Eggmann Sabrina, Verra Martin L, Stefanicki Valentine, Kindler Angela, Seyler Daphne, Hilfiker Roger, Schefold Joerg C, Bastiaenen Caroline H G, Zante Bjoern
Department of Physiotherapy, Inselspital, Bern University Hospital, Bern, Switzerland.
Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation CAPHRI, Maastricht University, Maastricht, The Netherlands.
Disabil Rehabil. 2022 Aug;44(16):4509-4518. doi: 10.1080/09638288.2021.1909152. Epub 2021 Apr 19.
To translate and cross-culturally adapt the Chelsea Critical Care Physical Assessment tool from English to German (CPAx-GE) and to examine its validity and reliability.
Following a forward-backward translation including an expert round table discussion, the measurement properties of the CPAx-GE were explored in critically ill, mechanically ventilated adults. We investigated construct, cross-sectional, and cross-cultural validity of the CPAx-GE with other measurement instruments at pre-specified timepoints, analysed relative reliability with intraclass correlation coefficients (ICCs) and determined absolute agreement with the Bland-Altman plots.
Consensus for the translated CPAx-GE was reached. Validity was excellent with >80% of the pre-specified hypotheses accepted at baseline, critical care, and hospital discharge. Interrater reliability was high (ICCs > 0.8) across all visits. Limit of agreement ranged from -2 to 2 points. Error of measurement was small, floor, and ceiling effects limited.
The CPAx-GE demonstrated excellent construct, cross-sectional, and cross-cultural validity as well as high interrater reliability in critically ill adults with prolonged mechanical ventilation at baseline, critical care, and hospital discharge. Consequently, the CPAx-GE can be assumed equal to the original and recommended in the German-speaking area to assess physical function and activity of critically ill adults across the critical care and hospital stay. DRKS00012983 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012983), registered on 20 September 2017, first patient enrolled on 21 November 2017.Implications for rehabilitationEarly rehabilitation of critically ill patients is recommended to prevent and treat the subsequent functional disability, but a suitable measurement instrument for the German-speaking area is lacking.The translated, cross-culturally adapted German CPAx demonstrated excellent validity and reliability in assessing physical function and activity in critically ill adults.Cross-sectional validity of the CPAx has been newly established and allows the use of this tool at clinically relevant time-points in the course of a critical illness.The CPAx-GE can therefore be used in clinical practice by German-speaking therapists to assess physical function and activity during early rehabilitation in the ICU and hospital.
将切尔西重症监护身体评估工具从英文翻译并进行跨文化调适为德文版（CPAx-GE），并检验其有效性和可靠性。
经过包括专家圆桌讨论在内的正向-反向翻译后，在接受机械通气的成年重症患者中探究CPAx-GE的测量属性。我们在预先设定的时间点，将CPAx-GE与其他测量工具一起调查其结构效度、横断面效度和跨文化效度，用组内相关系数（ICC）分析相对可靠性，并用布兰德-奥特曼图确定绝对一致性。
就翻译后的CPAx-GE达成了共识。效度极佳，在基线、重症监护和出院时，超过80%的预先设定假设被接受。在所有访视中，评定者间信度都很高（ICC>0.8）。一致性界限在-2至2分之间。测量误差小，地板效应和天花板效应有限。
CPAx-GE在基线、重症监护和出院时，对接受长时间机械通气的成年重症患者显示出极佳的结构效度、横断面效度和跨文化效度，以及较高的评定者间信度。因此，可以认为CPAx-GE等同于原版，并在德语区推荐使用，以评估成年重症患者在重症监护和住院期间的身体功能和活动情况。DRKS00012983（https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012983），于2017年9月20日注册，首例患者于2017年11月21日入组。
对康复的意义
建议对重症患者进行早期康复以预防和治疗随后出现的功能障碍，但德语区缺乏合适的测量工具。翻译后的、经过跨文化调适的德文版CPAx在评估成年重症患者的身体功能和活动方面显示出极佳的有效性和可靠性。CPAx的横断面效度是新确立的，允许在危重病病程中具有临床相关性的时间点使用该工具。因此，德语区的治疗师可以在临床实践中使用CPAx-GE来评估ICU和医院早期康复期间的身体功能和活动情况。
