Physical Function in the ICU - Scored (PFIT-s)

The PFIT-s measures physical function in people who are still in intensive care — a group for whom a six-minute walk test is out of the question, and for whom nothing happening might otherwise look the same as slow improvement.

Four things are tested. Shoulder flexion strength and knee extension strength are graded on the standard 0-to-5 muscle scale. Sit-to-stand records how much assistance the person needs to get up from sitting. Marching on the spot records cadence, the number of steps per minute. Each is converted to an ordinal score and the four combine, through a Rasch-derived algorithm, into a single interval score from 0 to 10.

• Denehy et al. (2013), the PFIT-s validation

Licensing Notes: The original PFIT was published in Critical Care and Resuscitation (2009); the scored version in Physical Therapy (2013). Scoring sheets and the summary protocol circulate freely.

Learn More: Test in order — strength first, then sit-to-stand, then marching — because the sequence runs from least to most demanding, and a person who cannot manage the earlier components will not manage the later ones. A change of 1.5 points on the 0-to-10 interval scale is the minimal clinically important difference. And the score predicts what happens next: a higher admission PFIT-s is associated with greater likelihood of discharge home, lower likelihood of discharge to inpatient rehabilitation, and shorter acute hospital stay.