Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index

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Abstract

Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions 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. Main Outcome Measures 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. Results 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. Conclusions 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.

Original languageEnglish
Pages (from-to)2157-2165
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume97
Issue number12
DOIs
Publication statusPublished - 1 Dec 2016

Keywords

  • Mobility limitation
  • Rehabilitation
  • Self report
  • Task performance and analysis

Cite this

@article{68042c4d8a5f446792f11ece8f7b9936,
title = "Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index",
abstract = "Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions 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. Main Outcome Measures 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. Results 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. Conclusions 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.",
keywords = "Mobility limitation, Rehabilitation, Self report, Task performance and analysis",
author = "Romi Haas and Bowles, {Kelly Ann} and Lisa O'Brien and Terry Haines",
year = "2016",
month = "12",
day = "1",
doi = "10.1016/j.apmr.2016.07.008",
language = "English",
volume = "97",
pages = "2157--2165",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
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TY - JOUR

T1 - Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index

AU - Haas, Romi

AU - Bowles, Kelly Ann

AU - O'Brien, Lisa

AU - Haines, Terry

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions 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. Main Outcome Measures 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. Results 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. Conclusions 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.

AB - Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions 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. Main Outcome Measures 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. Results 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. Conclusions 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.

KW - Mobility limitation

KW - Rehabilitation

KW - Self report

KW - Task performance and analysis

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U2 - 10.1016/j.apmr.2016.07.008

DO - 10.1016/j.apmr.2016.07.008

M3 - Article

VL - 97

SP - 2157

EP - 2165

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 12

ER -