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Title: The ICU Mobility Scale Has Construct and Predictive Validity and Is Responsive. A Multicenter Observational Study.
Austin Authors: Tipping, Claire J;Bailey, Michael J;Bellomo, Rinaldo ;Berney, Susan C ;Buhr, Heidi;Denehy, Linda;Harrold, Meg;Holland, Anne;Higgins, Alisa M;Iwashyna, Theodore J;Needham, Dale;Presneill, Jeff;Saxena, Manoj;Skinner, Elizabeth H;Webb, Steve;Young, Paul;Zanni, Jennifer;Hodgson, Carol L
Affiliation: Latrobe University, Melbourne, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine
Department of Physiotherapy, The Alfred Hospital, Melbourne, Victoria, Australia
The University of Melbourne, Melbourne, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
The Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
Curtin University, Perth, Western Australia, Australia
Royal Perth Hospital, Perth, Western Australia, Australia
Australian and New University, Melbourne, Victoria, Australia
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Johns Hopkins University, Baltimore, Maryland
The Mater Hospital, Brisbane, Queensland, Australia
The St George Hospital, Kogarah, New South Wales, Australia
Monash University, Melbourne, Victoria, Australia
Western Health, Melbourne, Victoria, Australia
University of Western Australia, Perth, Western Australia, Australia
Wellington Hospital, Wellington, New Zealand
Medical Research Institute of New Zealand, Wellington, New Zealand
Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan
The University of New South Wales, Sydney, New South Wales, Australia
The George Institute For Global Health, Sydney, New South Wales, Australia
Issue Date: Jun-2016
Publication information: Annals of the American Thoracic Society 2016; 13(6): 887-893
Abstract: The ICU Mobility Scale (IMS) is a measure of mobility milestones in critically ill patients. 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). 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. 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. Our findings support the validity and responsiveness of the IMS as a measure of mobility in the ICU.
DOI: 10.1513/AnnalsATS.201510-717OC
ORCID: 0000-0001-9002-2075
Journal: Annals of the American Thoracic Society
PubMed URL: 27015233
PubMed URL:
Type: Journal Article
Subjects: cohort studies
critical illness
Intensive Care Units
outcome assessment
Appears in Collections:Journal articles

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