Article

OBJECTIVE: To investigate the concurrent validity, responsiveness, and ceiling
effect of the revised High-Level Mobility Assessment Tool (HiMAT) in persons
after orthopedic multitrauma. DESIGN: Cross-sectional sample of convenience.
SETTING: A large tertiary rehabilitation hospital. PARTICIPANTS: Forty-three
participants with orthopedic multitrauma lower limb injuries that resulted from
motor vehicle accidents.
METHODS: This study compared the concurrent validity,
responsiveness, and ceiling effects of the revised HiMAT, motor subsection of the
Functional Independence Measure (FIM) instrument. Performances for all
participants were concurrently scored on the motor FIM, revised HiMAT, and the
Lower Extremity Functional Scale (LEFS) at initial testing, and 6 and 12 weeks
after the decision to fully bear weight. MAIN OUTCOME MEASUREMENTS: Revised
HiMAT, motor FIM, and LEFS. RESULTS: The correlation between the revised HiMAT
and the motor FIM was moderate (r = 0.49; P <.001) and partly induced by a
ceiling effect in the motor FIM. After 12 weeks of full weight bearing, 51.2% of
participants achieved the maximum score on the motor FIM. The correlation between
the revised HiMAT and LEFS was weak (r = 0.39; P = .012), which indicated a weak
relationship between self-reported mobility problems and actual performance. The
revised HiMAT was more responsive than the motor FIM and the LEFS, based on the
proportion of persons who exceeded the minimal detectable change score over a
period of 6 and 12 weeks. CONCLUSION: The revised HiMAT is more responsive to
change than the LEFS and motor FIM, and less susceptible to a ceiling effect than
the motor FIM for persons with orthopedic multitrauma. It has poor-to-moderate
concurrent validity with the LEFS and motor FIM, which suggests that it may be
measuring a different aspect of mobility.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS