“
“The Transition

Care Program was established in 2004-05 as a jointly funded initiative between the Commonwealth and states and territories of Australia. It is provided to older persons at the end of a hospital stay in the form of a package of services (Department of Health and Ageing 2008). Between October 2005 and February 2008 there were 12 573 discharges from the Transition Care Program nationally (Department of Health and Ageing 2008). A common component for all Transition Care Programs is the provision of allied health services to aid the assessment, treatment and discharge planning of patients. Across Australia current practice involves a broad range of models of care relating to the provision of Transition Care Program physiotherapy services and the use of allied health assistants. Also, a diverse range of outcome measures are applied. It is a current requirement selleck chemical that all Transition Care Programs apply Paclitaxel in vitro the Modified Barthel Index at admission to and discharge from the program (Department of Health and Ageing 2008). However, there is evidence that the Modified Barthel Index has a ceiling effect in older populations in hospital (de Morton et al 2007) and community settings (Hill et al 2008) and that it measures domains that

are not relevant to physiotherapy interventions (de Morton et al 2008c). Systematic reviews have identified drawbacks in the use of other activity limitation measures in hospital (de Morton et al 2008a) and community settings (Davenport

et al 2008). There are currently no best practice guidelines regarding the optimal method for measuring activity limitation for patients making the transition from hospital to the community. Physiotherapy focuses on the assessment and management of problems with movement (Jensen et al 1999). To conduct a Fossariinae rigorous evaluation of the efficacy of physiotherapy for patients making the transition from hospital to the community, a tool for measuring activity limitation that, in particular, measures the construct of mobility accurately is required. According to the World Health Organisation International Classification of Functioning ‘mobility’ is classified as one of nine domains of ‘activity and participation’ and is defined as ‘moving by changing body position or location or by transferring from one place to another, by carrying, moving or manipulating objects, by walking, running or climbing, and by using various forms of transportation’ (WHO 2001). An instrument that can be applied in a broad range of environments and that will accurately measure and monitor changes in mobility for all patients in Transition Care Programs without floor or ceiling effects would have many benefits. In 2008, the de Morton Mobility Index (DEMMI) was developed and validated in an older acute medical population (de Morton et al 2008b); it has since been validated in subacute hospital (de Morton and Lane, 2010) and community settings (Davenport and de Morton, 2010, de Morton et al 2010).