Skip to the content
 

Doctor de Morton measures up

7 July 2008

A simple test is revolutionising the way that clinicians measure mobility in older patients.

Natalie de Morton’s experience is a world away from that of most post-doctoral researchers. Less than one year after she graduated as the first Monash PhD in Physiotherapy, many health services in Australia and overseas apply her work, two Australian universities teach it in their curriculum, and European collaborators will soon translate it into Dutch and German.

It all comes down to a quick diagnostic tool called the de Morton Mobility Index, or DEMMI for short. A score card with 15 simple physical tests for assessing the mobility of elderly patients, it was developed based on the Rasch mathematical model and has since translated effectively into a range of health professions and environments.

“We wanted it to be a quick and easy test to administer, because otherwise it wouldn’t be used in the acute clinical setting. On average, it takes just under nine minutes to administer in an older acute medical population,” says Dr de Morton.

When she started her PhD, Dr de Morton initially conducted a pilot study to investigate the effects of exercise among older acute patients, but faced problems.

“One of the issues was that current methods for measuring the mobility of older people had significant limitations and we didn’t have a way to accurately measure this important construct in older people,” she says.

She recognised the need for an instrument that would be sensitive to small changes in mobility, helping to detect early decline in mobility and to accurately monitor its recovery.

Dr de Morton began developing the DEMMI as a Monash University PhD student based at Northern Health’s Northern Clinical Research Centre.

“Just like blood tests or blood pressure readings, mobility is a very important indicator of health status,” Dr de Morton says.

“We made it a very clear and simple instrument, in that most of the questions have ‘pass’ or ‘fail’ responses. A few of the items have three response options, but most are two.”

The clinician administering the test simply observes the patient as they perform each test item. DEMMI requires no training; a brief sentence on the back of the card explains each item on the test. Best of all, it can be easily completed at the bedside.

“I’ve been fairly overwhelmed with the feedback that we’ve had. Clinicians really like it because it’s quick to do because it has minimal equipment requirements and provides important information regarding patient mobility. You only need a chair, bed and a stopwatch to conduct the test, so it is inexpensive,” she says.

After presenting DEMMI at the 2007 World Confederation for Physical Therapy Congress in Vancouver, Dr de Morton had people contact her from the US, Canada, Scandinavia and Europe.

Now an NHMRC research fellow at Monash (which will begin teaching DEMMI in its undergraduate Physiotherapy course from next year) Dr de Morton will focus on testing the model across various settings and populations. Among other things, she wants to know when mobility first diminishes.

“Is it in your thirties or in your fifties and sixties?”

To learn more about DEMMI, email natalie.demorton@med.monash.edu.au.

Dr de Morton
More information

Thesis Supervisors
Professor Jenny Keating, Monash University
Dr Megan Davidson, La Trobe University
Dr David Berlowitz, Northern Health

Funding
NHMRC Dora Lush PhD scholarship
HCF Health and Medical Research Foundation
Northern Clinical Research Centre, Northern Health

Do you measure up under DEMMI?

Can you:

  • Roll over in bed (easiest)
  • Stand unsupported for ten seconds (medium)
  • Walk for 50 metres (medium)
  • Tandem-standing (with one foot in front of the other, heel touching toe) for 10 seconds with eyes closed (most difficult)