Objective To evaluate the internal consistency, validity, responsiveness, and minimal important difference of the Functional Status Score for the Intensive Care Unit (FSS-ICU), a physical function measure designed for the intensive care unit (ICU). Design Clinimetric analysis. Settings Five international data sets from the United States, Australia, and Brazil. Patients 819 ICU patients. Intervention None. Measurements and Main Results Clinimetric analyses were initially conducted separately for each data source and time point to examine generalizability of findings, with pooled analyses performed thereafter to increase power of analyses. The FSS-ICU demonstrated good to excellent internal consistency. There was good convergent and discriminant validity, with significant and positive correlations (r = 0.30 to 0.95) between FSS-ICU and other physical function measures, and generally weaker correlations with non-physical measures (|r| = 0.01 to 0.70). Known group validity was demonstrated by significantly higher FSS-ICU scores among patients without ICU-acquired weakness (Medical Research Council sumscore ≥48 versus <48) and with hospital discharge to home (versus healthcare facility). FSS-ICU at ICU discharge predicted post-ICU hospital length of stay and discharge location. Responsiveness was supported via increased FSS-ICU scores with improvements in muscle strength. Distribution-based methods indicated a minimal important difference of 2.0 to 5.0. Conclusions The FSS-ICU has good internal consistency and is a valid and responsive measure of physical function for ICU patients. The estimated minimal important difference can be used in sample size calculations and in interpreting studies comparing the physical function of groups of ICU patients.
Objective: The present study aimed to verify the state of the art of minimally invasive percutaneous surgical treatment for Haglund syndrome. Methods: This systematic review of the literature was based on a bibliographic survey in the PubMed, Medline and Embase databases. The descriptors "Haglund syndrome", "Haglund", "Achilles", "Minimally invasive", "Percutaneous surgery" and "Osteotomy" were used, in addition to the filters "Randomized Controlled Trial", "Randomized Clinical Trial", "Meta-Analysis", "Systematic Reviews", "Reviews", and "Clinical Trial". Results: A total of 37 articles were included. The total number of patients with Haglund syndrome treated in the included studies was 831 and 920. The mean patient age was 46.6 years (range, 28.7 to 61) and 58% were men. A higher success rate and a lower rate of complications were reported in men, and physically active patients had better treatment results. The mean success rate for minimally invasive percutaneous procedures was 83.4% (range 66 to 100%). Overall patient satisfaction was 77.5% (range 60 to 95%) and the complication rate was 6.3% (range 0 to 23%). Conclusion: Despite a lack of studies with the recommended evidence level, minimally invasive and percutaneous surgical treatments seem to be a good option for patients with Haglund syndrome when conservative treatment fails. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.
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