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Development of a cluster-based linkage framework between hospital mobility scales and international and Brazilian functional classifications.

INTRODUCTION: The diversity of instruments for assessing hospital mobility creates fragmentation in care and hinders interprofessional communication. The lack of systematic correspondence between clinical scales and established functional classifications limits care standardization and comparability...

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Published in:Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia Vol. 15; pp. 1 - 16
Main Authors: Veloso da Costa, Caio Henrique, Mello Zego, Lívia Rodrigues, Bená, Laryssa Irineu
Format: pictorial research tables/charts Journal Article
Published: Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia 2025
Online Access:View this record in EBSCOhost
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      dt: 2025
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      pub: Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia
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        10.17267/2238-2704rpf.2025.6456
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        atl: Development of a cluster-based linkage framework between hospital mobility scales and international and Brazilian functional classifications.
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          Veloso da Costa, Caio Henrique
          Mello Zego, Lívia Rodrigues
          Bená, Laryssa Irineu
        affil: Corresponding contact. Salvus Tecnologia (Recife). Pernambuco, Brazil
      sug:
        subj:
          Clinical Assessment Tools
          International Classification of Functioning, Disability, and Health
          Hospitals
          Physical Mobility Evaluation
          Human
          Artificial Intelligence, Generative
          Computer Simulation
          Methodological Research
          Cross Sectional Studies
          Analytic Research
          Functional Status
          Cluster Analysis
          Data Analysis Software
          Spearman's Rank Correlation Coefficient
          kappa Statistic
          Interrater Reliability
          Questionnaires
          Correlational Studies
          Descriptive Statistics
          Confidence Intervals
      ab:
        INTRODUCTION: The diversity of instruments for assessing hospital mobility creates fragmentation in care and hinders interprofessional communication. The lack of systematic correspondence between clinical scales and established functional classifications limits care standardization and comparability across studies. OBJECTIVE: To establish systematic linkages between the ICU Mobility Scale (IMS), Johns Hopkins Highest Level of Mobility Scale (JH-HLM), International Classification of Functioning (ICF), and Brazilian Classification of Physiotherapeutic Diagnoses (BCPD) through cluster analysis, aiming to create a unified framework for assessing hospital mobility. METHODS: This methodological study used ten detailed clinical scenarios, independently evaluated by three experts. Hierarchical cluster analysis (Ward's method) was applied to identify natural functional profiles. Reliability was assessed using the weighted Kappa coefficient, and cluster stability was assessed using bootstrap validation. RESULTS: Four distinct functional clusters with excellent stability were identified: Critical Mobility, Assisted Mobility, Partially Independent Mobility and Independent Mobility. Inter-rater agreement was substantial to excellent. CONCLUSIONS: The established linkage offers a framework for translation between different mobility instruments, facilitating interprofessional communication, continuity of care, and standardization of functional assessment in the hospital continuum.
        INTRODUÇÃO: A diversidade de instrumentos para avaliação da mobilidade hospitalar cria fragmentação no cuidado e dificulta a comunicação interprofissional. A falta de correspondência sistemática entre escalas clínicas e classificações funcionais estabelecidas limita a padronização assistencial e a comparabilidade entre estudos. OBJETIVO: Estabelecer linkage sistemático entre a Escala de Mobilidade em UTI (EMU), Escala de Maior Nível de Mobilidade de Johns Hopkins (EMNM-JH), Classificação Internacional de Funcionalidade (CIF) e Classificação Brasileira de Diagnósticos Fisioterapêuticos (CBDF) por meio de análise de clusters, visando criar framework unificado para avaliação da mobilidade hospitalar. MÉTODOS: Estudo metodológico utilizando dez cenários clínicos detalhados, avaliados independentemente por três especialistas. Aplicou-se análise de clusters hierárquica (método de Ward) para identificar perfis funcionais naturais. A confiabilidade foi avaliada pelo coeficiente Kappa ponderado e a estabilidade dos clusters por validação bootstrap. RESULTADOS: Identificaram-se quatro clusters funcionais distintos com excelente estabilidade: Mobilidade Crítica, Mobilidade Assistida, Mobilidade Parcialmente Independente e Mobilidade Independente. A concordância interavaliador foi de substancial a excelente. CONCLUSÕES: O linkage estabelecido oferece um framework para tradução entre diferentes instrumentos de mobilidade, facilitando a comunicação interprofissional, continuidade do cuidado e padronização da avaliação funcional no continuum hospitalar.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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