Muscle Weakness Clinical Trial
Official title:
Responsiveness and the Minimal Clinically Important Difference of the Chelsea Critical Care Physical Assessment Tool (CPAx) in Critically Ill, Mechanically Ventilated Adults
NCT number | NCT06419699 |
Other study ID # | 5678 |
Secondary ID | |
Status | Not yet recruiting |
Phase | |
First received | |
Last updated | |
Start date | May 2024 |
Est. completion date | October 2025 |
Intensive care unit (ICU) acquired weakness is a common complication associated with long-term physical impairments in survivors of a critical illness. The Chelsea Critical Care Physical Assessment tool (CPAx) is a valid and reliable instrument for physical function and activity in critically ill patients at risk for muscle weakness. However, its ability to measure change over time (responsiveness) and the minimal clinically important difference (MCID) have not yet been rigorously investigated. This multi-centre, mixed-methods, longitudinal cohort study therefore aims to establish responsiveness and the MCID of the CPAx in the target population from ICU baseline to ICU and hospital discharge. The study uses routine data from standard physiotherapy sessions like mobility, function and activity with no additional burden for critically ill adults. The investigators expect the CPAx to be responsive allowing its use as a primary outcome in future effectiveness trials for the treatment of ICU-acquired weakness using the newly established MCID for sample size calculation. A high quality, rigorously tested measurement tool for physical function and activity in the ICU should benefit researchers, clinicians and patients.
Status | Not yet recruiting |
Enrollment | 120 |
Est. completion date | October 2025 |
Est. primary completion date | October 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age = 18 years - Mechanical ventilation = 72 hours - Expected to remain for = 48 hours in the ICU - Physiotherapy referral Exclusion Criteria: - Not expected to survive to hospital discharge (imminent to death) - Second or subsequent ICU admission for this hospital stay - Transfer from external ICU (with an ICU stay of >72 hours) - Primary neurological admission diagnosis (i.e., of the central nervous system including stroke, intracerebral haemorrhage, traumatic brain injury) - Known pregnancy - Living in a care facility pre-admission (severe pre-existing mental or physical disability) - Local regulations (i.e. Switzerland: refusal of general consent) |
Country | Name | City | State |
---|---|---|---|
Switzerland | Inselspital | Bern |
Lead Sponsor | Collaborator |
---|---|
Insel Gruppe AG, University Hospital Bern | Monash University |
Switzerland,
Corner EJ, Wood H, Englebretsen C, Thomas A, Grant RL, Nikoletou D, Soni N. The Chelsea critical care physical assessment tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study. Physiotherapy. 2013 Mar;99(1):33-41. doi: 10.1016/j.physio.2012.01.003. Epub 2012 Mar 30. — View Citation
Eggmann S, Verra ML, Stefanicki V, Kindler A, Schefold JC, Zante B, Bastiaenen CHG. Predictive validity of the Chelsea Critical Care Physical Assessment tool (CPAx) in critically ill, mechanically ventilated adults: a prospective clinimetric study. Disabil Rehabil. 2023 Jan;45(1):111-116. doi: 10.1080/09638288.2021.2022785. Epub 2022 Jan 7. — View Citation
Eggmann S, Verra ML, Stefanicki V, Kindler A, Seyler D, Hilfiker R, Schefold JC, Bastiaenen CHG, Zante B. German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability. Disabil Rehabil. 2022 Aug;44(16):4509-4518. doi: 10.1080/09638288.2021.1909152. Epub 2021 Apr 19. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Chelsea Critical Care Physical Assessment tool (CPAx) change score | CPAx change score for ICU period (ICU baseline to ICU discharge); CPAx ranges from 0 (worst score) to 50 (best score) | Assessed at ICU discharge (within 24 hours before or after ICU discharge) | |
Secondary | CPAx change score | CPAx change score for hospital period (ICU to hospital discharge); CPAx ranges from 0 (worst score) to 50 (best score) | Assessed at hospital discharge (last value before discharge) | |
Secondary | Global rating of change scale | Seven-point global rating of change scale (GRC): (1) very much improved; (2) much improved; (3) little improved; (4) no change; (5) little deterioration; (6) much deterioration; (7) very much deterioration for 'physical function and activity' (rated by treating physiotherapist) | ICU and hospital discharge (change for ICU and hospital period) | |
Secondary | ICU Mobility Scale | To evaluate mobility level, the score ranges from 0 (worst) to 10 (best) | ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge | |
Secondary | Medical Research Council Sum Score | To assess muscle strength, the minimal score is 0 (worst), the maximal score 60 (best), ICUAW is defined as <48 points | ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge | |
Secondary | Richmond Agitation-Sedation Scale | To assess the level of sedation and/or cooperation, score ranges from -5 (unarousable) to +4 (combative) | ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge | |
Secondary | Modified Iowa Level of Assistance Scale | To determine assistance in functional tasks, the score ranges from 0 (worst) to 36 (best) | ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge | |
Secondary | ICU and discharge destinations | Categorical variable (death, external/internal hospital ward, external ICU/hospital, rehabilitation, home, other) to assess the predictive validity of the CPAx score | ICU and hospital discharge |
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