Instruments to evaluate mobility capacity of older adults during hospitalization: A systematic review. (September 2017) - Soares Menezes, Karla Vanessa Rodrigues
Highlights: Eleven mobility instruments used to evaluate elderly in acute care were identified. Evidence supports that DEMMI, SPPB and Tinetti scale had the best balance. More studies about the measurement properties of these instruments are needed. Abstract: Independent mobility is a key factor in predicting morbidity and determining hospital discharge readiness for older patients. The main objective was identify and appraise relevant instruments for the measurement of mobility of hospitalized geriatric patients. A systematic review was performed in two consecutive steps. Based on the definition of mobility of the International Classification of Functioning (ICF). Step 1 identified mobility measurement instruments used to assess patients 60 years of age and over hospitalized in acute care or intensive geriatric rehabilitation unit. Aim of the instrument, coverage of mobility construct, applicability (format, training required, administration time and use of assistive devices) were extracted. For each included instrument, Step 2 identified and appraised articles reporting about their measurement properties. Consensus-based Standards for the selection of health status Measurement INstruments (COSMIN) was used by two independent reviewers to critically appraise and compare the measurement properties. Step 1 resulted in 6350 articles, of which 28 articles reported about 17 different instruments. Step 2 retained 11 instruments with 70 articles reporting about their measurement properties in various settings. Judgement-based instruments (n = 5) covered the ICF mobility construct more broadly than performance-based measures (n = 6). Our results showed that 3 instruments (DEMMI, SPPB and Tinetti scale) had the most extensive and robust measurement properties, and from those, SPPB and DEMMI covered the mobility construct more broadly but SPPB had the longest administration (10–15 min). Conclusion SPPB presents the best balance between mobility coverage, measurement properties and applicability to acute care or intensive geriatric rehabilitation unit.