title: Critical Care Functional Rehabilitation Outcome Measure: developing a validated measure.
abstract: BACKGROUND
  In 2009, the National Institute for Health and Clinical Excellence (NICE) developed guidelines, which recognized that rehabilitation plays a vital role in recovery from illness and in returning patients to their previous activity levels. NICE recommended the use of valid and reliable "outcome measures" as an evaluation tool.
  
  
  OBJECTIVE
  To develop and evaluate the validity and reliability of a new Critical Care Functional Rehabilitation Outcome Measure (CcFROM).
  
  
  METHODS
  The CcFROM was developed by physiotherapists working within the authors' institution and was based on an evaluation of current measures. Face and content validity were investigated using a questionnaire posted to 21 physiotherapists. Same-day and between-day intra-rater reliability and inter-rater reliability were investigated by three physiotherapists viewing 20 physiotherapy rehabilitation sessions and completing the CcFROM. Data were analysed for relative and absolute reliability.
  
  
  RESULTS
  The questionnaire demonstrated very high face validity and moderate content validity. 43% of the physiotherapists also suggested including an upper limb activity. Clinically acceptable same-day and between-day intra-rater reliability was demonstrated with ICCs of 0.985 (CI, 0.968-0.993) and 0.985 (CI, 0.871-0.972), respectively. Inter-rater reliability was recorded with an ICC of 0.906 (CI: 0.816-0.959).
  
  
  CONCLUSIONS
  This study has shown that the CcFROM is a valid and reliable outcome measure for use in Critical Care.
authors.affiliation: a Department of Physiotherapy and.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Twose
authors.affiliation: b Department of Critical Care , Cardiff and Vale University Health Board, University Hospital of Wales , Cardiff , UK , and.
authors.forename: Matt P
authors.initials: MP
authors.lastname: Wise
authors.affiliation: c School of Physiotherapy, Cardiff University , Heath Park Campus , Cardiff , UK.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Enright
mesh_terms: D000203:Activities of Daily Living; D003422:Critical Care / Q000379:methods* / Q000592:standards; D000066891:Critical Care Outcomes; D051341:Dependent Ambulation; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D051346:Mobility Limitation; D053580:Muscle Strength; D015588:Observer Variation; D026741:Physical Therapy Modalities / Q000592:standards; D011237:Predictive Value of Tests; D020127:Recovery of Function; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking
keywords: Critical care; outcome measure; physiotherapy; rehabilitation