Hierarchical Assessment of Balance and Mobility

Braun, Tobias; Rieckmann, A.; Grüneberg, Christian; Marks, Detlef; Thiel, Christian

doi:10.1007/s00391-016-1026-0

Cited by 12 publications

(11 citation statements)

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“…In this study, 10 performance-based measures of the mobility capacity of older people were applied in the following order: DEMMI [27, 34], HABAM [35, 36], POMA [37], TUG [38], SPPB [39], 4-m gait speed (as part of the SPPB), 5-times chair rise test (5xCRT; as part of the SPPB), 2-min walk test [40], Barthel Index mobility subscale [41], and Functional Ambulation Categories (FAC) [42]. Additional file 1 provides a detailed description of the assessment procedures and all measurement instruments and their subscales.…”

Section: Methodsmentioning

confidence: 99%

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: Methodsmentioning

confidence: 99%

Reliability of mobility measures in older medical patients with cognitive impairment

et al. 2019

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“…Higher scores indicate greater ability (0-26 points). A validated German HABAM translation was used (16).…”

Section: Measurementsmentioning

confidence: 99%

“…The HABAM and DEMMI are commonly used tools that may accurately measure mobility and facilitate the proposition of healthcare services in older medical patients. German translations and cross-cultural adaptions of both scales have been performed recently (14,16). A comprehensive evaluation of the psychometric properties has been conducted for the German language DEMMI version in sub-acute geriatric rehabilita-tion only (17).…”

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

Braun

Grüneberg²,

Coppers³

et al. 2018

J Rehabil Med

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“…Higher scores indicate higher mobility functions (0 to 26 points) [55, 56]. A validated German language version was used [51, 57].…”

Section: Methodsmentioning

confidence: 99%

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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Hierarchical Assessment of Balance and Mobility

Abstract: A German HABAM version is now accessible for use in clinical practice. The results of a preliminary psychometric analysis indicate a potentially good practicability and sufficient construct validity. A comprehensive analysis of psychometric properties is pending.

Cited by 12 publications

References 35 publications

Reliability of mobility measures in older medical patients with cognitive impairment

Reliability of mobility measures in older medical patients with cognitive impairment

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

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

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