Cross-cultural Translation and Validation of the Performance Oriented Mobility Assessment (Poma) Scale Into Urdu Version

Among older persons, age-related impairments cause loss of postural control and balance that result in pain, independency and disability. One of the most common geriatric syndromes and most serious health issue threatening the independency of older persons is fall. The impact of these fall-related injuries on older person, families and societies and its fruitful intervention has made this issue important worldwide. Approximately 28-35% of people aged 65 years and 32-42% of aged 70 years' experience falls annually and 10% suffer serious injury such as, fracture, severe head trauma and joint dislocation. The incidence rate of fall is higher in hospitalized and residents of nursing home. It rises from middle age and peaks in person above 80 years. The risk factors associated with falls are, lower extremity muscle weakness, gait or balance deficits, use of an assistive device, cognitive impairment, visual deficit, arthritis and impaired activities of daily living . Different scales and tests are used for risk factors for falls, balance and mobility such as Berg Balance Scale, Time up and go test and dynamic gait index and Fullerton Advanced Balance Scale. One of these scales Performance-Oriented Mobility Assessment (POMA) scale. POMA scale has acceptable reliability and validity as compared to FRT and TUG in elderly. The advantages of this scale are; applicability, low cost, easy to administer, no equipment is needed other than a standard chair and stopwatch, evaluates functional activities and assesses both balance (POMA-B) and gait components (POMA-G)Originally POMA scale was used to assess risk of fall in institutionalized populations but later on used as an assessment tool for mobility and determine effects of interventions.

The POMA has found to be widely used in patients who have dynamic and reactive balance deficits. It comprises 16 items (9 balance and 7 gait related). Total time taken for administration is approximately 10 minutes and total score is 28; 16 is balance and 12 is gait score. Some Items are scored dichotomously (can/cannot perform) and others are scored 0, 1 or 2 points for quality of performance. The higher scores show low fall risk and better balance while lower score predicts poorer balance and greater risk of fall. The score 19-24/28 indicates moderate risk for falling while score <19 indicates a "high" risk for falling.