Feasibility and inter-rater reliability of the ICU Mobility Scale

Hodgson, Carol; Needham, Dale M.; Haines, Kimberley; Bailey, Michael; Ward, Alison; Harrold, Megan; Young, Paul; Zanni, Jennifer M.; Buhr, Heidi; Higgins, Alisa; Presneill, Jeffrey; Berney, Sue

doi:10.1016/j.hrtlng.2013.11.003

Cited by 319 publications

(294 citation statements)

References 26 publications

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“…The patient could receive assistance from staff or equipment but the patient actively participated in the exercise at the highest functional level. [15] The goal of EGDM was to maximise safe physical activity (Figure 1). [15] A physical therapy mobility team led EGDM.…”

Section: Intervention -Early Goal-directed Mobility (Egdm)mentioning

confidence: 99%

A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in the ICU*

Hodgson

Bailey

Bellomo

et al. 2016

Critical Care Medicine

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Objectives: To determine if the early goal-directed mobilization intervention could be delivered to patients receiving mechanical ventilation with increased maximal levels of activity compared with standard care. Design: A pilot randomized controlled trial. Setting: Five ICUs in Australia and New Zealand. Participants: Fifty critically ill adults mechanically ventilated for greater than 24 hours. Intervention: Patients were randomly assigned to either early goal-directed mobilization (intervention) or to standard care (control). Early goal-directed mobilization comprised functional rehabilitation treatment conducted at the highest level of activity possible for that patient assessed by the ICU mobility scale while receiving mechanical ventilation. Measurements and Main Results: The ICU mobility scale, strength, ventilation duration, ICU and hospital length of stay, and total inpatient (acute and rehabilitation) stay as well as 6-month post-ICU discharge health-related quality of life, activities of daily living, and anxiety and depression were recorded. The mean age was 61 years and 60% were men. The highest level of activity (ICU mobility scale) recorded during the ICU stay between the intervention and control groups was mean (95% CI) 7.3 (6.3–8.3) versus 5.9 (4.9–6.9), p = 0.05. The proportion of patients who walked in ICU was almost doubled with early goal-directed mobilization (intervention n = 19 [66%] vs control n = 8 [38%]; p = 0.05). There was no difference in total inpatient stay (d) between the intervention versus control groups (20 [15–35] vs 34 [18–43]; p = 0.37). There were no adverse events. Conclusions: Key Practice Points: Delivery of early goal-directed mobilization within a randomized controlled trial was feasible, safe and resulted in increased duration and level of active exercises.

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Section: Intervention -Early Goal-directed Mobility (Egdm)mentioning

confidence: 99%

A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in the ICU*

Hodgson

Bailey

Bellomo

et al. 2016

Critical Care Medicine

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189

202

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“…Un estudio no reportó el tamaño muestral según sexo 38,39 . En 2 estudios se describió la edad de la muestra, cuyos promedios fueron entre 51,0 y 64,5 años [40][41][42][43] (Tabla 1). De las patologías de ingreso a UPC, especificadas, las principales fueron quirúrgicas (46,0%), seguidas por enfermedades respiratorias (17,5%) (Tabla 2).…”

Section: Características De Los Estudios Primariosunclassified

Validez y confiabilidad de las escalas de evaluación funcional en pacientes críticamente enfermos. Revisión sistemática

Libuy

et al. 2017

Rev. méd. Chile

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“…Both the ACIF (ICC 0.94) and IMS (ICC 0.8) (Hodgson et al, 2014) have acceptable interrater reliability to be useful in an intensive care context. Whilst this study demonstrated that the ACIF and IMS correlate strongly across the spectrum of physical function in intensive care patients, there was significant spread of ACIF scores within each IMS category.…”

Section: Discussionmentioning

confidence: 99%

“…The assessor completing the electronic ACIF form also completed an IMS score, an 11-point ordinal scale of function (Hodgson et al, 2014), where a score of 0 indicates function is 'nothing' and 10 indicates 'walking independently without a gait aid'. ACIF and IMS scores were routinely collected electronically for all intensive care patients at least once per week beyond Day 3 of admission, and on intensive care unit discharge.…”

Section: Methodsmentioning

confidence: 99%

“…In the last 3 years, tools have been designed to specifically measure physical function in intensive care patients such as the Physical Function in ICU Tool (P-FIT) , the Chelsea Critical Care Physical Assessment tool (CPax) (Corner et al, 2014) and the ICU Mobility Scale (IMS) (Hodgson et al, 2014). All these tools have demonstrated inter-rater reliability.…”

Section: Introductionmentioning

confidence: 99%

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Inspiratory muscle training to enhance recovery from invasive mechanical ventilation

Bissett¹

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Inspiratory muscle weakness is a consequence of prolonged mechanical ventilation and may contribute to the residual physical disability which has been observed in intensive care survivors. Inspiratory muscle weakness is associated with duration of mechanical ventilation, with those ventilated for 7 days or longer most at risk of developing both strength and endurance deficits.Specific resistance training of the inspiratory muscles (inspiratory muscle training) improves inspiratory muscle strength and endurance in normal people, athletes and patients with a wide variety of underlying pathologies. Mechanisms of improvement include proliferation of both Type 1 and Type 2 inspiratory muscle fibres, enhanced metabolism resulting in reduced lactate production, attenuation of a fatigue-induced metaboreflex, adaptations to neural pathways and modulation of the perception of dyspnoea.Furthermore, inspiratory muscle training enhances exercise tolerance and reduces dyspnoea in both patients and athletes, while improving quality of life for patients with chronic lung or heart disease.There is a lack of evidence for inspiratory muscle training in intensive care patients, despite the potential benefits of training in this group. This project explores the feasibility, safety and efficacy of inspiratory muscle training in intensive care patients who have been mechanically ventilated for 7 days or longer, as this subset of patients is most likely to demonstrate inspiratory muscle weakness and therefore benefit from specific training. This project includes patient-centred outcome measures, as most studies of inspiratory muscle training to date have focused solely on impairments, rather than the patient experiences of quality of life, physical function or dyspnoea.Study 1 establishes the safety and feasibility of high-intensity interval-based inspiratory muscle training in selected ventilator-dependent patients. Across 195 inspiratory muscle training sessions, there were no adverse events recorded during or immediately following the treatment. No significant changes were observed in heart rate, blood pressure, respiratory rate or oxygen saturation. Furthermore, mean training pressures increased by a mean difference of 18.6 cm H2O across the 10 patients studied. Thus Study 1 confirms that inspiratory muscle training is safe in selected ventilator-dependent patients.-ii- (mean difference 11%), but not endurance, while quality of life improved more in the experimental group than the control (mean difference 12%). Improvements in physical function and dyspnoea were equivalent. Thus 2 weeks of inspiratory muscle training improves inspiratory muscle strength and quality of life in the post-weaning period.-iiiFinally, Study 5 is a protocol for a randomised trial of inspiratory muscle training performed by patients while mechanically-ventilated. Study 5 measures the impact of inspiratory muscle training on duration of mechanical ventilation, as well as residual inspiratory muscle strength and endurance, quality of life, physical f...

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Feasibility and inter-rater reliability of the ICU Mobility Scale

Abstract: The IMS is a feasible tool with strong inter-rater reliability for measuring the maximum level of mobility of adult patients in the ICU.

Cited by 319 publications

References 26 publications

A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in the ICU*

A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in the ICU*

Validez y confiabilidad de las escalas de evaluación funcional en pacientes críticamente enfermos. Revisión sistemática

Inspiratory muscle training to enhance recovery from invasive mechanical ventilation

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