Comparison of the de Morton Mobility Index and Hierarchical Assessment of Balance and Mobility in older acute medical patients

Braun, Tobias; Grüneberg, Christian; Coppers, Anna; Tofaute, L.; Thiel, Christian

doi:10.2340/16501977-2320

Cited by 9 publications

(10 citation statements)

References 31 publications

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“…The test-retest reliability of the DEMMI and HABAM has not been examined in a well-defined group of older people with cognitive impairment before. The test-retest reliability of the DEMMI (ICC = 0.99) is very high and comparable to the intra-rater reliability reported by other authors (0.86 to 0.98) [46, 57]. In addition, the HABAM ICC value of 0.98 found in the present sample is comparable to the test-retest reliability found in two samples of mixed geriatric inpatients, assessed within one ( n = 30; ICC = 0.99 [57]) or two ( n = 63; ICC = 0.91 [58]) hospital days.…”

Section: Discussionsupporting

confidence: 87%

Reliability of mobility measures in older medical patients with cognitive impairment

et al. 2019

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BackgroundMobility is a key indicator of physical functioning in older people, but there is limited evidence of the reliability of mobility measures in older people with cognitive impairment. This study aimed to examine the test-retest reliability and measurement error of common measurement instruments of mobility and physical functioning in older patients with dementia, delirium or other cognitive impairment.MethodsA cross-sectional study was performed in a geriatric hospital. Older acute medical patients with cognitive impairment, indicated by a Mini-Mental State Examination (MMSE) score of ≤24 points, were assessed twice within 1 day by a trained physiotherapist.The following instruments were applied: de Morton Mobility Index, Hierarchical Assessment of Balance and Mobility, Performance-Oriented Mobility Assessment, Short Physical Performance Battery, 4-m gait speed, 5-times chair rise test, 2-min walk test, timed up and go test, Barthel Index mobility subscale and Functional Ambulation Categories.As appropriate, the intraclass correlation coefficient (ICC), Cohen’s kappa, standard error of measurement, limits of agreement and minimal detectable change (MDC) values were estimated.ResultsSixty-five older acute medical patients with cognitive impairment participated in the study (mean age: 82 ± 7 years; mean MMSE: 20 ± 4, range: 10 to 24 points). Some participants were physically or cognitively unable to perform the gait speed (46%), 2-min walk (46%), timed up and go (51%) and chair rise (75%) tests.ICC and kappa values were above 0.9 in all instruments except for the gait speed (ICC = 0.86) and chair rise (ICC = 0.72) measures. Measurement error is reported for each instrument. The absolute limits of agreement ranged from 11% (de Morton Mobility Index and Hierarchical Assessment of Balance and Mobility) to 35% (chair rise test).ConclusionsThe test-retest reliability is sufficient (> 0.7) for group-comparisons in all examined instruments. Most mobility measurements have limited use for individual monitoring of mobility over time in older hospital patients with cognitive impairment because of the large measurement error (> 20% of scale width), even though relative reliability estimations seem sufficient (> 0.9) for this purpose.Trial registrationGerman Clinical Trials Register (DRKS00005591). Registered 2 February 2015.Electronic supplementary materialThe online version of this article (10.1186/s12877-019-1036-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Reliability of mobility measures in older medical patients with cognitive impairment

et al. 2019

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“…Second, at least one measure of mobility could be left out, e.g. TUG and/or HABAM and/or gait speed, since the DEMMI seems to be an appropriate, feasible and highly valid instrument to measure mobility capacity in this population [33, 51, 70]. Third, since routine MMSE discharge data was missing for 10 of 28 participants, the study personnel should carefully screen follow-up data on cognition and, if required, perform the MMSE with the participants.…”

Section: Discussionmentioning

confidence: 99%

“…The same device was used for all assessments in a single session. Descriptions of several study assessments used here are based on previous publications [49–51].…”

