The responsiveness of the Chelsea Critical Care Physical Assessment tool in measuring functional recovery in the burns critical care population: An observational study

Corner, Evelyn J; Hichens, Louise V.; Attrill, Kate M.; Vizcaychipi, Marcela P.; Brett, Stephen; Handy, Jonathan

doi:10.1016/j.burns.2014.12.002

Cited by 33 publications

(36 citation statements)

References 10 publications

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“…(45) However, these findings compare favorably to other ICU-specific physical measures (Web Table 3). The CPAx has the lowest ceiling effects at ICU discharge;(39;40) however, it is important to note that CPAx differs from other ICU-specific measures (Web Table 3) as it involves evaluation of both physical function (whole body activities and grip strength) and respiratory (ventilation, oxygenation, and secretion clearance) measures.…”

Section: Discussionmentioning

confidence: 99%

Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference

Huang

Chan

Zanni

et al. 2016

Critical Care Medicine

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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.

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Section: Discussionmentioning

confidence: 99%

Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference

Huang

Chan

Zanni

et al. 2016

Critical Care Medicine

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“…The tool is simple to use, responsive to change and has minimal floor and ceiling effects (Corner et al 2014 , 2015 ). It was designed to be used daily to monitor patients’ function and identify problem areas (Corner et al 2013 , 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study

Whelan

Aswegen

Corner

2018

South African Journal of Physiotherapy

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BackgroundCritically ill patients following traumatic injury or major surgery are at risk of loss of skeletal muscle mass, which leads to decreased physical function. Early rehabilitation in an intensive care unit (ICU) is thought to preserve or restore physical functioning. The Chelsea critical care physical assessment (CPAx) is a measurement tool used to assess physical function in the ICU.ObjectivesTo determine whether the use of the CPAx tool as part of physiotherapy patient assessment, in two adult trauma and surgical ICU settings where early patient mobilisation forms part of standard physiotherapy practice, had an impact on ICU and hospital length of stay (LOS) through delivery of problem-oriented treatment plans.MethodA single-centred pre–post quasi-experimental study was conducted. The population was a consecutive sample of surgical and trauma ICU patients. Participants’ functional ability was assessed with the CPAx tool on alternative days during their ICU stay, and rehabilitation goals were modified according to their CPAx score. Intensive care unit and hospital LOS data were collected and compared to data of a matched historical control group. Descriptive and inferential statistics were used.ResultsA total of 26 ICU patients were included in the intervention group (n = 26). They received CPAx-guided therapy, and outcomes were matched with ICU patients in the historical control group (n = 26). The median sequential organ failure assessment (SOFA) score was significantly higher in the control group (p = 0.005) (3.5 [IQR 2–6.3]) versus (2 [IQR 1.8–2.5]) for the intervention group. The median admission CPAx score for the intervention group was 33.5 (IQR 16.1–44), and the median ICU discharge score was 38 (IQR 28.5–43.8). No significant differences were found in ICU days (control 2.7 [IQR 1.1–5.2]; intervention 3.7 [IQR 2.3–5.4]; p = 0.27) or hospital LOS (control 13.5 [IQR 9.3–18.3]; intervention 11.4 [IQR 8.4–20.3], p = 0.42). Chelsea critical care physical assessment scores on ICU admission had a moderate negative correlation with hospital LOS (r = −0.58, p = 0.00, n = 23). Chelsea critical care physical assessment scores at ICU discharge had strong positive correlation with discharge SOFA scores (r = 0.7; p = 0.025; n = 10).ConclusionProblem-oriented patient rehabilitation informed by the CPAx tool resulted in improvement of physical function but did not reduce ICU or hospital LOS.Clinical implicationsA higher level of physical function at ICU admission, measured with CPAx, was associated with shorter hospital LOS.

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“…Corner and colleagues demonstrated that the CVI of CPAx was 1 (p < 0.05) [11][12] . They also showed that CPAx has good predictive validity, and that the CPAx score could be used as an alternative indicator of functional prognosis in critically ill patients by analyzing the relationship between the CPAx score and patient outcomes [13] . Other colleagues demonstrated the criterion validity of CPAx taking the scores for the MRC, Short Form (SF)-36, Sequential Organ Failure Assessment (SOFA), and GCS as a standard [23] .…”

Section: Validity Of Cpax-chimentioning

confidence: 99%

“…Chelsea Critical Care Physical Assessment Tool (CPAx) could be the optimal tool for predicting and evaluating ICU-AW. CPAx not only includes physical function, mobility and grip strength, it also includes respiratory function and cough ability [11][12][13] . CPAx has been translated into several languages for use in the UK, Sweden, Denmark and other countries [14][15] .…”

Section: Introductionmentioning

confidence: 99%

Reliability, Validity, and Cutoff Point of the Chinese Version of the Chelsea Critical Care Physical Assessment Tool in Critically Ill Patients

Wang

Ding

et al. 2020

Preprint

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Purpose: Translation and cross-cultural adaptation of the Chelsea Critical Care Physical Assessment Tool (CPAx) into a Chinese version of CPAx (“CPAx-Chi”), test the reliability and validity of CPAx-Chi, and verify the cutoff point for the diagnosis of intensive care unit-acquired weakness (ICU-AW) Material and methods: Translation and cross-cultural adaptation of CPAx into CPAx-Chi was based on the Brislin model. Participants were recruited from the general ICU of five third-grade class-A hospitals in western China. Adult patients (n = 200) 48 h after receiving intensive care were included (median age, 53 years; 64% males). Patients were assessed by two assessment scales: Medical Research Council Muscle Score (MRC-Score) and CPAx-Chi.Results: The item-level content validity was 0.889. The scale-level content validity was 0.955. Taking the MRC-Score scale as standard, the criterion validity of CPAx-Chi was r = 0.758 (p < 0.001) for Researcher A, and r = 0.65 (p < 0.001) for Researcher B. Cronbach’s ɑ was 0.939. The inter-rater reliability was 0.902 (p < 0.001). The AUC of CPAx-Chi for diagnosing ICU-AW based on MRC-Score ≤48 was 0.899 (95%CI 0.862–1.025) and 0.874 (0.824–0.925) for Researcher B. The maximum value of the Youden Index was 0.643, and the best cutoff point for CPAx-Chi for the diagnosis of ICU-AW was 31.5. The sensitivity was 87% and specificity was 77% for Researcher A, whereas it was 0.621, 31.5, 75%, and 87% for Researcher B, respectively. The consistency was high when taking CPAx-Chi ≤31 and MRC-Score ≤48 as the cutoff points for the diagnosis of ICU-AW. Also, kappa = 0.845 (p = 0.02) in Researcher A and 0.839 (p = 0.04) for Researcher B. Conclusions: CPAx-Chi had good content validity, criterion-related validity and reliability. CPAx-Chi showed the best accuracy in assessment of patients at risk for ICU-AW with good sensitivity and specificity at a recommended cutoff of 31.

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The responsiveness of the Chelsea Critical Care Physical Assessment tool in measuring functional recovery in the burns critical care population: An observational study

Cited by 33 publications

References 10 publications

Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference

Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference

Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study

Reliability, Validity, and Cutoff Point of the Chinese Version of the Chelsea Critical Care Physical Assessment Tool in Critically Ill Patients

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