Evaluating Physical Functioning in Survivors of Critical Illness: Development of a New Continuum Measure for Acute Care.
Crit Care Med
; 48(10): 1427-1435, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-32931188
ABSTRACT
OBJECTIVES:
Evaluation of physical functioning is central to patient recovery from critical illness-it may enable the ability to determine recovery trajectories, evaluate rehabilitation efficacy, and predict individuals at highest risk of ongoing disability. The Physical Function in ICU Test-scored is one of four recommended physical functioning tools for use within the ICU; however, its utility outside the ICU is poorly understood. The De Morton Mobility Index is a common geriatric mobility tool, which has had limited evaluation in the ICU population. For the field to be able to track physical functioning recovery, we need a measurement tool that can be used in the ICU and post-ICU setting to accurately measure physical recovery. Therefore, this study sought to 1) examine the clinimetric properties of two measures (Physical Function in ICU Test-scored and De Morton Mobility Index) and 2) transform these measures into a single measure for use across the acute care continuum.DESIGN:
Clinimetric analysis.SETTING:
Multicenter study across four hospitals in three countries (Australia, Singapore, and Brazil). PATIENTS One hundred fifty-one ICU patients.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Physical function tests (Physical Function in ICU Test-scored and De Morton Mobility Index) were assessed at ICU awakening, ICU, and hospital discharge. A significant floor effect was observed for the De Morton Mobility Index at awakening (23%) and minimal ceiling effects across all time points (5-12%). Minimal floor effects were observed for the Physical Function in ICU Test-scored across all time points (1-7%) and a significant ceiling effect for Physical Function in ICU Test-scored at hospital discharge (27%). Both measures had strong concurrent validity, responsiveness, and were predictive of home discharge. A new measure was developed using Rasch analytical principles, which involves 10 items (scored out of 19) with minimal floor/ceiling effects.CONCLUSIONS:
Limitations exist for Physical Function in ICU Test-scored and De Morton Mobility Index when used in isolation. A new single measure was developed for use across the acute care continuum.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Modalidades de Fisioterapia
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Estado Terminal
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Avaliação da Deficiência
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Desempenho Físico Funcional
/
Unidades de Terapia Intensiva
Tipo de estudo:
Clinical_trials
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Crit Care Med
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Austrália