Abstract
BackgroundMobility capacity is a key outcome domain in neurorehabilitation. The de Morton Mobility Index (DEMMI), an established and generic outcome assessment of mobility capacity in older patients, is promising for use in neurorehabilitation. The aim of this study was to examine the measurement properties of the DEMMI in rehabilitation inpatients with neurological conditions.MethodsCross-sectional study including a mixed sample of adult inpatients in a neurorehabilitation hospital. Structural validity, unidimensionality and measurement invariance (Rasch analysis), construct validity, internal consistency reliability, and inter-rater reliability of the DEMMI (scale range: 0–100 points) were established. The minimal detectable change, the 95% limits of agreement, and possible floor and ceiling effects were calculated to indicate interpretability.ResultsWe analyzed validity (n = 348) and reliability (n = 133) in two samples. In both samples, the majority of participants had a sub-acute stroke or Parkinson’s disease.Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 59.4, P = 0.074). There was no relevant measurement invariance by disease group. Hypotheses-based correlation analyses (DEMMI and other functional outcome assessments) showed sufficient construct validity. Internal consistency reliability (Cronbach’s alpha = 0.94) and inter-rater reliability (intraclass correlation coefficient = 0.94; 95% confidence interval: 0.91–0.95) were sufficient. The minimal detectable change with 90% confidence was 15.0 points and the limits of agreement were 39%. No floor or ceiling effects were observed.ConclusionsResults indicate sufficient measurement properties of the DEMMI in rehabilitation inpatients with neurological conditions. The DEMMI can be used as a generic outcome assessment of mobility capacity in neurorehabilitation.Trial registrationGerman Clinical Trials Register (DRKS00004681). Registered May 6, 2013.
Highlights
Mobility capacity is a key outcome domain in neurorehabilitation
The de Morton Mobility Index (DEMMI) can be used as a generic outcome assessment of mobility capacity in neurorehabilitation
Guideline-directed interventions vary for different neurological conditions, such as stroke or Parkinson’s disease (PD) [6, 7], patients are often treated in inpatient or outpatient rehabilitation facilities which are not focused on a single disorder
Summary
Mobility capacity is a key outcome domain in neurorehabilitation. The de Morton Mobility Index (DEMMI), an established and generic outcome assessment of mobility capacity in older patients, is promising for use in neurorehabilitation. Guideline-directed interventions vary for different neurological conditions, such as stroke or Parkinson’s disease (PD) [6, 7], patients are often treated in inpatient or outpatient rehabilitation facilities which are not focused on a single disorder. In such settings, generic outcome assessments are used to measure outcome domains that are common in many disease groups. Too, is a health-related outcome domain relevant to neurorehabilitation that is often assessed across different disease groups with generic outcome assessments. Ceiling effects impact clinical utility, when an assessment is intended to measure progress over the duration of recovery [10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
