Delphi Consensus for Core Outcome Set for Measuring Patient Outcomes After ICU

Instrument ICU Mobility Scale

Acronym IMS
Core Domain Physical Function and Symptoms
Area assessed (Number of N/A
questions)
Description A simple, one-question scale to quantify mobility status during the ICU stay.

Versions N/A
Recall Period 24 hours
Scoring information Mobility is assessed on an 11-point scale ranging from 0 (Nothing - lying in bed) to 10
(Walking independently without a gait aid).
Estimated time to complete <1 minute
Administer to Patient
Require trained administrator No
Mode of administration In-person, or via review of medical records
Order from N/A

Licensing Fee No Cost

Fees and licensing information is effective as
of 2016, but is subject to change over time

Equipment required Survey form and pen

Number of published Critical 0
Care publications using
Instrument (1970 – 2013)*
Highest COSMIN** rating No evaluation completed
(from a systematic review up
to March 2015***)
Additional comments Developed to be used in the intensive care unit
•Reliability (Inter-rater, Intraclass Correlation Coefficient=0.80)[1]
•Construct Validity (Compared to Medical Research Council Sum-score [Spearman r=0.57-
0.64], Physical Function in Intensive Care Test-scored [Spearman r=0.66-0.81])
•Divergent Validity (Compared to weight [Spearman r=0.06], gender [Spearman r=0.34])[2,3]
•Predictive Validity (Discharge home [OR= 1.16-1.54, p≤0.03], Survival to 90 days [OR=1.38,
p=0.001])[2,3]
•Responsiveness (Effect Size = 0.59 and 0.80, Significant change in scores across ICU time
points and up to 6 months)[2,3]
•Floor/ceiling effects: (Study admit: Floor = 96%; Ceiling = NR), (Awakening: Floor = 17%;
Ceiling = 0%), (Intensive care unit discharge: Floor = 0-14%; Ceiling = 4-5%)[2,3]
Online Example: English version: https://www.monash.edu/__data/assets/pdf_file/0010/933985/icu_mobility_scale.pdf
Japanese version: https://www.monash.edu/__data/assets/pdf_file/0007/1024729/imsver.pdf
Portuguese version: http://www.jornaldepneumologia.com.br/detalhe_anexo.asp?id=47
*Turnbull, A.E. et al. Outcome Measurement in ICU Survivorship Research from 1970-2013: A Scoping Review of 425 Publications. Critical Care Medicine. 2016; 44; 1267-77.
** COSMIN is used to rate a study's evaluation of a survey or test's measurement properties. COSMIN does NOT rate the instrument itself, but helps readers understand if they can have
confidence in the results of studies evaluating measurement properties of surveys and tests. For example, a rigorous study evaluating a test with poor measurement properties will receive a
“good” COSMIN rating, while a poorly-conducted study evaluating a test with good measurement properties will receive a “poor” COSMIN rating. You must consider both the COSMIN rating and
the results of studies provided when forming your opinion about that test. If more than one paper evaluated the same measurement property for a given test/survey, we present data from the
paper with a better COSMIN score. COSMIN ratings were only performed for studies evaluating instruments used in ICU survivors after ICU discharge.
***Robinson, K.A. et al. A systematic review finds limited data on measurement properties of instruments measuring outcomes in adult intensive care unit survivors. Journal of Clinical Epidemiology.
2017; 82; 37-46.
Last updated on January 10, 2018. If you are aware of any updates required for this document, please notify us via ImproveLTO@jhmi.edu.

This work, created by Dale M. Needham, MD, PhD and the Johns Hopkins University Outcomes After Critical Illness & Surgery (OACIS)
Group, was funded by NHLBI R24HL111895, and is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.
References:
1. Hodgson, C., et al., Feasibility and inter-rater reliability of the ICU mobility scale. Heart and
Lung, 2014. 43: p. 19-24.
2. Parry, S., et al., Functional outcomes in ICU - what should we be using? An observational study.
Critical Care, 2015. 19: p. 127.
3. Tipping, C., et al., The ICU Mobility scale has construct and predictive validity and is responsive:
A multi-centre observational study. Annals of American Thoracic Society. 2016,13(6):887-893.