Evaluating Physical Functioning in Survivors of Critical Illness: Development of a New Continuum Measure for Acute Care*
| Autor: | Geetha Kayambu, Selina M Parry, Sandy Clarke, Diana Sani, Claire E. Baldwin, Linda Denehy, Catherine L Granger, Laura D. Knight, Peter E. Morris, Zudin Puthucheary, Vinicius Zacarias Maldaner da Silva, Pimsiri Phongpagdi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Critical Illness medicine.medical_treatment Population Concurrent validity Critical Care and Intensive Care Medicine Disability Evaluation 03 medical and health sciences 0302 clinical medicine Floor effect Acute care medicine Humans Prospective Studies Survivors education Physical Therapy Modalities Aged education.field_of_study Rasch model Rehabilitation business.industry Reproducibility of Results 030208 emergency & critical care medicine Middle Aged Physical Functional Performance Post-intensive care syndrome Intensive Care Units 030228 respiratory system Physical therapy Ceiling effect Female business |
| Zdroj: | Critical Care Medicine. 48:1427-1435 |
| ISSN: | 0090-3493 |
| Popis: | 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 main results 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. |
| Databáze: | OpenAIRE |
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