Assessment of Mobility in Older People Hospitalized for Medical Illness Using the de Morton Mobility Index and Cumulated Ambulation Score-Validity and Minimal Clinical Important Difference.
Jeanette Trøstrup, Helle Andersen, Charlotte Agger Meiner Kam and 2 others
PMID 29252932WHAT IT FOUND
The DEMMI detects mobility changes in hospitalized older adults, including those with severe cognitive impairment.
A 10.7-point improvement marks a meaningful change. The CAS is quicker but hits a ceiling, making it poor for tracking recovery in high-functioning patients.
Key findings
01The DEMMI showed no floor or ceiling effects and demonstrated convergent and known-groups validity.
02A change of 10.7 points on the DEMMI was considered the minimal clinically important difference by patients.
03The CAS exhibited a ceiling effect at admission, limiting its ability to measure mobility changes across a broad range of abilities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
A large number of patients (80 of 235) had incomplete data sets, which may have influenced the results, although baseline characteristics were similar between those with and without complete data. The study was conducted only in urban hospitals in the Capital Region of Denmark, so findings may not generalize to rural areas. The MCID estimates rely on recall bias from the Global Rating of Change scale, which may be less reliable in patients with cognitive dysfunction. The CAS had a significant ceiling effect at admission, making it insensitive to change in patients who were already independent in basic mobility.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not use the CAS to monitor progress in patients who are already independent in basic mobility at admission. The CAS has a ceiling effect where many patients score the maximum possible value immediately, meaning it cannot detect improvements in this subgroup.