Elderly Mobility Scale (EMS) Calculator

How does this elderly mobility scale (EMS) calculator work?

This health tool provides a standardized mean to assess mobility in elderly patients. There are 7 dimensions of functional performance evaluated, all of which refer to abilities that are supporting the performing of activities of daily living.

This is why the interpretation of the elderly mobility scale (EMS) calculator refers to the patient’s capability to perform ADLs. The highest score is consistent with full independent capacity while scores below 10 indicate need for supervision, fall prevention and permanent care in the case of frail patients.

While it addresses geriatric patients, the scale has been devised by physical therapists to assess physical ability. EMS can be used for monitoring status during and after any physical therapy aimed at maintaining or gaining independence in ADLs.

The 7 dimensions evaluated by EMS are:

■ Gait – independent walk or aided by walking stick, need for supervision or not;

■ Lying to sitting – the ability to prop up from lying to a sitting position, with or without help;

■ Sitting to lying – lying down from sitting position, with or without help;

■ Timed walk – setting a specific distance to be walked and analyzing performance;

■ Sit to stand – ability to get up with or without help;

■ Functional reach – assessment of distance the subject can reach out forwards without falling;

■ Standing – ability to stand with or without support from mobility aids or people;

■ The EMS has been validated through subsequent studies and presents a good inter-rater reliability.

There are other similar mobility assessment tools available, such as the Berg Balance Scale or the Six Minute Walk Test.

Score interpretation

Each of the 7 items consists of answer choices weighing from 4 to 0 points. The final score adds these points to provide a total number of points up to a maximum of 20. There are three categories of interpretations based on the following three ranges of total scores:

■ 14 – 20: Patient is independent in basic activities of daily life and is generally safe at home, however, might require some help.

■ 10 – 13: Patient scores borderline independence in activities of daily life and requires some help with mobility maneuvers.

■ 0 – 9: Patient requires help with basic activities of daily life and is dependent of long term care.

While the score can depict the general status accurate enough, there are individual variations and other factors impacting mobility that should be taken into account.

Factors affecting mobility

Physical health is one of the main factors affecting mobility in the elderly, from occurrence of chronic or acute disease to sequels of stroke or cardiovascular orthostatic hypotension.

The level of nutrition also plays an important role in body alignment and overall mobility, for instance poorly nourished people suffer more frequently from muscle weakness and fatigue. On the other hand, obesity distorts movements and puts a lot of stress on joints.

Other risk factors for the elderly include high humidity, unsafe environments or slippery surfaces.

Activities of daily living (ADLs)

This is the term used to describe activities that refer to daily self care. It is used in healthcare settings in assessments that conclude the subject’s ability or inability to perform self care actions.

Examples include dressing, feeding, bathing, walking, work and leisure activities. For each individual, depending on lifestyle, these activities vary, however ability performance can be measured in similar manner.

There is also the concept of instrumental ADLs which are not necessary for fundamental functioning, however, offer a measure of independent living in assessments. Some examples of IADLs include housework, meal preparation, shopping, telephone and other communication means management, budgeting, transportation activities.

References

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

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

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

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