title: Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index.
abstract: To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI).
  
  
  
  Interrater agreement study.
  
  
  
  Outpatient hospital clinic.
  
  
  
  Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty.
  
  
  
  Participants completed a therapist-directed assessment of the DEMMI followed by self-report of performance. A random subsample (n=62, 48%) also completed a self-report of anticipated performance before the therapist-directed assessment. Both raters (participant and therapist) were blinded to the scores obtained from the other rater.
  
  
  
  Interrater agreement between patient self-report and therapist-directed assessment of the total DEMMI scores was assessed using the intraclass correlation coefficient model 2,1 (ICC2,1) with a 95% confidence interval. The Bland-Altman plots were also used to illustrate the agreement between the 2 raters.
  
  
  
  The intraclass correlation coefficient (ICC) between patient self-report after performance and therapist-directed assessment of the total DEMMI score was .967 (95% confidence interval, .952-.977). The ICC between patient self-report of anticipated performance and therapist-directed assessment of the total DEMMI score was .830 (95% confidence interval, .730-.894). The Bland-Altman plots depicted higher levels of agreement among participants with impaired levels of mobility (≤74 out of 100) than did those with near-maximum DEMMI scores.
  
  
  
  Patient self-report of anticipated performance is an acceptable proxy for DEMMI scores derived from the therapist rating of performance. Caution should be exercised when interpreting self-report scores of patients with near-maximum levels of mobility. Further research is required to establish whether these results can be generalized across a range of patient populations and to clinicians with differing backgrounds and expertise.
authors.affiliation: Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia. Electronic address: romi.haas@monash.edu.
authors.forename: Romi
authors.initials: R
authors.lastname: Haas
authors.affiliation: Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia.
authors.forename: Kelly-Ann
authors.initials: KA
authors.lastname: Bowles
authors.affiliation: Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia; Department of Occupational Therapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: O'Brien
authors.affiliation: Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Victoria, Australia; Monash Health Allied Health Research Unit, Cheltenham, Victoria, Australia.
authors.forename: Terry
authors.initials: T
authors.lastname: Haines
mesh_terms: D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D015588:Observer Variation; D000071066:Patient Reported Outcome Measures; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D015203:Reproducibility of Results
keywords: Mobility limitation; Rehabilitation; Self report; Task performance and analysis