Section: Methodsmentioning

confidence: 99%

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An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial

et al. 2019

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Background There is inconclusive evidence for the effectiveness of additional exercise in older hospital patients. The aims of this study were (1) to assess the feasibility of an augmented prescribed exercise program (APEP) in older acute medical patients and (2) to measure the potential effects of APEP on mobility capacity in order to assess the feasibility of a large full-scale study. Methods We conducted a single-center, prospective, parallel-group, single-blinded, randomized (1:1) controlled pilot and feasibility trial. Participants were recruited from acute geriatric wards of a general hospital. Key inclusion criteria were: age ≥ 65 years and walking ability. Key exclusion criteria were severe cognitive impairment and medical restriction for physical exercise interventions. Both groups received usual care, including physiotherapy. Intervention group participants were scheduled for additional exercise sessions (20–30 min, 4-5x/week). Feasibility of the trial design was assessed along pre-defined criteria for process, resources and management. Feasibility of the APEP intervention was analyzed by means of adherence, compliance and safety. Outcomes were measured at baseline and prior to hospital discharge. The primary outcome was mobility capacity (de Morton Mobility Index; DEMMI). Secondary outcomes were walking ability, physical endurance, fear of falling, frailty and length of stay. Results Thirty-five participants were recruited (recruitment rate 20.3%). We lost 7 participants to follow-up (retention rate: 80%). Intervention group participants (n = 17) each participated in 5.3 ± 2.2 additional exercise sessions (mean duration: 23.2 ± 4.0 min; mean adherence rate 78% ± 26%). No severe adverse events occurred during study assessments or APEP sessions. There were no statistically significant differences in mean change scores in any outcome measure. A sample of 124 participants would be required to detect a difference of 4 DEMMI points (ES = 0.45) with a power of 80%. Conclusions This small feasibility RCT indicates that an APEP intervention may be safe and feasible in older acute medical patients. APEP may possibly induce small to moderate effects on mobility, but the clinical relevance of these effects may be limited. These results inform the planning of a larger-scale phase III study. Trial registration German Clinical Trials Register ( DRKS00011262 ). Registered 27 October 2016. Electronic supplementary material The online version of this article (10.1186/s12877-019-1246-4) contains supplementary material, which is available to authorized users.

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DNVF Memorandum – Ziele und Methoden bewegungsbezogener Versorgungsforschung

Gabrys,

Schaller,

Peters

et al. 2024

Gesundheitswesen

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zusammenfassungDas DNVF Memorandum – Ziele und Methoden bewegungsbezogener Versorgungsforschung fasst das erste Mal das stark interdisziplinäre und interprofessionelle Feld der Bewegungsversorgung im deutschen Gesundheitssystem zusammen. Neben einer begrifflichen Einordnung und Definition zentraler Maßnahmen und Konzepte der Bewegungsversorgungsforschung werden bestehende Forschungslücken und Forschungsbedarfe herausgearbeitet und Methoden zur Weiterentwicklung des noch recht jungen Forschungsgebiets beschrieben. Ein besonderer Fokus liegt hierbei auf der Darstellung relevanter Zielparameter und deren standardisierte Erfassung mittels etablierter und valider Messinstrumente. Ziel des Memorandums ist es, ein einheitliches Verständnis für den komplexen Gegenstand der Bewegungsförderung und Bewegungstherapie im Kontext der Gesundheitsversorgung zu schaffen, neue Forschungsinitiativen anzustoßen und die bestehende gute Evidenz zur Wirksamkeit von körperlicher Aktivität und körperlichem Training stärker in die Gesundheitsversorgung zu integrieren.

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Comparison of the de Morton Mobility Index and Hierarchical Assessment of Balance and Mobility in older acute medical patients

Abstract: The DEMMI and the HABAM appear to be suitable for measuring mobility in older acute medical patients.

Cited by 9 publications

References 31 publications

Reliability of mobility measures in older medical patients with cognitive impairment

Reliability of mobility measures in older medical patients with cognitive impairment

An augmented prescribed exercise program (APEP) to improve mobility of older acute medical patients – a randomized, controlled pilot and feasibility trial

DNVF Memorandum – Ziele und Methoden bewegungsbezogener Versorgungsforschung

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