is advocated as a treatment to reduce iCu-acquired weakness and delirium. 15, 16 emphasis should be placed on progressive mobility, individual functional capability, and ambulation of patients who meet specific criteria. 17 patients in the iCu who receive early mobilization have had variable functional responses. 4, 18, 19 it is possible that this variability may be a result of the different tools used to capture function. in many of the iCu studies related to mobility interventions, the tools used to measure mobility status were not designed for patients tethered to tubes and lines, nor were they designed to detect changes in function in critically ill patients. several functional mobility tools have been used in published studies, including the functional independence Measure (fiM), 20 katz index of independence in activities of daily living, 21 Barthel index, 22 acute Care index of function, 23 university of rochester acute Care evaluation, 24 physical function iCu test, 25 and functional status score for intensive Care unit (fss-iCu). 26 however, these tools are not sensitive to measuring iCu mobility

Objective: To translate the Perme Intensive Care Unit Mobility Score and the ICU Mobility Scale (IMS) into Portuguese, creating versions that are cross-culturally adapted for use in Brazil, and to determine the interobserver agreement and reliability for both versions. Methods: The processes of translation and cross-cultural validation consisted in the following: preparation, translation, reconciliation, synthesis, back-translation, review, approval, and pre-test. The Portuguese-language versions of both instruments were then used by two researchers to evaluate critically ill ICU patients. Weighted kappa statistics and Bland-Altman plots were used in order to verify interobserver agreement for the two instruments. In each of the domains of the instruments, interobserver reliability was evaluated with Cronbach's alpha coefficient. The correlation between the instruments was assessed by Spearman's correlation test. Results: The study sample comprised 103 patients-56 (54%) of whom were male-with a mean age of 52 ± 18 years. The main reason for ICU admission (in 44%) was respiratory failure. Both instruments showed excellent interobserver agreement (κ > 0.90) and reliability (α > 0.90) in all domains. Interobserver bias was low for the IMS and the Perme Score (−0.048 ± 0.350 and −0.06 ± 0.73, respectively). The 95% CIs for the same instruments ranged from −0.73 to 0.64 and −1.50 to 1.36, respectively. There was also a strong positive correlation between the two instruments (r = 0.941; p < 0.001). Conclusions: In their versions adapted for use in Brazil, both instruments showed high interobserver agreement and reliability.

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