A head-to-head comparison of the de Morton Mobility Index (DEMMI) and Elderly Mobility Scale (EMS) in an older acute medical population.

Purpose: To compare the clinimetric properties of the de Morton Mobility Index (DEMMI®) and the Elderly Mobility Scale (EMS).

Method: A head-to-head comparison of the EMS and DEMMI® with 120 consecutive older acute medical patients. The DEMMI® and EMS were administered within 48 h of hospital admission and discharge.

Reliability and validity of the German translation of the de Morton Mobility Index (DEMMI) performed by physiotherapists in patients admitted to a sub-acute inpatient geriatric rehabilitation hospital.

Background: Mobility is a key outcome in geriatric rehabilitation. The de Morton Mobility Index (DEMMI) is an internationally well-established, unidimensional measure of mobility with good psychometric properties. The aim of this study was to examine the reliability and construct validity of the German translation of the DEMMI in geriatric inpatients.

A physical function test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored).

Background: Several tests have recently been developed to measure changes in patient strength and functional outcomes in the intensive care unit (ICU). The original Physical Function ICU Test (PFIT) demonstrates reliability and sensitivity.

Objective: The aims of this study were to further develop the original PFIT, to derive an interval score (the PFIT-s), and to test the clinimetric properties of the PFIT-s.

The Development of the de Morton Mobility Index (DEMMI) in an independent sample of older acute medical patients: refinement and validation using the Rasch model (part 2).

This study describes the refinement and validation of the 17-item DEMMI in an independent sample of older acute medical patients. Instrument refinement was based on Rasch analysis and input from clinicians and researchers. The refined DEMMI was tested on 106 older general medical patients and a total of 312 mobility assessments were conducted.

The development of the de morton mobility index (DEMMI) in an older acute medical population: item reduction using the Rasch model (part 1).

The DEMMI (de Morton Mobility Index) is a new and advanced instrument for measuring the mobility of all older adults across clinical settings. It overcomes practical and clinimetric limitations of existing mobility instruments. This study reports the process of item reduction using the Rasch model in the development of the DEMMI.

An enhanced exercise and cognitive programme does not appear to reduce incident delirium in hospitalised patients: a randomised controlled trial.

Objective: To determine if a programme of progressive resistance exercise, mobilisation and orientation, in addition to usual care, was superior to usual care alone in the prevention of incident delirium in older hospitalised patients.

Design: A randomised controlled trial.

Setting: The study was performed at a secondary referral hospital in Melbourne, Australia between May 2005 and December 2007.

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study.

Objective: To investigate factors that predict discharge destination for patients making the transition from hospital to the community.

Methods: Using a prospective cohort design, 696 patients from 11 Transition Care Programs were recruited. Baseline patient and program characteristics were considered for predicting discharge destination, functional status, and patient length of stay.

Validity of the de Morton Mobility Index (DEMMI) for measuring the mobility of patients with hip fracture during rehabilitation.

Purpose: Many patients suffer long term loss of mobility after hip fracture but there is no gold standard method for measuring mobility in this group. We aimed to validate a new mobility outcome measure, the de Morton Mobility Index (DEMMI) in a hip fracture population during inpatient rehabilitation.

Method: The DEMMI was compared with the existing measures of activity limitation: 6 minute walk test, 6 metre walk test and Barthel Index on 109 consecutive patients admitted to rehabilitation after surgery for hip fracture.

An investigation of the validity of six measures of physical function in people awaiting joint replacement surgery of the hip or knee.

Objective: To assess and compare the validity of six physical function measures in people awaiting hip or knee joint replacement.

Design: Eighty-two people awaiting hip or knee replacement were assessed using six physical function measures including the WOMAC Function scale, SF-36 Physical Function scale, SF-36 Physical Component Summary scale, Patient Specific Functional Scale, 30-second chair stand test, and 50-foot timed walk. Validity was assessed using a head-to-head comparison design.

Validation of the de Morton Mobility Index (DEMMI) with older community care recipients.

Aim:   To validate the de Morton Mobility Index (DEMMI) in community-dwelling older adults who require informal care.

Methods:   Thirty-five consecutively recruited older adults (>65 years) living in the community who required informal care were included from Melbourne and regional Victoria, Australia. Participants were assessed using a battery of questionnaires, the Falls Risk for Older People (Community version), modified Barthel Index, Geriatric Depression Scale, the Medical Outcomes Survey Short Form 36, the Assessment of Quality of Life and the DEMMI.

Reproducibility and validity of the Dutch translation of the de Morton Mobility Index (DEMMI) used by physiotherapists in older patients with knee or hip osteoarthritis.

Objective: To examine the reproducibility, construct validity, and unidimensionality of the Dutch translation of the de Morton Mobility Index (DEMMI), a performance-based measure of mobility for older patients.

Design: Cross-sectional study.

Setting: Rehabilitation center (reproducibility study) and hospital (validity study).

The de Morton Mobility Index (DEMMI) provides a valid method for measuring and monitoring the mobility of patients making the transition from hospital to the community: an observational study.

Question: Is the de Morton Mobility Index (DEMMI) valid for measuring the mobility of patients making the transition from hospital to the community?

Design: Observational cohort study.

