Proposing Development and Utility of a Mobility Composite Measure in Patients with a Neurologic Disorder

Abstract

Background. Outcome measures typically assess single domains making holistic assessment difficult. Our purpose was to develop a mobility composite measure (MCM) based on four commonly used outcome measures and compare this composite score to the individual measures in patients with neurologic disorders. Methods. We retrospectively reviewed 148 medical records for inclusion of primary neurologic diagnosis and scoring for 5 times sit-to-stand test (5TSST), 10-meter walk test (10MWT), 2-minute walk test (2MWT), and activities-specific balance confidence (ABC) scale. Results. After establishing that a single concept was being assessed with interitem correlations, raw scores were converted to percentage of normal and combined into the MCM for analysis from admission to discharge. Scores on each measure significantly improved after intervention (5TSST, p<.001; 10MWT, p<.001; 2MWT, p<.001; ABC, p=.02). Mean MCM (n=93) admission scores were 67.55±31.88% and discharge scores were 74.81±34.39% (p=.002). On average, patients improved 7.26% on the MCM exceeding the threshold of expected error (MDC95 = 3.59%). Conclusions. MCM detected change in patient outcomes statistically and clinically and appears to capture a holistic picture of functional status. We recommend a prospective study to further investigate a “composite measure” incorporating measures from several functional domains.