Tool Description

  • The COVS is a measure of mobility that has been applied to specific diagnostic groups such as stroke, traumatic brain injury, amputations, and musculoskeletal injuries in a variety of settings (acute, inpatient/outpatient rehabilitation, and community settings).
  • Items include rolling, lying to sitting, sitting balance, transfers, ambulation, wheelchair mobility, and arm function.
  • 2 subscales have been reported for the COVS: 1) General Mobility subscale (7 items) and 2) Ambulation subscale (5 items)

Clinical Considerations

There are two versions of this tool. The COVS is clinician-administered through observation of task performance. The TCOVS is self-reported and administered by telephone. Both versions of this tool offer a more relevant and complete profile of mobility after SCI when compared with other mobility tools.

ICF Domain

Activity ▶ Mobility

Administration

2 versions:

1) performance (clinician-administered through observation of task performance); can be conducted.

  • In-person assessment takes approximately 35 minutes.

2) Self-report (telephone interview – TCOVS).

  • Assessment via telephone interview takes approximately 5 minutes (subjects are given the questions ahead of time).

Number of Items

13

Equipment

  • Stopwatch
  • Bed sticks
  • Bed ladders
  • Lifting blocks
  • Transfer boards
  • Leg straps
  • Exercise mat
  • Ramp (1 inch to 12 inch rise)
  • 6 inch platform

Scoring

  • Each item is scored on a 7-point scale ranging from 1 (fully dependent mobility) to 7 (normal independent mobility).
  • COV scores are generally reported as a summed total score ranging from 13 to 91. The general mobility subscale has scores that range from 7-49, while the ambulation subscale has scores ranging from 5-35.

Languages

English

Training Required

Raters should be trained in the administration of both the COVS and TCOVS (see Campbell & Kendall 2003 for further details).

Availability

Worksheet can be found in Appendix of publication linked here.

Full guidelines and scoring software is available for purchase here.

Number of studies reporting psychometric properties: 2

Interpretability

  • Lower scores reflect poorer levels of mobility.
  • No cut-points or normative data have been established for the SCI population
  • Published data for the SCI population is available for comparison (see the Interpretability section of the Clinical Summary).

MCID: not established in SCI

SEM: not established in SCI

MDC: not established in SCI

Reliability – High

Number of studies reporting validity data: 1

High Test-retest reliability for the telephone-administered COVS (TCOVS)

Intraclass Correlation Coefficient = 1.00

High Equivalence reliability between TCOVS and COVS

Intraclass Correlation Coefficient = 0.98

(Barket et al. 2007; study 1 n=37; 31 males, 6 females; traumatic SCI, 18 tetraplegia, 19 paraplegia; 19 complete injury, 18 incomplete injury; mean time since injury (SD): 8 (3.7) months, community living)

Validity – High

Number of studies reporting reliability data: 1

  • The COVS can discriminate across clinically distinct groups (by lesion level, completeness of injury and walking status) during discharge from hospital and admission to a transitional rehabilitation program.

(Campbell & Kendall 2003; n=169; 124 males, 45 females; 36 complete paraplegia, 56 incomplete paraplegia, 25 complete paraplegia, 52 incomplete paraplegia, community rehab)

Responsiveness

No values were reported for the responsiveness of the COVS for the SCI population.

Floor/ceiling effect

No values were reported for the presence of floor/ceiling effects in the COVS for the SCI population.

Reviewers

Dr. Carlos Cano-Herrera, Tyra Chu

Date Last Updated

December 31, 2024

Barker RN, Amsters DI, Kendall MD, Pershouse KJ, Haines TP. Reliability of the Clinical Outcome Variables Scale when administered via telephone to assess mobility in people with spinal cord injury. Arch Phys Med Rehabil 2007; 88: 632-7.
http://www.ncbi.nlm.nih.gov/pubmed/17466733

Campbell J, Kendall M. Investigating the suitability of the Clinical Outcome Variables Scale (COVS) as a mobility outcome measure in spinal cord in jury rehabilitation. Physiother. Can 2003; 55: 135-144.
http://scholar.google.ca/scholar?q=Investigating+the+suitability+of+the+Clinical+Outcome+Variables+Scale+%28COVS%29+as+a+mobility+outcome+measure+in+spinal+cord+injury+rehabilitation.&btnG=&

Ekstrand E, Ringsberg KA, Pessah-rasmussen H. The physiotherapy clinical outcome variables scale predicts length of hospital stay, discharge destination and future home facility in the acute comprehensive stroke unit. J Rehabil Med. 2008;40(7):524-8.
http://www.ncbi.nlm.nih.gov/pubmed/18758668

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