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Outcome measures report different aspects of patient function three months following critical care

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Abstract

Background

Previous investigation of the relationship between physical performance and patient self-report physical function (PF) measures in intensive care unit (ICU) survivors have not been performed.

Objectives

To (1) analyze the extent to which other activity-based measures of physical performance may serve as proxies for the 6-min walk test (6MWT); (2) determine the extent to which the Short Form (SF) 36 domain of PF and physical component summary (PCS) score, reflect components of physical performance and (3) examine the relationship between demographic and ICU variables and the 6MWT.

Design

Cross-sectional data from two clinical trials.

Setting

Two acute care hospitals (Melbourne, Australia and Denver, USA).

Patients

A total of 177 survivors of ICU.

Measurements

Were evaluated at 3 months. Performance-based measures were: 6MWT, timed up and go test (TUG), the five times sit to stand test (5×STS), the Berg balance scale (BBS) and two self-report measures: the SF-36 PF domain and the PCS score.

Main results

6MWT showed excellent correlation with the TUG (rho = −0.79) and BBS (rho = 0.80); and good correlation with 5×STS (rho = −0.69) and SF-36 PF scores (rho = 0.69). 6MWT explained 54 and 33 % of variance in SF-36 PF and PCS scores respectively. No variables were clinically important in predicting 6MWT.

Conclusions

The 6MWT and TUG may both be acceptable measures of PF performance 3 months after ICU. Performance-based tests measure different constructs than self-report measures and choice of outcome variables should be aligned with study aims to ensure the most appropriate measure is used.

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Acknowledgments

The current research is funded by the National Institutes of Health (R01 NR011051 to MM) and National Health and Medical Research Council (APP454717).

Conflicts of interest

The authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Physiotherapy, The University of Melbourne, Melbourne, Australia

    Linda Denehy & Lara Edbrooke

  2. Department of Physical Medicine and Rehabilitation, University of Colorado, Denver, USA

    Amy Nordon-Craft, Daniel Malone & Margaret Schenkman

  3. Department of Physiotherapy, Austin Hospital, Melbourne, Australia

    Sue Berney

  4. Department of Medicine, University of Colorado School of Medicine, Denver, USA

    Marc Moss

Authors
  1. Linda Denehy
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  2. Amy Nordon-Craft
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  3. Lara Edbrooke
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  4. Daniel Malone
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  5. Sue Berney
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  6. Margaret Schenkman
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  7. Marc Moss
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Corresponding author

Correspondence to Linda Denehy.

Additional information

Take-home message: The 6-min walk test and the timed up and go showed excellent correlations in 177 ICU survivors; these tests may both be acceptable measures of physical function performance 3 months after ICU. The performance-based measures explained one third to one half of self-reported measures (SF-36 physical function and physical component summary scores). Performance-based tests may measure different constructs than self-report measures, and choice of outcome variables should be aligned with study aims to ensure that the most appropriate measure is used.

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Denehy, L., Nordon-Craft, A., Edbrooke, L. et al. Outcome measures report different aspects of patient function three months following critical care. Intensive Care Med 40, 1862–1869 (2014). https://doi.org/10.1007/s00134-014-3513-3

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  • DOI: https://doi.org/10.1007/s00134-014-3513-3

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