Evaluating physical functioning in critical care: considerations for clinical practice and research

Selina M Parry; Minxuan Huang; Dale M Needham

doi:10.1186/s13054-017-1827-6

Evaluating physical functioning in critical care: considerations for clinical practice and research

Crit Care. 2017 Oct 4;21(1):249. doi: 10.1186/s13054-017-1827-6.

Authors

Selina M Parry¹, Minxuan Huang^{2

3}, Dale M Needham^{4

5

6

7}

Affiliations

¹ Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
² Outcomes after Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA.
³ Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁴ Outcomes after Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD, USA. dale.needham@jhmi.edu.
⁵ Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. dale.needham@jhmi.edu.
⁶ Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. dale.needham@jhmi.edu.
⁷ Johns Hopkins University, 1830 East Monument Street, 5th Floor, Baltimore, MD, 21205, USA. dale.needham@jhmi.edu.

Abstract

The evaluation of physical functioning is valuable in the intensive care unit (ICU) to help inform patient recovery after critical illness, to identify patients who may require rehabilitation interventions, and to monitor responsiveness to such interventions. This viewpoint article discusses: (1) the concept of physical functioning with reference to the World Health Organization International Classification of Functioning, Disability and Health; (2) the importance of measuring physical functioning in the ICU; and (3) methods for evaluating physical functioning in the ICU. Recommendations for clinical practice and research are made, along with discussion of future directions.

Keywords: Critical illness; Early mobility; Outcome measurement; Physical function; Physical rehabilitation.

MeSH terms

Critical Care / methods*
Critical Illness / rehabilitation*
Health Status*
Humans
Intensive Care Units / organization & administration
Physical Examination / methods
Physical Examination / standards*

Grants and funding

R24 HL111895/HL/NHLBI NIH HHS/United States