Development of a cluster-based linkage framework between hospital mobility scales and international and Brazilian functional classifications
DOI:
https://doi.org/10.17267/2238-2704rpf.2025.6456Keywords:
Multidimensional Scaling Analysis, International Classification of Functioning, Disability and Health, Moving and Lifting Patients, Health Care Quality, Access, and Evaluation, Classification AlgorithmsAbstract
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 Classifcação Brasileira de Diagnósticos Fisioterapêuticos (CBDF) 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.
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Copyright (c) 2025 Caio Henrique Veloso da Costa, Lívia Rodrigues Mello Zego, Laryssa Irineu Bená
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