Participants: 696 consecutive patients admitted to 11 Transition Care Programs for multidisciplinary care in Victoria and Tasmania during a 6-month period. The DEMMI and Modified Barthel Index were administered within 5 working days of admission and discharge from the Transition Care Program.

Clinimetric properties of the de Morton Mobility Index in healthy, community-dwelling older adults.

Objective: To investigate the clinimetric properties of the de Morton Mobility Index (DEMMI) in healthy, community-dwelling older adults.

Design: Cohort study.

Setting: Retirement village and Returned and Services League (RSL) club in Melbourne, Australia.

Unidimensionality of the Elderly Mobility Scale in older acute medical patients: different methods, different answers.

Objective: To investigate the unidimensionality of the Elderly Mobility Scale (EMS) in an older acute medical population.

Study Design: EMS data were collected within 48 hours of hospital admission and discharge, respectively, from consecutive older acute medical patients. Rasch and factor analysis of EMS data were conducted.

Reliability of the de Morton Mobility Index (DEMMI) in an older acute medical population.

Background: The de Morton Mobility Index (DEMMI) is an instrument that accurately measures the mobility of older people across clinical settings.

Purpose: To report the multiple reliability studies conducted during the development and validation of the DEMMI.

Methods: Intra-rater and inter-rater reliability studies were conducted for the DEMMI in two independent samples (development and validation samples) of older acute medical patients (aged 65 years or older).

Validity and reliability of the de Morton Mobility Index in the subacute hospital setting in a geriatric evaluation and management population.

Objective: To investigate the clinimetric properties of the de Morton Mobility Index (DEMMI) in a Geriatric Evaluation and Management (GEM) population.

Design: A longitudinal validation study (n = 100) and inter-rater reliability study (n = 29) in a GEM population.

Patients: Consecutive patients admitted to a GEM rehabilitation ward were eligible for inclusion.

Application of Rasch analysis in health care is increasing and is applied for variable reasons in mobility instruments.

Objective: To identify the frequency of Rasch analysis use in health instrument development or refinement and the characteristics of Rasch application in mobility scales.

Study Design And Setting: The entire databases of Medline, CINAHL, PEDro, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews were searched until January 2009. Articles that reported the development or refinement of health instruments using Rasch analysis were included.

Validity, responsiveness and the minimal clinically important difference for the de Morton Mobility Index (DEMMI) in an older acute medical population.

Background: The de Morton Mobility Index (DEMMI) is a new mobility instrument that overcomes the limitations of existing instruments. It is the first mobility instrument that accurately measures the mobility of all older adults. The aim of this study was to provide a detailed report of investigations of the validity, responsiveness to change and minimal clinically important difference (MCID) of the DEMMI during its development in an older acute medical population.

The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study.

Questions: Does the PEDro scale measure only one construct ie, the methodological quality of clinical trials? What is the hierarchy of items of the PEDro scale from least to most adhered to? Is there any effect of year of publication of trials on item adherence? Are PEDro scale ordinal scores equivalent to interval data?

Design: Rasch analysis of two independent samples of 100 clinical trials from the PEDro database scored using the PEDro scale.

Results: Both samples of PEDro data showed fit to the Rasch model with no item misfit. The PEDro scale item hierarchy was the same in both samples, ranging from the most adhered to item random allocation, to the least adhered to item therapist blinding.

The de Morton Mobility Index (DEMMI): an essential health index for an ageing world.

Background: Existing instruments for measuring mobility are inadequate for accurately assessing older people across the broad spectrum of abilities. Like other indices that monitor critical aspects of health such as blood pressure tests, a mobility test for all older acute medical patients provides essential health data. We have developed and validated an instrument that captures essential information about the mobility status of older acute medical patients.

A systematic review of mobility instruments and their measurement properties for older acute medical patients.

Background: Independent mobility is a key factor in determining readiness for discharge for older patients following acute hospitalisation and has also been identified as a predictor of many important outcomes for this patient group. This review aimed to identify a physical performance instrument that is not disease specific that has the properties required to accurately measure and monitor the mobility of older medical patients in the acute hospital setting.

Methods: Databases initially searched were Medline, Cinahl, Embase, Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials without language restriction or limits on year of publication until July 2005.

Rasch analysis of the barthel index in the assessment of hospitalized older patients after admission for an acute medical condition.

Objective: To investigate the validity of item score summation for the original and modified versions of the Barthel Index.

Design: Rasch analysis of Barthel Index data.

Setting: General medical wards at 2 acute care hospitals in Australia.

Additional exercise does not change hospital or patient outcomes in older medical patients: a controlled clinical trial.

Question: What are the effects of additional exercise on hospital and patient outcomes for acutely-hospitalised older medical patients?

Design: Controlled clinical trial.

Participants: 236 Patients aged 65 or older admitted to an acute care hospital with a medical illness between October 2002 and July 2003.

Intervention: The experimental group received usual care plus an individually tailored exercise program administered twice daily from hospital admission to discharge.

The effect of exercise on outcomes for older acute medical inpatients compared with control or alternative treatments: a systematic review of randomized controlled trials.

Objective: To determine the effect of exercise interventions for acutely hospitalized older medical patients on functional status and hospital outcomes.

Data Sources: MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PEDro, Current Contents and Sports Discus were searched until February 2006. Additional studies were identified through reference and citation tracking and contacting authors of eligible trials.