TIPS
FOR CHOOSING A FUNCTIONAL OUTCOME TOOLS FOR PATIENTS IN ICU
The use of outcome
measures by physical therapists to assess mobility status and functional
performance of patients is a vital element of clinical and research practice in
ICU.
Parry et al. (Intensive Care Med
(2015) 41:744–762)
addressed the assessment of impairment and activity limitations in the
critically ill. This
manuscript is a systematic review and identified 26 measurement
instruments and their clinometric properties. Interestingly, only six were
ICU-specific instruments. On that same year, McWilliams et al. (2015) published
the “Manchester Mobility Score”, which is also considered an ICU-specific tool.
Each one of the
available ICU-specific tools have their
strengths and also their weaknesses. When deciding which tool to use for
patients in ICU, it is important to consider the clinometric analysis to
determine the best tool for an institution
or individual clinician.
Here is a list of the
available ICU-specific tools and some references:
1.
Perme ICU Mobility Score ( Perme Score)
a. Nydahl
P et al. The German translation of the
Perme ICU Mobility Score and inter-rater reliability between physiotherapists
and nurses. European Journal of Physiotherapy. Pages1-7. Published online:
24 Nov 2017. DOI: 10.1080/21679169.2017.1401660
b. Kawaguchi
YMF et al. Perme Intensive Care Unit Mobility Score and ICU Mobility Scale:
translation into Portuguese and cross-cultural adaptation for use in Brazil.
J Bras Pneumol. 2016;42(6):429-431. PMID: 28117473
c. Perme
C et al. A tool to assess mobility status in critically ill patients: the
Perme Intensive Care Unit Mobility Score. Methodist Debakey Cardiovasc J.
2014 Jan-Mar; 10(1):41-9. PMID: 24932363
d. Nawa
RK et al. Initial interrater reliability for a novel measure of patient
mobility in a cardiovascular intensive care unit. J Crit Care. 2014
Jun;29(3):475. PMID: 24630690
2.
Chelsea Critical Care Physical Assessment Tool
(CPAx)
a. Corner EJ, et al. The Chelsea critical care
physical assessment tool (cpax): validation of an innovative new tool to
measure physical morbidity in the general adult critical care population; an
observational proof-of-concept pilot study. Physiotherapy 99 (2013) 33–41.
PMID: 23219649
b. Corner EJ et al. Construct validity of the Chelsea
critical care physical assessment tool: an observational study of recovery from
critical illness. Crit Care. 2014 Mar 27; 18(2):R55. PMID: 24669784
c. Corner EJ et al. The responsiveness of the
Chelsea Critical Care Physical Assessment tool in measuring functional recovery
in the burns critical care population: an observational study. Burns. 2015
Mar; 41(2):241-7 PMID: 25554262.
3. Functional
Status Score for ICU (FSS-ICU)
a. Huang M et al. Functional Status Score for the ICU: An International Clinimetric
Analysis of Validity, Responsiveness, and Minimal Important Difference.
Crit Care Med. 2016 Aug 3. PubMed PMID: 27488220.
b. Thrush
et al. The clinical utility of the
Functional Status Score for the Intensive Care Unit (FSS-ICU) at a longterm
acute care hospital: a prospective cohort study. Phys Ther. 2012;92. PMID:
22956427
c. Zanni
et al. Rehabilitation therapy and
outcomes in acute respiratory failure: an observational pilot project. J
Crit Care2010 Jun;25(2):254-6
4.
ICU Mobility Scale (IMS)
a. Hodgson C et al. Feasibility and inter-rater
reliability of the ICU mobility scale. Heart lung. 2014 jan-feb;
43(1):19-24. PMID: 24373338
5.
Manchester Mobility Score ( MMS)
a. McWilliams D et al. Enhancing rehabilitation of
mechanically ventilated patients in the intensive care unit: a quality
improvement project. J Crit Care. 2015 Feb; 30(1):13-8.
PMID: 25316527.
6.
Physical function outcome measure (PFIT)
a. Skinner EH et al. Development of a physical
function outcome measure (PFIT) and a pilot exercise training protocol for use
in intensive care. Crit Care Resusc. 2009 Jun;11(2):110-5. PMID: 19485874
b. Denehy L et al .A physical function test for use
in the intensive care unit: validity, responsiveness, and predictive utility of
the physical function ICU test (scored). Phys ther. 2013
dec;93(12):1636-45. PMID: 23886842
7.
Surgical Optimal Mobilisation Score (SOMS)
a. Kasotakis G et al. The surgical intensive care
unit optimal mobility score predicts mortality and length of stay. Crit
Care Med. 2012 Apr; 40(4):1122-8. PMID: 22067629.
b. Meyer MJ et al. Surgical Intensive Care Unit
Optimal Mobilisation Score (SOMS) trial: a protocol for an international,
multicentre, randomised controlled trial focused on goal-directed early
mobilisation of surgical ICU patients. BMJ Open. 2013 Aug 19; 3(8):e003262.
PMID: 23959756
c. Piva S et al. The Surgical Optimal Mobility Score
predicts mortality and length of stay in an Italian population of medical,
surgical, and neurologic intensive care unit patients. J Crit Care. 2015
Dec;30(6):1251-7.PMID: 26315654
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