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A patient who is capable of walking with crutches independently, without being able to transfer into a standing position in the absence of assistance, cannot receive more than 4 points transfer from bed to chair. The medical data used in this study was data of the clinical routine, obtained and used in the routine treatment processes, therefore no additional written consent was needed to be obtained for its analysis. Eight experts four physicians and four physiotherapists, each with at least 3 years of experience in ACR , who were not involved in the development process of the instrument, answered a dichotomous question about the concordance of the instrument and the measured construct. Kappa describes the concordance of two variables with a value between 0 and 1, where higher values represent a higher concordance [ 42 ]. The item wheelchair mobility could not logically be included in the hierarchical sequence. However, the autonomous accomplishment of the mobility tasks is crucial. Therefore, we decided to operationalise wheelchair mobility outside of the sequential hierarchy. Recently, she starred in the film Jyothi Lakshmi , directed by Puri Jagannadh.
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