Development of a mobility scale for use in a multicentre Australia and New Zealand: Trial of early activity and mobilisation in ICU

Carol Lynette Hodgson, Sue Berney, Kimberley Haines, Megan Harrold, P Young, Heidi Buhr, Dale Needham

Research output: Contribution to journalLetterOther


Aims: The aims of this study were to develop a mobility scale for measuring daily the highest level of functional activity in the ICU, and to assess its feasibility and inter-rater reliability in the ICU setting. Methods: This study was performed at two quaternary intensive care units in Melbourne, Australia in September 2012. The study was approved by the ethics committees of Austin Health and Alfred Health. Patient consent was waived. Feasibility A multi-disciplinary group of critical care clinicians including physicians, physiotherapists and nurses with expertise in scale development and ICU rehabilitation was recruited for developing the scale. A convenient sample of twenty multi-disciplinary ICU clinicians in Australia with varying levels of experience were administered a survey to assess the feasibility of the TEAM mobility scale. Inter-rater reliability Three categories of pairwise data were analysed including 1. nurse- junior physiotherapist 2. nurse ? senior physiotherapist 3. junior physiotherapist to senior physiotherapist. For each category no more than one pairwise rating was analysed in every patient. Pair wise weighted kappa was calculated for the TEAM mobility scale. For 40 consecutive ICU patients at the two centres, one nurse, one senior physiotherapists and one junior physiotherapist scored highest level of activity using the TEAM scale. Results: Feasibility The TEAM mobility scale was able to be used quickly and efficiently by participants within ICU to assess the patients? physical function. Ninety-five percent of respondents reported that the scale took less than one minute to complete. All participants reported the scale to be clear and unambiguous. Inter-rater reliability The senior physiotherapist and junior physiotherapist showed the highest level of agreement with a weighted Kappa of 0.98 (0.95-1.0). The agreement between the nurse and junior physiotherapist had a weighted Kappa of 0.93 (0.85-1.0). The nurse and senior physiotherapist had a weighted Kappa of 0.92 (0.85-0.99). Conclusion: In conclusion, the TEAM mobility scale is a reliable scale that records the highest level of functional activity of patients in the ICU. It is simple and quick to use by ICU nurses and physiotherapists; however, it is not designed to replace other tests of physical function.
Original languageEnglish
Pages (from-to)3123 - 3123
Number of pages1
JournalAmerican Journal of Respiratory and Critical Care Medicine
Publication statusPublished - 2013

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