The ICU mobility scale has construct and predictive validity and is responsive: A multicenter observational study

Claire J Tipping, Michael J. Bailey, Rinaldo Bellomo, Susan Berney, Heidi Buhr, Linda Denehy, Meg Harrold, Anne Holland, Alisa M. Higgins, Theodore J. Iwashyna, Dale Needham, Jeff Presneill, Manoj Saxena, Elizabeth H. Skinner, Steve Webb, Paul Young, Jennifer Zanni, Carol L. Hodgson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)887-893
Number of pages7
JournalAnnals of the American Thoracic Society
Volume13
Issue number6
DOIs
Publication statusPublished - 1 Jun 2016

Keywords

  • Cohort studies
  • Critical illness
  • Intensive care units
  • Outcome assessment
  • Rehabilitation

Cite this

Tipping, Claire J ; Bailey, Michael J. ; Bellomo, Rinaldo ; Berney, Susan ; 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. / The ICU mobility scale has construct and predictive validity and is responsive : A multicenter observational study. In: Annals of the American Thoracic Society. 2016 ; Vol. 13, No. 6. pp. 887-893.
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title = "The ICU mobility scale has construct and predictive validity and is responsive: A multicenter observational study",
abstract = "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.",
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author = "Tipping, {Claire J} and Bailey, {Michael J.} and Rinaldo Bellomo and Susan Berney and Heidi Buhr and Linda Denehy and Meg Harrold and Anne Holland and Higgins, {Alisa M.} and Iwashyna, {Theodore J.} and Dale Needham and Jeff Presneill and Manoj Saxena and Skinner, {Elizabeth H.} and Steve Webb and Paul Young and Jennifer Zanni and Hodgson, {Carol L.}",
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The ICU mobility scale has construct and predictive validity and is responsive : A multicenter observational study. / Tipping, Claire J; Bailey, Michael J.; Bellomo, Rinaldo; Berney, Susan; 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.

In: Annals of the American Thoracic Society, Vol. 13, No. 6, 01.06.2016, p. 887-893.

Research output: Contribution to journalArticleResearchpeer-review

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.

PY - 2016/6/1

Y1 - 2016/6/1

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

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SP - 887

EP - 893

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

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