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德莫顿活动指数用于测量帕金森病住院患者活动能力的测量特性研究。

An investigation of the measurement properties of the de Morton Mobility Index for measuring mobility capacity in hospital patients with Parkinson's disease.

机构信息

Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany.

Physiotherapy Department, Rehaklinik Zihlschlacht, Zihlschlacht, Thurgau, Switzerland.

出版信息

Clin Rehabil. 2021 Mar;35(3):423-435. doi: 10.1177/0269215520966472. Epub 2020 Nov 11.

DOI:10.1177/0269215520966472
PMID:33172299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7944422/
Abstract

OBJECTIVE

To examine the measurement properties of the de Morton Mobility Index (DEMMI), a performance-based clinical outcome assessment of mobility capacity, in hospital patients with Parkinson's disease.

DESIGN

Cross-sectional study.

PARTICIPANTS

Hospital patients with Parkinson's disease.

MAIN OUTCOME MEASURE(S): Structural validity and unidimensionality (Rasch analysis), construct validity, internal consistency reliability, and inter-rater reliability of the de Morton Mobility Index (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.

RESULTS

We analysed validity ( = 100; mean age: 70 years; 71% male) and reliability ( = 47; mean age: 71 years; 68% male) in two samples. The mean Hoehn and Yahr stage was 3.2 and the mean disease duration was 12 years in both samples. Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 21.49,  = 0.122). Seventy-three percent of hypotheses on construct validity were confirmed. Internal consistency reliability (Cronbach's alpha = 0.91) and inter-rater reliability (intraclass correlation coefficient = 0.88; 95% confidence interval: 0.80 to 0.93) were sufficient. The minimal detectable change with 90% confidence was 17.5 points and the limits of agreement were 31%. No floor or ceiling effects were observed. The mean administration time was 6.6 minutes.

CONCLUSION

This study provides evidence of unidimensionality, sufficient internal consistency reliability, inter-rater reliability, construct validity, and feasibility of the de Morton Mobility Index in hospital patients with Parkinson's disease.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS00004681). Registered May 6, 2013.

摘要

目的

检验德莫顿移动指数(DEMMI)的测量性能,DEMMI 是一种基于性能的移动能力临床结局评估方法,用于评估帕金森病住院患者。

设计

横断面研究。

参与者

帕金森病住院患者。

主要观察指标

结构效度和单维性(Rasch 分析)、构念效度、内部一致性信度和德莫顿移动指数(量表范围:0-100 分)的评分者间信度。计算最小可检测变化、95%一致性界限以及可能的地板效应和天花板效应,以指示可解释性。

结果

我们分析了两个样本的有效性(n=100;平均年龄:70 岁;71%为男性)和可靠性(n=47;平均年龄:71 岁;68%为男性)。两个样本的平均 Hoehn 和 Yahr 分期为 3.2,平均病程为 12 年。Rasch 分析表明具有单维性,整体符合模型(卡方=21.49,p=0.122)。73%的结构效度假设得到验证。内部一致性信度(Cronbach's alpha=0.91)和评分者间信度(组内相关系数=0.88;95%置信区间:0.80 至 0.93)充足。90%置信区间的最小可检测变化为 17.5 分,一致性界限为 31%。未观察到地板效应或天花板效应。平均管理时间为 6.6 分钟。

结论

本研究为帕金森病住院患者的德莫顿移动指数具有单维性、充足的内部一致性信度、评分者间信度、构念效度和可行性提供了证据。

试验注册

德国临床试验注册(DRKS00004681)。2013 年 5 月 6 日注册。

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BMC Geriatr. 2019 Jan 23;19(1):20. doi: 10.1186/s12877-019-1036-z.
2
Current use of measurement instruments by physiotherapists working in Germany: a cross-sectional online survey.德国物理治疗师当前对测量仪器的使用情况:一项横断面在线调查。
BMC Health Serv Res. 2018 Oct 23;18(1):810. doi: 10.1186/s12913-018-3563-2.
3
Validity and reproducibility of the Functional Gait Assessment in persons after stroke.
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Clin Rehabil. 2019 Jan;33(1):94-103. doi: 10.1177/0269215518791000. Epub 2018 Aug 7.
4
Measuring mobility in older hospital patients with cognitive impairment using the de Morton Mobility Index.使用 de Morton 活动能力指数测量认知障碍老年住院患者的活动能力。
BMC Geriatr. 2018 Apr 23;18(1):100. doi: 10.1186/s12877-018-0780-9.
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COSMIN guideline for systematic reviews of patient-reported outcome measures.COSMIN 患者报告结局测量系统评价指南。
Qual Life Res. 2018 May;27(5):1147-1157. doi: 10.1007/s11136-018-1798-3. Epub 2018 Feb 12.
6
Reliability and validity of the de Morton Mobility Index in individuals with sub-acute stroke.德莫顿行动能力指数在亚急性脑卒中患者中的信度和效度。
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7
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COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures.COSMIN 患者报告结局测量系统评价偏倚风险清单。
Qual Life Res. 2018 May;27(5):1171-1179. doi: 10.1007/s11136-017-1765-4. Epub 2017 Dec 19.
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Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations.评估帕金森病患者姿势、步态和平衡的测量工具:评价和建议。
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