Measuring Mobility in Low Functioning Hospital Patients: An AM-PAC Replenishment Project

Daniel L Young; Sowmya Kumble; Carmen Capo-Lugo; Heather Littier; Annette Lavezza; Erik Hoyer; Michael Friedman; Dale M Needham; Debra Rogers; Susan C Martin; Tami Minnier; Beth A Matcho; Tracey Euloth; Pengsheng Ni; Alan Jette

doi:10.1016/j.apmr.2020.01.020

Measuring Mobility in Low Functioning Hospital Patients: An AM-PAC Replenishment Project

Arch Phys Med Rehabil. 2020 Jul;101(7):1144-1151. doi: 10.1016/j.apmr.2020.01.020. Epub 2020 Mar 12.

Authors

Daniel L Young¹, Sowmya Kumble², Carmen Capo-Lugo³, Heather Littier⁴, Annette Lavezza⁵, Erik Hoyer⁵, Michael Friedman⁵, Dale M Needham⁴, Debra Rogers⁶, Susan C Martin⁶, Tami Minnier⁶, Beth A Matcho⁷, Tracey Euloth⁷, Pengsheng Ni⁸, Alan Jette⁹

Affiliations

¹ Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, Nevada; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland. Electronic address: [email protected].
² Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland.
³ Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland; Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama.
⁴ Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
⁵ Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland.
⁶ Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
⁷ Centers for Rehab Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
⁸ School of Public Health, Boston University, Boston, Massachusetts.
⁹ Department of Physical Therapy, MGH Institute, Boston, Massachusetts.

PMID: 32173327
DOI: 10.1016/j.apmr.2020.01.020

Abstract

Objective: To expand an existing validated measure of basic mobility (Activity Measure for Post-Acute Care [AM-PAC]) for patients at the lowest levels of function.

Design: Item replenishment for existing item response theory (IRT) derived measure via (1) idea generation and creation of potential new items, (2) item calibration and field testing, and (3) longitudinal pilot test.

Setting: Two tertiary acute care hospitals.

Participants: Consecutive inpatients (N=502) ≥18 years old, with an AM-PAC Inpatient Mobility Short Form (IMSF) raw score ≤15. For the longitudinal pilot test, 8 inpatients were evaluated.

Results: Fifteen new AM-PAC items were developed, 2 of which improved mobility measurement at the lower levels of functioning. Specifically, with the 2 new items, the floor effect of the AM-PAC IMSF was reduced by 19%, statistical power and measurement breadth were greater, and there was greater measurement sensitivity in longitudinal pilot testing.

Conclusion: Adding 2 new items to the AM-PAC IMSF lowered the floor and increased statistical power, measurement breadth, and sensitivity.

Keywords: Delivery of health care; Health services research; Physical functional performance.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Academic Medical Centers
Activities of Daily Living*
Aged
Disability Evaluation*
Female
Humans
Inpatients / statistics & numerical data*
Longitudinal Studies
Male
Middle Aged
Mobility Limitation
Outcome Assessment, Health Care*
Pilot Projects
Risk Assessment
Subacute Care / methods*
Tertiary Care Centers
United States