solely on physical activity and have not included environment interaction in their assessment of function. Thus, MAPS is different because it addresses environmental interaction and is not limited to a single component of function (ie, movement or physical activity). Through integrating

Conclusions

While traditional functional assessments have been clinic based, this new measure provides a more comprehensive assessment of a person's activity and interaction within their environment in real-life situations to assess function. It is important to assess the entirety of function and disability by including an assessment of physical activity and environmental interaction. This study showed that GPS and accelerometer data could be combined to provide a meaningful outcome score that evaluates

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    Supported in part by a grant from the National Athletic Trainers' Association Research and Education Foundation and the Roy J. Carver Charitable Foundation to the University of Northern Iowa Graduate College.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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