Identifying mobility instruments used in emergency departments and evaluating their measurement properties: A systematic review

Abstract

Background

Emergency clinicians need a measure of mobility that is valid, reliable, and quick and simple to administer. This review aimed to identify the available mobility instruments used to assess patients in the emergency department and to summarize their measurement properties.

Methods

We performed a systematic review in accordance with the PRISMA-COSMIN guideline. We searched electronic databases; PsycINFO, CINAHL, MEDLINE, and EMBASE from inception to March 2025 and included peer-reviewed publications that reported mobility instruments used in the emergency department and/or evaluated their measurement properties. The risk of bias of included studies was rated and the measurement properties (e.g. reliability) of included mobility instruments were summarized. We assessed the certainty of evidence for each measurement property using the GRADE approach, and provided an overall recommendation.

Results

Sixteen studies describing eight different mobility instruments were included. Two studies reported measurement properties for the 30 s Chair-Stand test, Cumulated Ambulation Score and the 4 m Gait Speed test. The measurement properties included reliability, measurement error, criterion and construct validity, and responsiveness. Each of the mobility instruments had ‘sufficient’ reliability and were recommended as being potentially suitable for use. Only evidence relating to the reliability of the 30 s Chair-Stand test was graded to be of high quality.

Conclusion

The 30 s Chair-Stand test, Cumulated Ambulation Score and the 4 m Gait Speed test are potentially suitable for use in the emergency department. There is a need for high-quality clinimetric studies to evaluate the measurement properties of mobility instruments used in the ED.