Introduction of the Charité Mobility Index (CHARMI) – A Novel Clinical Mobility Assessment for Acute Care Rehabilitation

Abstract

IntroductionMobility is an essential part of a person’s functioning and independence. It encompasses locomotive functions, but also the more basic functions of positioning and transferring. Despite the availability of several mobility-related assessment instruments to date, there is a need for assessment instruments with the specific capability to display the full range of mobilisation. Our aim was to develop and validate a scoring instrument with hierarchical composition where every score value stands for a defined mobility level.Participants and MethodsA previously developed and validated pilot instrument was applied to assess patients (n = 113) admitted to an acute rehabilitation programme. Mobility was assessed during admission, subsequently at weekly intervals and at discharge to acquire a detailed status of mobility at multiple time points and individual mobilisation profiles over time. The scoring instrument was then remodelled based on clinical criteria to establish an easy-to-use scoring system with hierarchical composition. Psychometric properties were calculated using an independent sample of 87 consecutive patients.ResultsContent validity could be affirmed. The psychometric tests demonstrated excellent convergent validity with the three mobility items of the Barthel Index (r = 0.93), despite an adequately lower correlation with the whole Barthel Index (r = 0.63). Adequate floor and ceiling effects (20%) and a large responsiveness to change (ǀdǀ = 1.7, p < 0.001) between admission and discharge values were demonstrated. Inter-rater reliability was excellent (κ = 0.88).ConclusionsThe Charité Mobility Index (CHARMI) is a promising, easy-to-use hierarchical scoring instrument assessing the full individual spectrum from immobility to unlimited mobility, including positioning, transfer and locomotion items. It allows for monitoring of mobilisation.

DNA of centuries-old timber can reveal its origin

“…ring-porous wood with wide multiseriate axial rays, it is not feasible to identify the continental origin of archaeological oak ship timber based on its wood structure 55 . Continental provenance identification of such timber based on the DNA analyses and using previously developed markers 26 specifically for this purpose can overcome this problem. From nine ship samples, material collected from Mönchgut Ostsee shipwreck in Rügen, Northeast Germany, showed a clear signal of European origin.…”

“…To determine the continental origin, we used the chloroplast marker set developed and published by Schroeder et al 26 . First, we used DNA from the contemporary trees to test whether continental provenancing also worked for Q. pyrenaica and Q. faginea —two species that were not included in the study of Schroeder et al 26 but were commonly used in constructions 10 . Next, DNA from the historical objects extracted by both extraction protocols was amplified according to Schroeder et al 26 .…”

“…First, we used DNA from the contemporary trees to test whether continental provenancing also worked for Q. pyrenaica and Q. faginea —two species that were not included in the study of Schroeder et al 26 but were commonly used in constructions 10 . Next, DNA from the historical objects extracted by both extraction protocols was amplified according to Schroeder et al 26 . Due to the small amount of total DNA extracted from the historic objects, the DNA quantity was not determined and a standard dilution of 1:10 and 1:20 (DNA:water) was used for all PCR reactions.…”

“…Some of the haplotypes are spread over large areas but some are unique for certain regions and thus can be used for identification of timber origin. Moreover, Schroeder et al 26 developed a set of DNA markers for the identification of oak timber origin on a continental level. These markers can be used as a first step to identify the continental source (i.e.…”

Fachübergreifende Frührehabilitation nach Sepsis – Eine retrospektive Analyse *

“…Eine Zuordnung der differenziert verordneten Hilfsmittel wurde anhand des Hilfsmittelverzeichnisses auf Grundlage des § 139 SGB V getroffen[44]. Zur Erfassung der Mobilität wurde der Charité Mobilitätsindex (CHARMI ® ) eingesetzt[45]. Die Operationalisierung der ADL-Kompetenz erfolgte mittels Barthel-Index (BI).…”