The Barthel Index and the Cumulated Ambulation Score are superior to the de Morton Mobility Index for the early assessment of outcome in patients with a hip fracture admitted to an acute geriatric ward

Abstract

The value of using DEMMI and 30-s CST in patients with hip fracture during the acute hospitalization seems limited in comparison with BI and CAS. DEMMI and CAS seem to assess similar constructs. Implications for Rehabilitation Outcome measures used for the evaluation of patients with hip fracture should be validated in the specific time-line and rehabilitation setting following surgery, before being implemented in daily clinical practice. We suggest the Cumulated Ambulation Score for monitoring basic mobility during the acute hospitalization for the entire group of patients recovering from a hip fracture, while DEMMI seems more feasible for the subgroup of patients with higher functional levels. The modified Barthel Index seems useful for the assessment of activities of daily living in the acute care setting of patients with hip fracture. We cannot recommend the original 30-s Chair Stand Test to be used for the evaluation of patients with hip fracture in the acute hospital setting.

Preliminary effect and feasibility of physiotherapy with strength training and protein-rich nutritional supplement in combination with anabolic steroids in cross-continuum rehabilitation of patients with hip fracture: protocol for a blinded randomized controlled pilot trial (HIP-SAP1 trial)

“…The de Morton Mobility Index is used for measuring mobility and consists of 15 mobility items ranging from mobility in bed to dynamic balance. The test result is a total score from 0 to 100, with 100 representing the highest level of mobility [39–41]. Activity: Sedentary time (lying/sitting), upright time (standing/walking), steps, and transfers is measured using a body-worn accelerometer-based activity monitor (activPAL) [42].…”

Reliability, validity, interpretability and responsiveness of the DEMMI mobility index for Brazilian older hospitalized patients

“…Moreover, all alpha values were less than 0.90, indicating that no redundant exists in the DEMMI [21]. The values reported by all authors classify agreement as very good in all versions [8,14,15,16]. Accordingly, these findings suggest that the Brazilian Portuguese version of the DEMMI also appears to be a useful measure assessing patients' mobility function…”

“…In our study, we used for comparison an objective measurement of the level of physical activity during 24 hours, using accelerometry. The other studies used for comparison the Barthel [8] index, Timed Up and Go test [14,15] and Cumulated Ambulation Score [16]. Among all those analyzed, only the Cumulated Ambulation Score presents domains closer to the construct of the DEMMI, which explains the greater…”

“…No floor or ceiling effects were observed in Brazilian Portuguese version, probable because our sample was composed by old and very old individuals in different clinical situations, which outlines the potential of this instrument to evaluate patients in different clinical states. The only previous version that reported a floor effect was the Danish [16], however the individuals involved in their study were in their first day after hip fracture corrective surgery. In this kind of surgery, the individual cannot discharge all his weight on the operated lower limb and the pain may be significant at this time [32].…”

“…The DEMMI was developed in English and previously translated into different languages [14][15][16]. Most language versions of the DEMMI were translated through a rigorous procedure for cross-cultural validation and adaption [17].…”