An investigation of the measurement properties of the de Morton Mobility Index for measuring mobility capacity in hospital patients with Parkinson's disease.
Tobias Braun, Detlef Marks, Christian Thiel and 2 others
PMID 33172299WHAT IT FOUND
The DEMMI can measure mobility across the full range in hospital patients with Parkinson's disease.
It is quick, safe and consistent between raters, but tracking one patient's change over time with different therapists is less reliable.
Key findings
0111 of 15 planned comparisons were confirmed; lower limb strength, daily activities, motor scores and freezing of gait did not match the expected relationship.
02Overall agreement between two physiotherapists was 0.88, but 10 items had agreement below the 0.70 standard, so different raters limit checking one patient's change.
03The DEMMI took 6.6 minutes on average, had no adverse events, and had no floor or ceiling effects.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in one Swiss rehabilitation hospital, so the results may not apply to other settings. The reliability sample had 47 participants, which was smaller than planned. Ten items had relative agreement below 0.70 between raters, even though overall scores agreed. The change needed to be sure a patient improved or worsened between different raters was 17.5 points on the 0 to 100 scale, and the authors say this value may be overestimated. The study did not test whether the DEMMI can detect real change over time, what a minimal important change is, or how well it predicts outcomes. Patients with severe cognitive impairment were excluded, so the results do not show how the measure works in that group.
Declared interests
The authors declared no conflicts of interest and received no financial support.
The easy way to misread this
Do not treat a small score change as real progress when a different therapist administers the DEMMI. The study did not test whether the score can detect real change over time, and the change needed to be sure was 17.5 points on the 0 to 100 scale, a value the authors say may be overestimated.