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.
Methods: This cross-sectional study included patients admitted to a sub-acute inpatient geriatric rehabilitation hospital (reliability sample: N = 33; validity sample: N = 107). Reliability, validity, and unidimensionality were investigated.
Results: Inter-rater reliability between two graduate physiotherapists was excellent, with intra-class correlation coefficient of 0.94 (95% confidence interval: 0.88-0.97). The minimal detectable change with 90% confidence was 9 points. Construct validity for the DEMMI was evidenced by significant moderate to strong correlations with other measures of mobility and related constructs (Performance Oriented Mobility Assessment: rho = 0.89; Functional Ambulation Categories: rho = 0.70; six-minute walk test: rho = 0.73; gait speed: rho = 0.67; Falls Efficacy Scale International: rho = -0.68). Known-groups validity was indicated by significant DEMMI mean group differences between independent versus dependent walkers and walking aid users versus non-users. Unidimensionality of the German DEMMI translation was confirmed by Rasch analysis.
Conclusions: The German translation of the DEMMI is a unidimensional instrument producing valid and reproducible measurement of mobility in an inpatient geriatric rehabilitation setting.
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http://dx.doi.org/10.1186/s12877-015-0035-y | DOI Listing |
Cureus
December 2024
Department of Osteopathic Manipulative Medicine, Liberty University College of Osteopathic Medicine, Lynchburg, USA.
An 88-year-old male with a history of cervical spondylosis (status post laminectomy of C2-C3 and laminoplasty of C4-C5), chronic congestive heart failure (CHF), pulmonary embolism, and lumbar spinal stenosis presented to an outpatient sports medicine clinic with neck pain following a fall five days prior due to loss of balance. He reported pain on the left side worsened by movement and accompanied by neck "clicking." A physical exam showed severe limitation in cervical spine extension limited by pain and loss of lordotic curve and a neurologic exam demonstrated weakness in the left leg secondary to a previous back surgery.
View Article and Find Full Text PDFFront Psychiatry
December 2024
Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China.
Postoperative delirium (POD) represents a common neurological complication encountered predominantly among the elderly cohort undergoing surgical intervention for hip fractures. This phenomenon, particularly commonplace in geriatric populations with heightened preoperative risk profiles, pronounced comorbidities, and later stages of lifespan, poses complex clinical challenges. The impact of perioperative pharmacological interventions and anesthetic strategies on POD's emergence cannot be understated, as it may profoundly affect the length of hospital stays, rehabilitation milestones, and the overall mortality hazard.
View Article and Find Full Text PDFJMIR Serious Games
January 2025
Department of Medical and Rehabilitation Care, Angers University Hospital, Angers, France.
Background: Reminiscence therapy through music is a psychosocial intervention with benefits for older patients with neurocognitive disorders. Therapies using virtual or augmented reality are efficient in ecologically assessing, and eventually training, episodic memory in older populations. We designed a semi-immersive musical game called "A Life in Songs," which invites patients to immerse themselves in a past era through visuals and songs from that time period.
View Article and Find Full Text PDFBMJ Open
January 2025
Siriraj Health Policy Unit, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Objectives: To evaluate the cost-utility of botulinum toxin A (BoNT-A) for treating upper limb (UL) and lower limb (LL) post-stroke spasticity.
Design: Using a Markov model, adopting a societal perspective and a lifetime horizon with a 3% annual discount rate, the cost-utility analysis was conducted to compare BoNT-A combined with standard of care (SoC) with SoC alone. Costs, utilities, transitional probabilities and treatment efficacy were derived from 5-year retrospective data from tertiary hospitals and meta-analysis.
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