TY - JOUR
T1 - The ICU mobility scale has construct and predictive validity and is responsive
T2 - A multicenter observational study
AU - Tipping, Claire J.
AU - Bailey, Michael J.
AU - Bellomo, Rinaldo
AU - Berney, Susan
AU - Buhr, Heidi
AU - Denehy, Linda
AU - Harrold, Meg
AU - Holland, Anne
AU - Higgins, Alisa M.
AU - Iwashyna, Theodore J.
AU - Needham, Dale
AU - Presneill, Jeff
AU - Saxena, Manoj
AU - Skinner, Elizabeth H.
AU - Webb, Steve
AU - Young, Paul
AU - Zanni, Jennifer
AU - Hodgson, Carol L.
N1 - Publisher Copyright:
Copyright © 2016 by the American Thoracic Society.
PY - 2016/6
Y1 - 2016/6
N2 - 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- WhitneyUtests, 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.
AB - 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- WhitneyUtests, 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.
KW - Cohort studies
KW - Critical illness
KW - Intensive care units
KW - Outcome assessment
KW - Rehabilitation
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U2 - 10.1513/AnnalsATS.201510-717OC
DO - 10.1513/AnnalsATS.201510-717OC
M3 - Article
C2 - 27015233
AN - SCOPUS:84989316752
SN - 2325-6621
VL - 13
SP - 887
EP - 893
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 6
ER -