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The de Morton Mobility Index (DEMMI): an essential health index for an ageing world.

de Morton NA, Davidson M, Keating JL - Health Qual Life Outcomes (2008)

Bottom Line: The DEMMI provides clinicians and researchers with a valid interval-level method for accurately measuring and monitoring mobility levels of older acute medical patients.DEMMI validation studies are underway in other clinical settings and in the community.Given the ageing population and the importance of mobility for health and community participation, there has never been a greater need for this instrument.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, PO Box 527, Frankston, Victoria 3199, Australia. natalie.demorton@med.monash.edu.au

ABSTRACT

Background: Existing instruments for measuring mobility are inadequate for accurately assessing older people across the broad spectrum of abilities. Like other indices that monitor critical aspects of health such as blood pressure tests, a mobility test for all older acute medical patients provides essential health data. We have developed and validated an instrument that captures essential information about the mobility status of older acute medical patients.

Methods: Items suitable for a new mobility instrument were generated from existing scales, patient interviews and focus groups with experts. 51 items were pilot tested on older acute medical inpatients. An interval-level unidimensional mobility measure was constructed using Rasch analysis. The final item set required minimal equipment and was quick and simple to administer. The de Morton Mobility Index (DEMMI) was validated on an independent sample of older acute medical inpatients and its clinimetric properties confirmed.

Results: The DEMMI is a 15 item unidimensional measure of mobility. Reliability (MDC(90)), validity and the minimally clinically important difference (MCID) of the DEMMI were consistent across independent samples. The MDC(90) and MCID were 9 and 10 points respectively (on the 100 point Rasch converted interval DEMMI scale).

Conclusion: The DEMMI provides clinicians and researchers with a valid interval-level method for accurately measuring and monitoring mobility levels of older acute medical patients. DEMMI validation studies are underway in other clinical settings and in the community. Given the ageing population and the importance of mobility for health and community participation, there has never been a greater need for this instrument.

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Validation sample: flow of participants through the study. * 6 patients were readmitted during the study period and were tested twice as 'new admissions.' # 106 'new admission' patients (100 patients) completed a hospital admission assessment (6 patients did not perform an admission assessment)
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Figure 3: Validation sample: flow of participants through the study. * 6 patients were readmitted during the study period and were tested twice as 'new admissions.' # 106 'new admission' patients (100 patients) completed a hospital admission assessment (6 patients did not perform an admission assessment)

Mentions: Figure 3 shows that of 344 new hospital admissions screened, 216 were eligible, 132 were recruited and 112 performed at least one mobility assessment. Six patients were readmitted during the study period and were included twice as new hospital admissions. Another six patients did not complete a hospital admission assessment. Table 2 shows the admission characteristics for the 106 patients included in this study. A total of 312 mobility assessments were performed using the 17 mobility items. Patients in the validation study did not differ from the instrument development sample on any baseline characteristic.


The de Morton Mobility Index (DEMMI): an essential health index for an ageing world.

de Morton NA, Davidson M, Keating JL - Health Qual Life Outcomes (2008)

Validation sample: flow of participants through the study. * 6 patients were readmitted during the study period and were tested twice as 'new admissions.' # 106 'new admission' patients (100 patients) completed a hospital admission assessment (6 patients did not perform an admission assessment)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2551589&req=5

Figure 3: Validation sample: flow of participants through the study. * 6 patients were readmitted during the study period and were tested twice as 'new admissions.' # 106 'new admission' patients (100 patients) completed a hospital admission assessment (6 patients did not perform an admission assessment)
Mentions: Figure 3 shows that of 344 new hospital admissions screened, 216 were eligible, 132 were recruited and 112 performed at least one mobility assessment. Six patients were readmitted during the study period and were included twice as new hospital admissions. Another six patients did not complete a hospital admission assessment. Table 2 shows the admission characteristics for the 106 patients included in this study. A total of 312 mobility assessments were performed using the 17 mobility items. Patients in the validation study did not differ from the instrument development sample on any baseline characteristic.

Bottom Line: The DEMMI provides clinicians and researchers with a valid interval-level method for accurately measuring and monitoring mobility levels of older acute medical patients.DEMMI validation studies are underway in other clinical settings and in the community.Given the ageing population and the importance of mobility for health and community participation, there has never been a greater need for this instrument.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, PO Box 527, Frankston, Victoria 3199, Australia. natalie.demorton@med.monash.edu.au

ABSTRACT

Background: Existing instruments for measuring mobility are inadequate for accurately assessing older people across the broad spectrum of abilities. Like other indices that monitor critical aspects of health such as blood pressure tests, a mobility test for all older acute medical patients provides essential health data. We have developed and validated an instrument that captures essential information about the mobility status of older acute medical patients.

Methods: Items suitable for a new mobility instrument were generated from existing scales, patient interviews and focus groups with experts. 51 items were pilot tested on older acute medical inpatients. An interval-level unidimensional mobility measure was constructed using Rasch analysis. The final item set required minimal equipment and was quick and simple to administer. The de Morton Mobility Index (DEMMI) was validated on an independent sample of older acute medical inpatients and its clinimetric properties confirmed.

Results: The DEMMI is a 15 item unidimensional measure of mobility. Reliability (MDC(90)), validity and the minimally clinically important difference (MCID) of the DEMMI were consistent across independent samples. The MDC(90) and MCID were 9 and 10 points respectively (on the 100 point Rasch converted interval DEMMI scale).

Conclusion: The DEMMI provides clinicians and researchers with a valid interval-level method for accurately measuring and monitoring mobility levels of older acute medical patients. DEMMI validation studies are underway in other clinical settings and in the community. Given the ageing population and the importance of mobility for health and community participation, there has never been a greater need for this instrument.

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