Using Outcome Measures to Transition Ambulation From Physical Therapy to Nursing for Patients With Mechanical Circulatory Support

Abstract

The primary aim of this pilot study was to propose cutoff scores for the functional outcome measures at which patients with mechanical circulatory support (MCS) device can transition ambulation from a skilled physical therapy service to a nursing-led ambulation program. This was an exploratory pilot study (N = 46) of patients in an intensive care unit (ICU) with MCS devices. Three functional outcome measures were used: Activity Measure for Post-Acute Care (AM-PAC), Perme ICU Mobility Score (Perme Score), and 5-m gait speed test (gait speed). Cutoff scores were identified using area under the curve (AUC) of receiver operating characteristic. Twenty-two patients (intra-aortic balloon pump n = 16; Impella n = 6) were transitioned to a nursing-led ambulation program. The proposed cutoff scores to transition to a nursing-led ambulation program were 19.5 raw score (whole number >19) (>45.44 t score) for AM-PAC, 29.5 (whole number >29) for Perme Score, and 0.57 m/s or more for gait speed. The proposed cutoff scores for the 3 commonly used outcome measures for patients in the ICU are possibly useful when transitioning the ambulation program safely from skilled physical therapy to nursing service.