title: de Morton Mobility Index Is Feasible, Reliable, and Valid in Patients With Critical Illness.
abstract: BACKGROUND
  Intensive care unit (ICU) stays often lead to reduced physical functioning. Change in physical functioning in patients in the ICU is inadequately assessed through available instruments. The de Morton Mobility Index (DEMMI), developed to assess mobility in elderly hospitalized patients, is promising for use in patients who are critically ill.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the clinimetric properties of the DEMMI for patients in the ICU.
  
  
  METHODS
  A prospective, observational reliability and validity study was conducted.
  
  
  METHODS
  To evaluate interrater and intrarater reliability (intraclass correlation coefficients), patients admitted to the ICU were assessed with the DEMMI during and after ICU stay. Validity was evaluated by correlating the DEMMI with the Barthel Index (BI), the Katz Index of Independence in Activities of Daily Living (Katz ADL), and manual muscle testing (MMT). Feasibility was evaluated based on the percentage of participants in which the DEMMI could be assessed, the floor and ceiling effects, and the number of adverse events.
  
  
  RESULTS
  One hundred fifteen participants were included (Acute Physiology and Chronic Health Evaluation II [APACHE II] mean score=15.2 and Sepsis-related Organ Failure Assessment [SOFA] mean score=7). Interrater reliability was .93 in the ICU and .97 on the wards, whereas intrarater reliability during the ICU stay was .68. Validity (Spearman rho coefficient) during the ICU stay was .56, -.45, and .57 for the BI, Katz ADL, and MMT, respectively. The DEMMI showed low floor and ceiling effects (2.6%) during and after ICU discharge. There were no major adverse events.
  
  
  CONCLUSIONS
  Rapid changes in participants' health status may have led to underestimation of intrarater reliability.
  
  
  CONCLUSIONS
  The DEMMI was found to be clinically feasible, reliable, and valid for measuring mobility in an ICU population. Therefore, the DEMMI should be considered a preferred instrument for measuring mobility in patients during and after their ICU stay.
authors.affiliation: J. Sommers, PT, MSc, Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Juultje
authors.initials: J
authors.lastname: Sommers
authors.affiliation: T. Vredeveld, PT, MSc, Education of Physical Therapy, ACHIEVE-Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Vredeveld
authors.affiliation: R. Lindeboom, PhD, Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam.
authors.forename: Robert
authors.initials: R
authors.lastname: Lindeboom
authors.affiliation: F. Nollet, MD, Department of Rehabilitation, Academic Medical Center, University of Amsterdam.
authors.forename: Frans
authors.initials: F
authors.lastname: Nollet
authors.affiliation: R.H.H. Engelbert, PT, Department of Rehabilitation, Academic Medical Center, University of Amsterdam, and ACHIEVE-Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences.
authors.forename: Raoul H H
authors.initials: RH
authors.lastname: Engelbert
authors.affiliation: M. van der Schaaf, PT, PhD, Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands, and ACHIEVE-Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands. m.vanderschaaf@amc.nl.
authors.forename: Marike
authors.initials: M
authors.lastname: van der Schaaf
mesh_terms: D000368:Aged; D016638:Critical Illness; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index