To examine interrater agreement of scores by physical therapy novices and experienced
clinicians on videotaped and live performances of the balance portion of Tinetti's
Performance Oriented Mobility Assessment (BPOMA).
A reliability design was used to assess the interrater agreement and consistency of
the BPOMA scores in an elderly population.
General community hospital and skilled nursing facility.
Twenty-six residents of a skilled nursing home, ranging in age from 66 to 99 yrs (mean
= 80.4, SD = 6.8), participated in Phase 1. Twenty-four hospital inpatients and five
residents of a skilled nursing home, ranging in age from 60 to 92 yrs (mean = 74.7,
SD = 7.9), participated in Phase 2. RATERS: Three student physical therapists scored
the patients in Phase 1. One student was designated the administrating rater (AR).
The AR instructed, guarded, and scored the subjects. The other two students were the
observing raters (ORs), whose role was to observe and score the subject's performances.
Nine physical therapy clinicians, ranging from 0 to 6 years of experience, rated subjects
in Phase 2.
Consistency and agreement of BPOMA scores were compared between clinicians with varying
levels of experience. In Phase I, BPOMA was scored on-site by three student physical
therapists. In Phase 2, videotaped performances were scored by five physical therapists,
one physical therapist assistant, and three student physical therapists.
Phase 1 demonstrated fair to excellent kappa coefficients (.40-1.00) in all maneuvers
across all raters. The ORs had higher agreement compared with the AR, ranging from
good to excellent (.75-1.00). Phase 2 demonstrated fair to good kappa coefficients
(.40-.75) in 5 of 8 maneuvers across all nine raters. When comparing proportion of
observed agreement to evaluate the years of experience on rater agreement, there was
no significant difference between clinician groups.
Fair to good reliability of BPOMA scores occurred across many rates of varied experience
with a small amount of training.