title: A tool to assess mobility status in critically ill patients: the Perme Intensive Care Unit Mobility Score.
abstract: The benefits of early mobilization for adult patients in the intensive care unit (ICU) are reduced length of ICU and hospital stays, fewer readmissions to the ICU, decreased duration of mechanical ventilation, fewer days of detrimental bedrest, minimal adverse or unsafe events, and improved walking distance. Because there are no available tools to specifically measure mobility status of patients in the ICU setting, there is an urgent need to create a reliable tool that measures and standardizes the assessment of mobility status for these patients. The purpose of this study was to describe the development of this novel ICU-specific tool to assess a patient's mobility status, examine the initial reliability of the tool, and address its clinical application. The Perme ICU Score was quickly and easily administered by physical therapists. Overall, the inter-rater agreement was 94%. A total of six items had kappa values of < .6, and these low scores may have been the result of the procedure to collect inter-rater scores, wherein one rater assisted with the activity while a second rater observed. In order to improve reliability, the authors developed directions to standardize the assessment. The Perme ICU Mobility Score is a tool developed to measure the patient's mobility status starting with the ability to follow commands and culminating in the distance walked in two minutes. Preliminary data suggest that the validity of this tool is supported by expert concurrence, its overall reliability is high, and its clinical use is acceptable.
authors.affiliation: Houston Methodist Hospital, Houston, Texas.
authors.forename: Christiane
authors.initials: C
authors.lastname: Perme
authors.affiliation: University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Ricardo Kenji
authors.initials: RK
authors.lastname: Nawa
authors.affiliation: Case Western Reserve University, Cleveland, Ohio.
authors.forename: Chris
authors.initials: C
authors.lastname: Winkelman
authors.affiliation: Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.
authors.forename: Faisal
authors.initials: F
authors.lastname: Masud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000145:classification*; D004434:Early Ambulation; D005080:Exercise Test; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D015588:Observer Variation; D011237:Predictive Value of Tests; D020127:Recovery of Function; D015203:Reproducibility of Results; D013997:Time Factors; D016138:Walking
keywords: assessment; critical care; early ambulation; early mobilization; intensive care unit; mobility; outcomes; physical therapy