Comparison of FSS-ICU with Other ICU-Specific Physical Function Measures

(1)

Web Table 3. Comparison of FSS-ICU versus other ICU-specific physical function measures Measures Floor effect Ceiling effect Concurrent

construct validity Divergent

validity Known group analysis

Predictive validity Responsiveness MID

Function-al Status Score for the Intensive Care Unit (FSS-ICU)^a,b,c

0.5%-3% at awakening^a,c,0-

0.3% at ICU d/c^c,0% at

hospital^a

0-0.7% at awakening^a,c, 3-11% at ICU d/c^c,21% at hospital d/c^a

ADL, IADL, hand grip, IMS, ICU and

hospital LOS^a, PFIT-s^c, MMT^a,c

BMI, continence, hemodialysis,

home oxygen, steroids, insulin ^a

MMT, d/c location^a

Shorter hospital LOS, d/c to home^a,b;

d/c to home^c

MMT, ADL From awakening to ICU d/c: Effect size (ES) = 2.0,

(large)^a; ES = 0.46 (small)

c

2.0-5.0 (6- 14% of

scale width)^a; 4.3-5.6 (12-

16% of scale width)^c Physical Function

in Intensive care Test scored (PFIT-s)^c,d,e

9-22% at admission/awa

kening^c,d, 2- 32% at/prior to

ICU d/c^c,e

2% on awakening, 5-

22% at ICU d/c^c,d,e

TUG^d, 6MWT^d, MMT^c,d,e, FSS-ICU^c, IMS^c,

SPPB^c, grip strength^e

BMI^d Not

evaluated Shorter hospital LOS, higher MMT, d/c to

home^c,d, d/c to LTACH^e

From awakening to ICU d/c: ES = 0.71 (large)^c,d,e

1.5 (15% of scale width)^d

ICU mobility scale

(IMS) ^c 16.7% on

awakening, 0%

at ICU d/c

0% on awakening, 4.7% at ICU

d/c

PFIT, MMT Not

evaluated Not

evaluated D/c to home From awakening to ICU d/c: ES = 0.59 (moderate)

Not evaluated

Chelsea Critical Care Physical Assessment (CPAx)^f,g,h

3.2%

at awakening^g

0.8%^g, 0% at ICU

d/c^h

MMT, GCS, sedation score,

SF-36 PCS, SOFA^f

Not evaluated

Days of mechanical ventilation^f hospital d/c location^g

Good responsiveness

and recovery trajectory^h

6 (12% of the total

CPAx scale)^h Surgical intensive

care unit Optimal Mobilization Score (SOMS)^i,j,k

4.8-14.4% at ICU admission^j,k

2.1-12.8% at ICU admission^j,k

Not evaluated Not

evaluated Not

evaluated Shorter hospital LOS^i,j,k, ICU LOS^j,k, and hospital mortality^i,k

Not evaluated Not evaluated

Perme ICU

Mobility Scale^l,m Not evaluated Not evaluated Not evaluated Not

evaluated Not

evaluated Not evaluated Not evaluated Not

evaluated Acute Care Index

of Function (ACIF)ⁿ

10% during ICU stay

0% during ICU stay

Not evaluated

ACIF<0.40 at ICU discharge predicted discharge to destination

other than home.

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Abbreviations: FSS-ICU: functional status score for the intensive care unit; MID: minimal important difference; d/c: discharge; ADL: activities of daily living; IADL: instrumental activities of daily living; MMT: manual muscle testing; IMS: ICU mobility scale; LOS: length of stay; PFIT-s: Physical Function in Intensive care Test scored; BMI: body mass index; TUG: timed up and go test; 6MWT: 6 minute walk test; LTACH: long-term acute care hospital; CPAx: Chelsea Critical Care Physical Assessment; GCS: Glasgow coma scale; SF-36: short form-36; SOFA: sequential organ failure assessment; SOMS: Surgical intensive care unit Optimal Mobilization Score; SICU: surgical ICU.

a Huang, M. et al. Functional Status Score for the Intensive Care Unit (FSS-ICU): an international clinimetric analysis of validity, responsiveness, and minimal important difference

b Thrush A, et al. The clinical utility of the Functional Status Score for the Intensive Care Unit (FSS-ICU) at a long-term acute care hospital: a prospective cohort study. Phys Ther. 2012;92:1536–45.

c Parry SM, et al. Functional outcomes in ICU – what should we be using? – an observational study. Crit Care 2015 March 29;19(1):127.

d Denehy L, et al. A physical function test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored). Phys Ther. 2013;9312:1638–45.

e Nordon-Craft A, et al. The physical function intensive care test: implementation in survivors of critical illness. PhysTher. 2014;94:1499–507.

f Corner EJ, et al. The Chelsea Critical Care Physical Assessment Tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study. Physiotherapy. 2013;99(1):33-41

g Corner EJ, et al. Construct validity of the Chelsea Critical Care Physical Assessment tool: an observational study of recovery from critical illness.

Crit Care. 2014;18(2):R55

h Corner EJ, et al. The responsiveness of the Chelsea Critical Care Physical Assessment tool in measuring functional recovery in the burns critical care population: An observational study. Burns. 2015;41(2):241-7.

i Kasotakis G, et al. The surgical intensive care unit optimal mobility score predicts mortality and length of stay. Crit Care Med. 2012;40(4):1122-8.

j Piva S, et al. The surgical optimal mobility score predicts mortality and length of stay in an Italian population of medical, surgical, and neurologic intensive care unit patients. J Crit Care. 2015.

k Schaller SJ, Stauble CG, Suemasa M et al. The German validation study of the surgical intensive care unit optimal mobilitys score. J Crit Care 2016;Apr(32):201-6.

l Perme C, et al. A tool to assess mobility status in critically ill patients: the Perme intensive care unit mobility score. Methodist Debakey Cardiovasc J. 2014 Jan-Mar;10(1):41-9.l

m Nawa RK, et al. Initial inter-rater reliability for a novel measure of patient mobility in a cardiovascular ICU. J Crit Care. 2014;29(3):475.e1-5.

n Bissett B, et al. Reliability and utility of the Acute Care Index of Function in intensive care patients: An observational study. Heart Lung. 2016 Jan- Feb;4591):10-4.