Reliability and Validity of Persian Version of Performance-oriented Mobility Assessment (POMA) in Community-dwelling Iranian Older Adults: Psychometric Properties

Objectives: An appropriate and accurate assessment tool is needed to predict the risk of falling in older adults. This study aimed at investigating the construct validity, factor analysis, internal consistency, test-retest and inter-rater reliability, and ceiling/floor effects of the Persian version of Performance-oriented Mobility Assessment (POMA) in community-dwelling elderly. Methods: One hundred and forty-five older adults aged ۶۵ years and older (mean age: ۷۳.۶۸ years) were recruited from daily care centers of Tehran by convenience sampling method. Timed Up and Go (TUG) test and Berg Balance Scale (BBS) were used to investigate the construct validity of the POMA. Test-retest (۷-۱۴ days with interval) and inter-rater reliability of the gait and balance subscales and the total score of the POMA were determined by Intraclass Correlation Coefficient (ICC۲,۱).  Results: A moderate to very high correlation (r=۰.۶۷-۰.۹, P≤۰.۰۵) was found between the total score of the POMA and BBS, Fullerton Advanced Balance Scale, step test (right and left), TUG, Dynamic Gait index, and walking speed, whereas the correlation between the total score of the POMA and step length was poor (r=۰.۳۹, P≤۰.۰۵). The results of confirmatory factor analysis showed a poor goodness-of-fit of POMA with the two-factor model (balance and gait) in community-dwelling elderly. Internal consistency (Cronbach's alpha=۰.۹۴), test-retest reliability (ICC۲,۱)=۰.۹۷), as well as inter-rater reliability (ICC۲,۱)=۰.۹۲) of the POMA were excellent. The results revealed no floor effect for the total score of the POMA; however, its ceiling effect was ۳.۴۴%.  Discussion: The Persian version of POMA showed excellent psychometric properties for evaluating different aspects of balance in community-dwelling elderly.