Highlights
- •Measuring the physical functioning of critically ill patients remains a challenge.
- •Functional Status Score for the Intensive Care Unit (FSS-ICU) is a recommended physical functioning measure for patients in the intensive care unit (ICU).
- •Actigraphy provides a more objective comparison than other clinical instruments.
- •Actigraphy measures showed that high inactivity time had a worse FSS-ICU in the ICU.
- •Strong correlation exists between muscle strength, mechanical ventilation duration, and ICU length of stay.
Abstract
Objective
To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version
of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous
actigraphy from intensive care unit (ICU) admission to ICU discharge.
Design
The Chilean-Spanish version of the FSS-ICU was used in a prospective observational
study to mainly evaluate its correlation with actigraphy variables. The FSS-ICU was
assessed on awakening and at ICU discharge, while actigraphy variables were recorded
from ICU admission to ICU discharge.
Setting
A 12-bed academic medical-surgical ICU.
Participants
Mechanically ventilated patients (N=30), of 92 patients screened.
Interventions
Not applicable.
Main Outcome Measures
Construct validity of the FSS-ICU Chilean-Spanish version was assessed by testing
12 hypotheses, including the correlation with activity counts, activity time (>99
counts/min), inactivity time (0-99 counts/min), muscle strength, ICU length of stay,
and duration of mechanical ventilation.
Results
The median FSS-ICU was 19 points (interquartile range [IQR], 10-26 points) on awakening
and 28.5 points (IQR, 22-32 points) at ICU discharge. There was no floor/ceiling effect
of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that
was acceptable (0%/10%). Less activity time was associated with better mobility on
the FSS-ICU at both awakening (ρ=−0.62, P<.001) and ICU discharge (ρ=−0.79, P<.001). Activity counts and activity time were not correlated as expected with the
FSS-ICU.
Conclusions
The Chilean-Spanish FSS-ICU had a strong correlation with inactivity time during the
ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.
Keywords
List of abbreviations:
CPAx (Chelsea Critical Care Physical Assessment Tool), FSS-ICU (Functional Status Score for the Intensive Care Unit), ICU (intensive care unit), ICU-AW (intensive care unit–acquired weakness), IMS (Intensive Care Unit Mobility Scale), IQR (interquartile range), LOS (length of stay), PFIT-s (Physical Function in Intensive Care Unit Test-scored), MRC-SS (Medical Research Council Sum Score)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 20, 2020
Footnotes
Supported by the School of Physical Therapy at the Universidad del Desarrollo and the Unidad de Investigación y Ensayos Clínicos at the Clínica Alemana de Santiago, Chile. The funding body had no influence on the design of the study, data collection, analysis, and interpretation or in writing the manuscript.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
