What is the ICU Mobility Scale (IMS)?
The ICU Mobility Scale is an 11-item categorical scale designed to measure the highest level of functional mobility patients achieve in the intensive care units (ICU). It is a critical tool for healthcare professionals, providing a standardized method to assess and monitor the mobility and functional abilities of critically ill patients and patients with ICU-acquired weakness, including those with acute respiratory failure and mechanically ventilated patients.
The IMS delineates various patient activity levels, ranging from Level 0 (complete inactivity) to Level 10 (independent ambulation). Each level is precisely defined, offering a clear framework for evaluating patient progress:
- Level 0: Nothing (lying in bed): The patient remains passively in bed with any movement, including passive rolling or exercises, facilitated by the staff.
- Level 1: Sitting in bed, exercises in bed: The patient engages in any bed-based activity, including physical therapy exercises. However, the patient does not move out of or over the edge of the bed.
- Level 2: Passively moved to chair (not standing): The patient is transferred to the chair through housing, passive lifting, or slide transfers.
- Level 3: Sitting over the edge of the bed: The patient actively sits on the side of the bed with some degree of trunk control. possibly with assistance from the staff.
- Level 4: Standing: The patient bears weight through the feet in a standing position with or without assistance.
- Level 5: Transferring bed to chair: The patient actively transfers from the bed to a chair, stepping or shuffling through standing and shifting weight from one leg to another.
- Level 6: Marching on the spot (at bedside): The patient performs on-the-spot marching by lifting alternate feet at least four times (twice per foot), with or without assistance.
- Level 7: Walking with assistance of 2 or more people - The patient walks at least 5 meters away from the bed or chair, assisted by two or more individuals.
- Level 8: Walking with assistance of 1 person - The patient walks at least 5 meters away from the bed or chair, assisted by one person.
- Level 9: Walking independently with a gait aid - The patient walks at least 5 meters away from the bed or chair using a gait aid, but without assistance from another person. This level also includes wheelchair-bound patients who wheel themselves independently.
- Level 10: Walking independently without a gait aid - The patient walks at least 5 meters away from the bed or chair without a gait aid or any assistance.
The IMS is essential in managing ICU patients by enabling precise and consistent mobility assessment. Categorizing patients’ functional abilities aids in tailoring individualized rehabilitation plans, facilitates progress monitoring, and ultimately contributes to improved patient outcomes during their stay in the intensive care unit.










