Elderly Mobility Scale (EMS)

Evaluates mobility in frail elderly patients through 7 functional tests.

Read more below the tool about the administration of the tests and the interpretation of the results.


The elderly mobility scale EMS is used to evaluate the functional ability of geriatric patients to perform ADLs (activities of daily living).

In order to do so, the patient is required to perform 7 actions which are evaluated on the individual answer choices of each corresponding item in the scale.

As a scale, the EMS has been validated through subsequent studies and presents a good inter-rater reliability.


The 7 functional tests in the EMS assess the following:

1. Gait – independent walk;

2. Lying to sitting – ability to prop up;

3. Sitting to lying – ability to lie down;

4. Timed walk – analysing time performance;

5. Sit to stand – ability to get up;

6. Functional reach – ability to reach forward without falling;

7. Standing – ability to stand with or without support.


1

Lying To Sitting

2

Sitting To Lying

3

Sitting To Standing

4

Standing

5

Gait

6

Timed Walk (6 metres)

7

Functional Reach

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Elderly Mobility Scale

The EMS was aimed as a standardised, validated scale for the assessment of frail geriatric patients, in or outside clinical settings.

It focuses on evaluation functional performance in abilities that support activities of daily living. Therefore, the EMS refers to the ability of the elderly person to perform ADLs.

EMS item Evaluation options (points)
Lying To Sitting Independent (2)
Needs help of 1 person (1)
Needs help of 2+ people (0)
Sitting To Lying Independent (2)
Needs help of 1 person (1)
Needs help of 2+ people (0)
Sitting To Standing Independent in under 3 seconds (3)
Independent in over 3 seconds (2)
Needs help of 1 person (1)
Needs help of 2+ people (0)
Standing Stands without support and able to reach (3)
Stands without support but needs support to reach (2)
Stands but needs support (1)
Stands only with physical support of another person (0)
Gait Independent (+ / - stick) (3)
Independent with frame (2)
Mobile with walking aid but erratic / unsafe (1)
Needs physical help to walk or constant supervision (0)
Timed Walk (6 metres) Under 15 seconds (3)
16 - 30 seconds (2)
Over 30 seconds (1)
Unable to cover 6 metres (0)
Functional Reach Over 20 cm (4)
10 - 20 cm (2)
Under 10 cm (0)
 

EMS score interpretation

Based on the practical evaluation, each of the 7 functional tests described above, is awarded a number of points, varying from 0 to 4.

The highest score obtainable, 20, is consistent with full independent capacity.

A threshold at 10 has been established, with patients obtaining scores below this value requiring supervision, fall prevention and, in some cases, permanent care.

Scores are divided in three categories, according to the result interpretation:

EMS score Result interpretation
14 - 20 Patient is independent in basic activities of daily life. He/she may require some help but is generally safe alone at home.
10 - 13 Patient scores borderline independence in activities of daily life. He/she requires some degree of help with mobility related manoeuvres.
0 - 9 Patient requires help with basic activities of daily life and is dependent of long term care.

Some of the benefits of the EMS include its functionality, its clinical and personal significance, the fact that it can be administered in about 15 minutes and requires little training.

One of the main criticisms received by the scale refer to the fact that it requires a particular environment, i.e. the 6 metres course, the fact that the ceiling effect is achieved quickly by patients with better capability and the fact that it doesn’t account for other personal factors, such as confidence issues.

 

About the original study

The Elderly Mobility Scale was designed as a 20 point validated assessment tool (on an ordinal scale) for the assessment of frail elderly subjects.

The scale considers locomotion, balance and changes of position.

It has been tested for inter-rater reliability (with results of clinical physiotherapists) and its predictive capacity has been validated through subsequent studies.

Concurrent validity was assessed by correlating scores with the Functional Independence Measure and Barthel Index. The EMS was found to be more likely to detect improvement in mobility than the Barthel Index.

Discriminant validity was assessed by testing healthy community dwelling volunteers.

 

Activities of daily living

ADL is the abbreviation for activities of daily living, which is the term used to describe activities that are likely to occur every day, such as self-care. Healthcare settings use such examples to evaluate the subject’s ability to perform self-care actions.

Some of the most common examples of ADLs include walking, work or leisure activities, bathing, dressing or feeding. Physical health is considered to be the major factor affecting elderly mobility, whether it is chronic or acute.

There is another type of ADLs, the instrumental ADLs which are not compulsory for fundamental functioning and are used for independent living assessments. These are abbreviated IADLs and may include housework, shopping, telephoning, meal preparation or transportation.

 

Original source

Smith R. Validation and Reliability of the Elderly Mobility Scale. Physiotherapy. 1994; 80 (11); 744-747

Validation study

Nolan JS, Remilton LE, Green MM. The Reliability and Validity of the Elderly Mobility Scale in the Acute Hospital Setting. IJAHSP. 2008; 6 (4)

Other references

1. Spilg EG, Martin BJ, Mitchell SL, Aitchison TC. A comparison of mobility assessments in a geriatric day hospital. Clin Rehabil. 2001; 15(3):296-300.

2. Prosser L, Canby A. Further validation of the Elderly Mobility Scale for measurement of mobility of hospitalized elderly people. Clin Rehabil. 1997; 11(4):338-43.


App Version: 1.0.1

Coded By: MDApp

Specialty: Geriatrics

Objective: Assessment

Type: Scale

No. Of Items: 7

Year Of Study: 1994

Abbreviation: EMS

Article By: Denise Nedea

Published On: March 15, 2017 · 04:44 PM

Last Checked: March 15, 2017

Next Review: March 9, 2018