Early Rehabilitation Index: translation and crosscultural adaptation to Brazilian Portuguese; and Early Rehabilitation Barthel Index: validation for use in the intensive care unit

Abstract

Objetivo Traduzir, adaptar transculturalmente para o português do Brasil o instrumento Early Rehabilitation Index e validar para uso na unidade de terapia intensiva o instrumento Early Rehabilitation Barthel Index , para avaliação do estado funcional. Métodos Foram executadas as seguintes etapas: preparação, tradução, reconciliação, tradução reversa, revisão, harmonização, pré-teste e avaliação psicométrica. Após esse processo inicial, a versão em português foi aplicada por dois avaliadores em pacientes que permaneciam pelo menos 48 horas internados na unidade de terapia intensiva. Verificou-se a confiabilidade da escala por meio da consistência interna, da confiabilidade entre avaliadores e do efeito piso e teto. Para a validade de constructo, correlacionou-se o Early Rehabilitation Barthel Index com instrumentos que usualmente são utilizados para avaliação do estado funcional na unidade de terapia intensiva. Resultados Participaram 122 pacientes com mediana de idade de 56 [46,8 - 66] anos. O Early Rehabilitation Barthel Index teve confiabilidade adequada com coeficiente alfa de Cronbach de 0,65. A confiabilidade entre avaliadores foi excelente, com coeficiente de correlação intraclasse de 0,94 (IC95% 0,92 - 0,96) e moderado a excelente com índice de concordância de kappa de 0,54 a 1,0. Os efeitos piso e teto foram mínimos. Observou-se a validade do Early Rehabilitation Barthel Index por meio das correlações com o escore total do Perme Escore (rô = 0,72), da Escala de Estado Funcional em UTI (rô = 0,77), do Physical Function in Intensive Care Test-score (rô = 0,69), do Medical Research Council sum score (rô = 0,58), além das dinamometrias de preensão palmar (rô = 0,58) e manual de coxa (rô = 0,55), todos com p < 0,001. Conclusão A versão adaptada do Early Rehabilitation Index para o português brasileiro e na sua totalidade, Early Rehabilitation Barthel Index é confiável e válida para avaliação do estado funcional dos pacientes na alta da unidade de terapia intensiva.

Validation of the Barthel Index in Chinese nursing home residents: an item response theory analysis

“…Similarly, the 15-item BI also demonstrated a narrow assessment precise width (−1 < θ < 1) (Zhao et al, 2022 ). Furthermore, reports of ceiling effects (>15% of the sample attaining the maximum score) and floor effects (>15% of the sample scoring the minimum) have been reported across different populations, such as patients with stroke (Balu, 2009 ), patients in the intensive care unit (Reis et al, 2021 ), and older hospitalized patients with cognitive spectrum disorders (Braun et al, 2021 ). These observations suggest an inherent limitation in the BI's measurement due to its focus on a limited range of ADLs and the absence of assessment beyond basic ADLs (Bouwstra et al, 2019 ).…”

Analysis of physical function, muscle strength, and pulmonary function in surgical cancer patients: a prospective cohort study

“…Indirect muscle strength was measured using the Medical Research Council Sum-Score (MRC-SS) 20 . Participants were considered eligible to participate in the study if they responded at least three of the ve commands proposed by De Jonghe 21 : "open/close your eyes"; "look at me"; "open your mouth and put out your tongue"; "nod your head"; and "raise your eyebrows when I have counted up to ve".…”

“…The MRC-SS is a simple tool for assessing global muscle strength in intensive care patients and has good inter-rater reliability 22 . The tool has been translated into Portuguese and adapted for use in Brazil 20 .…”

The structure of the Early Rehabilitation Barthel Index (ERBI) should be modified: evidence from a Rasch analysis study

“…Although ERBI has been administered in several studies in persons with sABI, 13 , 14 its psychometric properties were assessed in detail by few studies. 7 , 15 , 16 Particularly, Rollnik et al 15 demonstrated high correlations between nurses’ and physicians’ assessments (r=0.849) and moderate correlations with BI (r=0.438 and r=0.430 if administrated by nurses of physicians, respectively) in 273 neurological rehabilitation patients. 15 Furthermore, Reis et al 16 showed that a Brazilian Portuguese version of the ERBI had a moderate to excellent inter-rater reliability (kappa ranging from 0.54 to 1.00) and that its total score correlated significantly with several other functional indicators in 122 patients admitted to the general intensive care unit.…”

“… 15 Furthermore, Reis et al 16 showed that a Brazilian Portuguese version of the ERBI had a moderate to excellent inter-rater reliability (kappa ranging from 0.54 to 1.00) and that its total score correlated significantly with several other functional indicators in 122 patients admitted to the general intensive care unit. 16 Finally, Rollnik et al. 15 , 17 demonstrated the predictive validity of low ERBI total scores in terms of significantly longer length of stay 15 , 17 and significant morbidities.…”