Many unique challenges are present for accurately measuring and scoring physical function in major burn ICU patients. Notably, The Physical Function in Intensive Care Test scored (PFIT-s), The Functional Status Score for ICU (FSS-ICU), The Chelsea Critical Care Physical Assessment (CPAx) and Perme Mobility Score have withstood clinometric examination in general intensive care patients but none have proven clinical utility in burn intensive Care patients. In recent years researchers have proposed an array of functional outcome measures which were developed in general intensive care patients. This was highlighted in The National Institute of Health and Clinical Excellence “Rehabilitation after critical illness” guideline published in 2009 (NICE CG83).

With growing awareness of the safety, feasibility and benefits of early active exercise and functional rehabilitation programmes for intensive care patients, ,, , ], the need for the development of patient specific functional outcome measures to score and monitor patients’ progress and predict discharge outcome has never been greater. This likely intensifies the effects of ICU-AW and limits recovery of patients’ physical function in the long term. Major burn results in hypermetabolism and protein catabolism leading to amplified loss of lean muscle long term. Furthermore, physical aspects of quality of life are frequently impaired for years.

The impact of ICU-AW is significant and far reaching, resulting in prolonged duration of ventilation, length of hospital stay and physical functional impairment after discharge from hospital. ICU-AW is a collective term used to describe the severe neuromuscular weakness that results from critical illness. Recently, an increase in survival from sepsis and critical illness has emerged, although the majority (60–80%) of survivors have physical functional impairment from Intensive Care unit Acquired Weakness (ICU-AW).

Appetence by C.C. Burns