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在一家亚急性老年住院康复医院收治的患者中,物理治疗师对德莫顿运动指数(DEMMI)德语翻译版本的可靠性和有效性。

Reliability and validity of the German translation of the de Morton Mobility Index (DEMMI) performed by physiotherapists in patients admitted to a sub-acute inpatient geriatric rehabilitation hospital.

作者信息

Braun Tobias, Schulz Ralf-Joachim, Reinke Julia, van Meeteren Nico L, de Morton Natalie A, Davidson Megan, Thiel Christian, Grüneberg Christian

机构信息

Department of Applied Health Sciences, Physiotherapy Program, Hochschule für Gesundheit, Universitätsstr. 105, 44789, Bochum, Germany.

University of Cologne, Medical Faculty, Kerpener Str. 62, 50937, Cologne, Germany.

出版信息

BMC Geriatr. 2015 May 3;15:58. doi: 10.1186/s12877-015-0035-y.

Abstract

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.

摘要

背景

活动能力是老年康复的关键结果。德莫顿活动指数(DEMMI)是一种国际上广泛认可的、用于测量活动能力的单维度指标,具有良好的心理测量特性。本研究的目的是检验DEMMI德文版在老年住院患者中的信度和结构效度。

方法

这项横断面研究纳入了入住亚急性老年住院康复医院的患者(信度样本:N = 33;效度样本:N = 107)。对信度、效度和单维度性进行了调查。

结果

两名研究生物理治疗师之间的评分者间信度极佳,组内相关系数为0.94(95%置信区间:0.88 - 0.97)。90%置信度下的最小可检测变化为9分。DEMMI的结构效度通过与其他活动能力测量指标及相关结构的显著中度至强相关性得以证明(以表现为导向的活动能力评估:rho = 0.89;功能性步行分类:rho = 0.70;六分钟步行试验:rho = 0.73;步速:rho = 0.67;国际跌倒效能量表:rho = -0.68)。独立步行者与依赖步行者以及使用助行器者与非使用者之间的DEMMI平均组间差异显著,表明了已知群体效度。通过拉施分析证实了DEMMI德文版的单维度性。

结论

DEMMI德文版是一种单维度工具,可在老年住院康复环境中对活动能力进行有效且可重复的测量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b907/4424447/6cf3355b7b81/12877_2015_35_Fig1_HTML.jpg

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