Table 2.
Clinical utility and practical considerations of functional measures in the ICU setting
| Outcome measure | Type of assessment# | Patient population with original development | Equipment required* | Scoring information (minimum to maximum score) | Time required to physically undertake testing | Training Rresources |
|---|---|---|---|---|---|---|
| ACIF [32] | Comprehensive | Acute neurological (including neurosurgery) [23] | Access to 5 stairs; walking marker (distance) | 20 items, 4 subcategories (0–1.00) | 12 min | No specified training package or video currently available, instructions and recording sheet available [23] |
| CPAx [33, 34–36] | Comprehensive | General and trauma ICU [31] | Handgrip dynamometera | 10 items, each scored 0–5 (0 –50) | 2–10 min | Online 40–60 min free training (requires registration) at http://cpax.ocbmedia.com |
| CcFROM [37] | Comprehensive | General, neurosurgery and trauma ICU [33] | Stopwatch | 9 items, each scored 0–7 (0–63) | 10–30 min | Instructions and recording sheet available [33], no training package or video currently available |
| DEMMI [38] | Comprehensive | General hospitalized geriatric medical patients [24] | Chair with 45 cm seat height with arm rests; stopwatch; pen (DEMMI item 13); walking marker (distance) | 15 items, 5 subcategories, each scored 0–2 (0–100) | 10–30 min | Instructions and recording sheet available in supplementary [24] (no details specific to the ICU setting) |
| FSS-ICU [26, 31, 39, 40–42] | Comprehensive | Medical ICU [37] | Walking marker (distance) | 5 items, each scored 0–7 (0–35) | 10–30 min | Detailed free instructions (registration required) at www.improvelto.com/, free training package including video available from primary author1 |
| IMS [43, 26, 44, 45] | Simple | General ICU (medical, surgical, trauma) [28] | None | 1 item, score based on highest classification level (11 options) (0–10) | <1 min | Instructions available [28] |
| MMS [46] | Simple | General ICU (medical, surgical, trauma) [39] | None | 1 item, score based on highest classification level (7 options) (0–7) | <1 min | Instructions and recording sheet available [39]—further detailed instructions available from primary author2, no training package or video currently available |
| PFIT-s [26, 30, 47, 48] | Comprehensive | General ICU (medical, surgical) [43] | Stopwatch; Borg RPE sheet (optional) | 4 items, individual items scored 0–3 (0–10) | 10–15 min | Free training package, including video, available from primary author3 |
| Perme Score [49, 50, 44] | Comprehensive | General ICU; cardiovascular ICU [46, 47] | None | 15 items, individual items scored 0–3 (0–32) | 15–60 min | No training package or video currently available. The scoring criteria and detailed instructions are available in the manuscript [46] |
| SOMS [51, 52–54] | Simple | Surgical ICU [49] | None | 1 item, score based on highest classification level (5 options) (0–4) | <1 min | No training package or video currently available, scoring criteria available in manuscript [49] |
| SPPB [26] | Comprehensive | Geriatric, non-hospitalized | Stopwatch; tape-measure (for 4-m course) | 3 items, each item scored 0–4 (0–12) | 5–10 min | Free training via: https://www.irp.nia.nih.gov/branches/leps/sppb/index.htm and https://www.youtube.com/watch?v=XgiuciJXPm4 (no details specific for ICU) |
*Additional equipment required beyond standard hospital bed, chair, and gait aids
#Type of assessment was defined into two categories: 1) “simple” involving observation of patient’s current ability (time to complete: <5 min); and 2) “Comprehensive” providing greater understanding of the impairments in physical functioning (time to complete: 10–15 min)
1Dale Needham, School of Medicine, Johns Hopkins University. Contact email: dale.needham@jhmi.edu
2David Williams, Therapy Services, University Hospitals Birmingham NHS Foundation Trust. Contact email: david.mcwilliams@uhb.nhs.uk
3Linda Denehy, Physiotherapy Department, The University of Melbourne. Contact email: l.denehy@unimelb.edu.au
a A table is able to be downloaded at the end of the eLearning module which provides the gender/age values for handgrip strength in order to work out percentage grip strength which is required to complete the CPAx
ACIF Acute Care Index of Function, CPAx Chelsea Critical Care Physical Assessment Tool, CcFROM Critical Care Functional Rehabilitation Outcome Measure, DEMMI De Morton Mobility Index, FSS-ICU Functional Status Score for the ICU, ICU intensive care unit, IMS ICU mobility scale, MMS, Perme Perme ICU Mobility Score, PFIT-s Physical Function in intensive care test scored, RPE rating of perceived exertion, SOMS Surgical Optimal Mobility Scale, SPPB Short Physical Performance Battery, MMS Manchester Mobility Score