A Hierarchical Assessment of Balance and Mobility.

The Hierarchical Assessment of Balance and Mobility (HABAM) is a new instrument which displays changes in balance and mobility graphically. To assess the validity, reliability, and responsiveness to change of the HABAM it was compared with the Barthel Index, the Spitzer Quality of Life Index, the Folstein Mini Mental Status Examination, and the Lawton-Brody Instrumental Activities of Daily Living Scale. A consecutive sample (n = 28) of patients aged 65 and older admitted to a tertiary-care teaching hospital was studied. Convergent construct validity was assessed by correlation with the Barthel Index (r = 0.76) and its mobility subscale (r = 0.74), and discriminant validity by correlation with the Folstein Mini Mental Status Exam (r = 0.15), Lawton-Brody Instrumental Activities of Daily Living (r = 0.30), and Spitzer Quality of Life Index (r = 0.39). Reliability was demonstrated by an intra-class correlation coefficient of R1 = 0.94. Responsiveness was demonstrated by a relative efficiency of 3.13 and an effect size of 0.59. The HABAM, a new instrument to assess balance and mobility in the hospitalized elderly, is valid, reliable, and responsive to change.