Construct validity, responsiveness and minimal important difference of the cumulated ambulation score in older adults with hip fracture in sub-acute rehabilitation facility.
Ilaria Arcolin, Marica Giardini, Stefano Corna and 3 others
PMID 38656174WHAT IT FOUND
After hip fracture rehabilitation, a two-point rise on the six-point mobility score meant patients improved enough to be considered clinically important.
The score tracked other mobility and independence measures, but at discharge 32.2% reached the top score.
Key findings
01A change of at least two points on the cumulated ambulation score was the threshold for clinically important improvement between admission and discharge.
02309 participants showed a clinically important change between admission and discharge.
03At discharge, 32.2% of patients reached the maximum score of 6.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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
The study was done at one rehabilitation institute, so results may not transfer to other settings. The anchors used to define important change were clinical measures, not a patient-reported global rating of change. The minimal detectable change relied on test-retest data from a previous publication rather than repeated testing in this sample. At discharge, 32.2% of patients reached the maximum score, so the measure may not capture further improvement in higher-functioning patients. Patients were older adults with hip fracture in sub-acute rehabilitation and had low independence at admission, so findings may not apply to acute care or to patients starting near the top of the scale.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication.
The easy way to misread this
Do not read the two-point threshold as proof that the rehabilitation programme caused improvement. It describes how to interpret a change in the mobility score in older adults with hip fracture in sub-acute rehabilitation, and the score reached a ceiling in 32.2% of patients at discharge.