TY - JOUR
T1 - Inter-rater reliability of the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) in the intensive care unit
AU - Hiser, Stephanie
AU - Chung, Chi Ryang
AU - Toonstra, Amy
AU - Friedman, Lisa Aronson
AU - Colantuoni, Elizabeth
AU - Hoyer, Erik
AU - Needham, Dale M.
N1 - Publisher Copyright:
© 2020 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Background: The Johns Hopkins Highest Level of Mobility (JH-HLM) scale is used to document the observed mobility of hospitalized patients, including those patients in the intensive care unit (ICU) setting. Objective: To evaluate the inter-rater reliability of the JH-HLM, completed by physical therapists, across medical, surgical, and neurological adult ICUs at a single large academic hospital. Methods: The JH-HLM is an ordinal scale for documenting a patient's highest observed level of activity, ranging from lying in bed (score = 1) to ambulating >250 feet (score = 8). Eighty-one rehabilitation sessions were conducted by eight physical therapists, with 1 of 2 reference physical therapist rater simultaneously observing the session and independently scoring the JH-HLM. The intraclass correlation coefficient was used to determine the inter-rater reliability. Results: A total of 77 (95%) of 81 assessments had perfect agreement. The overall intraclass correlation coefficient for inter-rater reliability was 0.98 (95% confidence interval: 0.96, 0.99), with similar scores in the medical, surgical, and neurological ICUs. A Bland–Altman plot revealed a mean difference in JH-HLM scoring of 0 (limits of agreement: −0.54 to 0.61). Conclusion: The JH-HLM has excellent inter-rater reliability as part of routine physical therapy practice, across different types of adult ICUs.
AB - Background: The Johns Hopkins Highest Level of Mobility (JH-HLM) scale is used to document the observed mobility of hospitalized patients, including those patients in the intensive care unit (ICU) setting. Objective: To evaluate the inter-rater reliability of the JH-HLM, completed by physical therapists, across medical, surgical, and neurological adult ICUs at a single large academic hospital. Methods: The JH-HLM is an ordinal scale for documenting a patient's highest observed level of activity, ranging from lying in bed (score = 1) to ambulating >250 feet (score = 8). Eighty-one rehabilitation sessions were conducted by eight physical therapists, with 1 of 2 reference physical therapist rater simultaneously observing the session and independently scoring the JH-HLM. The intraclass correlation coefficient was used to determine the inter-rater reliability. Results: A total of 77 (95%) of 81 assessments had perfect agreement. The overall intraclass correlation coefficient for inter-rater reliability was 0.98 (95% confidence interval: 0.96, 0.99), with similar scores in the medical, surgical, and neurological ICUs. A Bland–Altman plot revealed a mean difference in JH-HLM scoring of 0 (limits of agreement: −0.54 to 0.61). Conclusion: The JH-HLM has excellent inter-rater reliability as part of routine physical therapy practice, across different types of adult ICUs.
KW - Critical illness
KW - Intensive care unit
KW - Mobility limitations
KW - Physical function
KW - Rehabilitation
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U2 - 10.1016/j.bjpt.2020.07.010
DO - 10.1016/j.bjpt.2020.07.010
M3 - Article
C2 - 32811787
AN - SCOPUS:85089446621
SN - 1413-3555
VL - 25
SP - 352
EP - 355
JO - Brazilian Journal of Physical Therapy
JF - Brazilian Journal of Physical Therapy
IS - 3
ER -