Inter‐rater reliability of activity measure for post‐acute care ‘6‐Clicks’ inpatient mobility short form in the intensive care unit

Abstract

Objective Examine the inter‐rater reliability of the activity measure for post‐acute care (AM‐PAC) inpatient mobility short form (IMSF) when completed by physical therapists (PTs), during routine clinical practice, in a variety of patients with critical illness. Methods A prospective observational evaluation at single, large academic hospital in the United States. Patients (n = 76) in surgical, medical and neurological intensive care units (ICUs) were evaluated as part of routine clinical practice using the AM‐PAC IMSF administered by eight PTs with at least 6 months of experience using this tool. One of two reference rater PTs observed the physical therapy session, and simultaneously scored the AM‐PAC IMSF. The reference rater and clinical PTs were blinded to each other's scores with a minimum of 10 assessments completed by each clinical PT. Bland–Altman plots were constructed and intra‐class correlation coefficients (ICC) were computed using a random intercept (physical therapy session) model. Results Eighty one assessments (five patients assessed twice) were scored by both a clinical PT and reference rater PT (total assessments = 162). Bland–Altman plots revealed a mean difference in AM‐PAC IMSF scoring of 0.0 (95% limits of agreement: −3.0 to +3.0), with an ICC (95% confidence interval) of 0.957 (0.947–0.964). The ICC (95% confidence interval) for patients in surgical, medical and neurological ICUs was very similar: 0.949 (0.927–0.959), 0.963 (0.946–0.971) and 0.936 (0.886–0.955), respectively. Conclusions The AM‐PAC IMSF demonstrates excellent reliability compared with reference rater PTs when performed by PTs during clinical care across surgical, medical and neurological ICUs.