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Ann Am Thorac Soc. 2016 Jun;13(6):887-93. doi: 10.1513/AnnalsATS.201510-717OC.

The ICU Mobility Scale Has Construct and Predictive Validity and Is Responsive. A Multicenter Observational Study.

Author information

1
1 Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine.
2
2 Department of Physiotherapy, The Alfred Hospital, Melbourne, Victoria, Australia.
3
3 The University of Melbourne, Melbourne, Victoria, Australia.
4
4 Austin Health, Heidelberg, Victoria, Australia.
5
5 The Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
6
6 Curtin University, Perth, Western Australia, Australia.
7
7 Royal Perth Hospital, Perth, Western Australia, Australia.
8
8 Latrobe University, Melbourne, Victoria, Australia.
9
9 Australian and New University, Melbourne, Victoria, Australia.
10
10 Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
11
11 Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan.
12
12 Johns Hopkins University, Baltimore, Maryland.
13
13 The Mater Hospital, Brisbane, Queensland, Australia.
14
14 The St George Hospital, Kogarah, New South Wales, Australia.
15
15 The University of New South Wales, Sydney, New South Wales, Australia.
16
16 The George Institute For Global Health, Sydney, New South Wales, Australia.
17
18 Monash University, Melbourne, Victoria, Australia.
18
17 Western Health, Melbourne, Victoria, Australia.
19
19 University of Western Australia, Perth, Western Australia, Australia.
20
20 Wellington Hospital, Wellington, New Zealand; and.
21
21 Medical Research Institute of New Zealand, Wellington, New Zealand.

Abstract

RATIONALE:

The ICU Mobility Scale (IMS) is a measure of mobility milestones in critically ill patients.

OBJECTIVES:

This study aimed to determine the validity and responsiveness of the IMS from a prospective cohort study of adults admitted to the intensive care unit (ICU).

METHODS:

Construct and predictive validity were assessed by comparing IMS values at ICU discharge in 192 patients to other variables using Spearman rank correlation coefficient, Mann-Whitney U tests, and logistic regression. Responsiveness was assessed using change over time, effect size, floor and ceiling effects, and percentage of patients showing change.

MEASUREMENTS AND MAIN RESULTS:

The IMS at ICU discharge demonstrated a moderate correlation with muscle strength (r = 0.64, P < 0.001). There was a significant difference between the IMS at ICU discharge in patients with ICU-acquired weakness (median, 4.0; interquartile range, 3.0-5.0) compared with patients without (median, 8.0; interquartile range, 5.0-8.0; P < 0.001). Increasing IMS values at ICU discharge were associated with survival to 90 days (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.14-1.66) and discharge home (OR, 1.16; 95% CI, 1.02-1.32) but not with return to work at 6 months (OR, 1.09; 95% CI, 0.92-1.28). The IMS was responsive with a significant change from study enrollment to ICU discharge (d = 0.8, P < 0.001), with IMS values increasing in 86% of survivors during ICU admission. No substantial floor (14% scored 0) or ceiling (4% scored 10) effects were present at ICU discharge.

CONCLUSIONS:

Our findings support the validity and responsiveness of the IMS as a measure of mobility in the ICU.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01674608.

KEYWORDS:

cohort studies; critical illness; intensive care units; outcome assessment; rehabilitation

PMID:
27015233
DOI:
10.1513/AnnalsATS.201510-717OC
[Indexed for MEDLINE]

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