Critical Care Functional Rehabilitation Outcome Measure: developing a validated measure

Introduction: 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. Aim: To develop and evaluate the validity and reliability of a new Critical Care Functional Rehabilitation Outcome Measure (CcFROM). Method: 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). Conclusion: This study has shown that the CcFROM is a valid and reliable outcome measure for use in Critical Care.