German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability

S. Eggmann*, M.L. Verra, V. Stefanicki, A. Kindler, D. Seyler, R. Hilfiker, J.C. Schefold, C.H.G. Bastiaenen, B. Zante

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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PurposeTo 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.Materials and methodsFollowing 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.ResultsConsensus 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.ConclusionsThe 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.
Original languageEnglish
Pages (from-to)4509-4518
Number of pages10
JournalDisability and Rehabilitation
Issue number16
Early online date19 Apr 2021
Publication statusPublished - 31 Jul 2022


  • ICU
  • ILL
  • Physiotherapy
  • UNIT
  • activity
  • critical illness
  • early rehabilitation
  • measurement instrument
  • physical function

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