Confiabilidade e validade do escore Perme de mobilidade na terapia intensiva e enfermaria pediátrica

Abstract

Introduction: Mobility is a key domain to be monitored in pediatric intensive care unit (PICU) patients, as it enables early mobilization—a recommended practice to prevent complications and promote recovery. However, there is a lack of validated instruments to assess mobility in pediatric patients. The Perme Intensive Care Unit Mobility Score (Perme Score) is a tool designed to assess mobility, but its applicability in children and adolescents has not yet been evaluated. Objective: To assess the validity and inter- and intra-rater reliability of the Perme Score in children and adolescents admitted to PICUs and pediatric wards. Methods: This methodological, observational and cross-sectional study was carried out in two hospital institutions, including children and adolescents aged 6 to 17 years, hospitalized in the PICU or ward. The Perme Score, which assesses functional mobility across seven domains with a total score ranging from 0 to 32 (higher scores indicate better mobility), and the Functional Status Scale (FSS), which evaluates functional status across six domains with scores ranging from 6 to 30 (lower scores indicate better function), were used. After enrollment, participants were assessed independently by two physical therapists (PT1 and PT2), and PT1 repeated the assessment after 30 minutes (test–retest). Results: A total of 166 patients were included (51% female), with a median age of 11 years (IQR: 8–14). The mean Perme Score was 26.13 ± 7.89 points, and the mean FSS score was 7.25 ± 2.21 points. A moderate-to-strong negative correlation was found between the Perme Score and FSS (r = – 0.642; p < 0.01). The Perme Score demonstrated excellent inter-rater reliability, with mean scores of 26.4 ± 7.7 for PT1 and 26.5 ± 7.6 for PT2 (ICC = 0.99; 95%CI: 0.99–0.99; p < 0.001). Intra-rater reliability (PT1 test–retest) was also excellent, with a mean score of 26.5 ± 8.1 for both assessments (ICC = 0.99; 95%CI: 0.99–0.99; p < 0.001). Conclusion: The Perme Score, originally developed for adult ICU patients, is a reliable and valid tool for objectively assessing mobility of patients aged 6 to 17 years hospitalized in PICUs and medical/surgical pediatric wards.