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Validity of motor impairment scale in long-term care insurance system of Korea.

Kim YH, Kwon CH, Shin HI - Ann Rehabil Med (2013)

Bottom Line: There were significant differences in characteristics between facility group and domiciliary group.In domiciliary group, no significant correlation was found between the MIS and service time.As an easy, objective, and simple method, MIS can be a useful tool in the LTCI system of Korea.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To validate the Motor Impairment Scale (MIS) of the Korean long-term care insurance (LTCI) system by comparing with the service time offered for aiding activities of daily living (ADL) and the ADL score.

Methods: A total of 407 elderly subjects without dementia who had used LTCI services were included in this study. Spearman correlations and multivariate linear regression models were employed to determine the relationship of the upper and lower limb MIS (U-MIS and L-MIS, respectively) to the service time and ADL. Stratified analyses for the facility group (n=121) and the domiciliary group (n=286) were performed.

Results: There were significant differences in characteristics between facility group and domiciliary group. The MIS was significantly correlated with service time in facility group (Spearman p=0.41 for U-MIS, Spearman p=0.40 for L-MIS). After adjusting for age, sex, and cognition score, U-MIS was an independent predictor for service time in facility group (p=0.04). In domiciliary group, no significant correlation was found between the MIS and service time. The MIS correlated with all of the ADL items and total ADL score in both groups. After adjusting for other factors including age, sex, and cognitive score, U-MIS and L-MIS were independent variables for explaining the total ADL score in both groups.

Conclusion: The validity of the MIS as an evaluation tool in the physically-disabled elderly is higher in facility group than in domiciliary group. As an easy, objective, and simple method, MIS can be a useful tool in the LTCI system of Korea.

No MeSH data available.


Related in: MedlinePlus

The positions to evaluate the Motor Impairment Scale in long-term care insurance for upper limbs (A) and lower limbs (B). Each upper limb was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and hand in palm-down position in the sitting or standing state. For each of the lower limbs, investigators instructed the elderly to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position.
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Figure 2: The positions to evaluate the Motor Impairment Scale in long-term care insurance for upper limbs (A) and lower limbs (B). Each upper limb was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and hand in palm-down position in the sitting or standing state. For each of the lower limbs, investigators instructed the elderly to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position.

Mentions: The evaluation items in the LTCI system were recorded by qualified evaluation agents. The evaluation agents recorded age, sex, care grade, vision impairment, and hearing impairment after gathering this information from the participants, caregivers or care staff. Motor impairment was evaluated using the MIS with a 3-grade system by observing the actual movements of the participants, and not just by inquiring about the ability to perform. The MIS was assessed for each of the upper and lower limbs as shown in Fig. 2 (U-MIS and L-MIS, respectively). Each of the upper limbs was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and the hand in the palm-down position, in the sitting or standing state. For each of the lower limbs, investigators instructed the subject to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position. After the limb was placed in the appropriate position, the subject's effort in making the movement was graded on a scale from 0 to 2: normal was 0, partial paralysis was 1, and complete paralysis was 2. A normal (score of 0) was defined as holding the limb for a full 10 seconds for the upper limbs, and a full 5 seconds for the lower limbs. Partial paralysis (score of 1) was defined as making some effort against gravity or drifting down before the full 10 seconds for the upper limbs, and 5 seconds for the lower limbs. Complete paralysis (score of 2) was defined as no movement or no effort against gravity for both of the upper and lower limbs. Each limb was tested in turn, and the scores for the upper limbs were added together to determine the U-MIS. L-MIS was acquired by adding the scores for each lower limb. Each of the U-MIS and L-MIS ranged from 0 to 4 points. A higher MIS score indicated more severe motor impairment.


Validity of motor impairment scale in long-term care insurance system of Korea.

Kim YH, Kwon CH, Shin HI - Ann Rehabil Med (2013)

The positions to evaluate the Motor Impairment Scale in long-term care insurance for upper limbs (A) and lower limbs (B). Each upper limb was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and hand in palm-down position in the sitting or standing state. For each of the lower limbs, investigators instructed the elderly to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3713298&req=5

Figure 2: The positions to evaluate the Motor Impairment Scale in long-term care insurance for upper limbs (A) and lower limbs (B). Each upper limb was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and hand in palm-down position in the sitting or standing state. For each of the lower limbs, investigators instructed the elderly to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position.
Mentions: The evaluation items in the LTCI system were recorded by qualified evaluation agents. The evaluation agents recorded age, sex, care grade, vision impairment, and hearing impairment after gathering this information from the participants, caregivers or care staff. Motor impairment was evaluated using the MIS with a 3-grade system by observing the actual movements of the participants, and not just by inquiring about the ability to perform. The MIS was assessed for each of the upper and lower limbs as shown in Fig. 2 (U-MIS and L-MIS, respectively). Each of the upper limbs was assessed by asking the subject to extend the limb and hold it for 10 seconds with 90° of shoulder flexion and the hand in the palm-down position, in the sitting or standing state. For each of the lower limbs, investigators instructed the subject to extend the limb and hold it for 5 seconds with 30° of hip flexion in the supine position. After the limb was placed in the appropriate position, the subject's effort in making the movement was graded on a scale from 0 to 2: normal was 0, partial paralysis was 1, and complete paralysis was 2. A normal (score of 0) was defined as holding the limb for a full 10 seconds for the upper limbs, and a full 5 seconds for the lower limbs. Partial paralysis (score of 1) was defined as making some effort against gravity or drifting down before the full 10 seconds for the upper limbs, and 5 seconds for the lower limbs. Complete paralysis (score of 2) was defined as no movement or no effort against gravity for both of the upper and lower limbs. Each limb was tested in turn, and the scores for the upper limbs were added together to determine the U-MIS. L-MIS was acquired by adding the scores for each lower limb. Each of the U-MIS and L-MIS ranged from 0 to 4 points. A higher MIS score indicated more severe motor impairment.

Bottom Line: There were significant differences in characteristics between facility group and domiciliary group.In domiciliary group, no significant correlation was found between the MIS and service time.As an easy, objective, and simple method, MIS can be a useful tool in the LTCI system of Korea.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To validate the Motor Impairment Scale (MIS) of the Korean long-term care insurance (LTCI) system by comparing with the service time offered for aiding activities of daily living (ADL) and the ADL score.

Methods: A total of 407 elderly subjects without dementia who had used LTCI services were included in this study. Spearman correlations and multivariate linear regression models were employed to determine the relationship of the upper and lower limb MIS (U-MIS and L-MIS, respectively) to the service time and ADL. Stratified analyses for the facility group (n=121) and the domiciliary group (n=286) were performed.

Results: There were significant differences in characteristics between facility group and domiciliary group. The MIS was significantly correlated with service time in facility group (Spearman p=0.41 for U-MIS, Spearman p=0.40 for L-MIS). After adjusting for age, sex, and cognition score, U-MIS was an independent predictor for service time in facility group (p=0.04). In domiciliary group, no significant correlation was found between the MIS and service time. The MIS correlated with all of the ADL items and total ADL score in both groups. After adjusting for other factors including age, sex, and cognitive score, U-MIS and L-MIS were independent variables for explaining the total ADL score in both groups.

Conclusion: The validity of the MIS as an evaluation tool in the physically-disabled elderly is higher in facility group than in domiciliary group. As an easy, objective, and simple method, MIS can be a useful tool in the LTCI system of Korea.

No MeSH data available.


Related in: MedlinePlus