International Classification of Functioning, Disability, and Health Domains of 60 Physical Functioning Measurement Instruments Used During the Adult Intensive Care Unit Stay: A Scoping Review

Abstract

Background There has been a recent surge in the creation and adaptation of instruments to measure physical functioning (PF) in the intensive care unit (ICU). Selecting the right measurement instrument depends on understanding the core constructs that it measures in terms of the International Classification of Functioning, Disability and Health (ICF) domains. Purpose The purpose of this study was to map systematically the ICF domains and subdomains included in the PF measurement instruments used for adult patients during the ICU stay. Data Sources A systematic search was carried out in Cochrane CENTRAL, PubMed, CINAHL, and LILACS as well as a hand search up to May 17, 2017. Study Selection Study selection included all types of research articles that used at least 1 PF measurement instrument in adult patients within the ICU. Data Extraction Study design, year of publication, study population, and the measurement instruments reported were recorded. A consensus of experts analyzed the ICF domains included in each instrument. Data Synthesis We found 181 articles containing 60 PF measurement instruments used during the ICU stay. Twenty-six ICF domains were identified, 38 instruments included Mobility , and 13 included Muscle function . Limitations Studies not written in English or Spanish were excluded. Conclusions There are numerous PF measurement instruments used in adult patients in the ICU. The most frequent ICF domain measured is Mobility . This study highlights the ICF domains contained in the instruments that can be used clinically, providing a complete database of instruments that could facilitate selection of the most appropriate measure based on the patients’ needs.

German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability

“…Internal consistency of the CPAx-GE was good during the ICU stay and moderate at hospital discharge. The CPAx-GE involves respiratory and muscle functions, movements and mobility [12]. Considering that strength does not imply function, the interrelatedness of these items may change over time.…”

“…The 10 items evaluate respiratory function, functional mobility (position changes, sitting, standing, stepping), and grip strength with an ordinal scale from 0 (unable/dependent) to 5 (independent) resulting in a maximum score of 50 (independent) and a minimum score of 0 (completely dependent). The measured constructs of the CPAx are allocated to the domains of body functions and activitiesparticularly muscle functions, movement functions, functions of the respiratory system and mobilityaccording to the International Classification of Functioning, Disability, and Health (ICF) [12]. A recent systematic review confirmed the CPAx as a robust measurement for critically ill patients with excellent measurement properties, although cross-sectional validity, i.e., the validity at different time-points in the course of a disease, has not yet been established [13].…”

Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit

“…The selection of the most appropriate measure must be made based on the psychometric properties [ 50 ]. In a review, González-Seguel et al [ 51 ] identified sixty physical function measurement instruments under different domains for adult patients admitted to the ICU. Mobility was the most frequent domain to be measured and included 38 instruments.…”

Nutritional Interventions on Physical Functioning for Critically Ill Patients: An Integrative Review

“…Physical functioning (PF) is the physical abilities allowing functional independence and those related to movement. 1 Poor PF, including decreased muscle mass, muscle strength, and function, is a frequent problem in critically ill patients, 2–4 since skeletal muscle proteolysis is enhanced due to the catabolism caused by the hypermetabolic state of acute illness, 5 , 6 which is associated with adverse clinical outcomes including infections, difficult weaning from mechanical ventilation (MV), a longer length of stay, increases mortality, higher financial costs, decreased quality of life of survivors. 4 , 7 Rapid muscle loss is independently correlated with increased intensive care unit (ICU) mortality and in-hospital mortality in ICU patients.…”