Validity of the Children's Chelsea Critical Care Physical Assessment Tool (cCPAx-TR) in Turkish Pediatric Intensive Care Patients

This single-center, prospective observational study aims to translate, culturally adapt, and evaluate the Turkish version of the Children's Chelsea Critical Care Physical Assessment Tool (cCPAx-TR) for use in pediatric intensive care settings.

The study will be conducted in the Pediatric Intensive Care Unit (PICU) of Göztepe Prof. Dr. Süleyman Yalçın City Hospital. The translation and cultural adaptation will follow internationally accepted guidelines, including forward and backward translation, expert panel review, and pilot testing.

Following pilot testing, psychometric evaluation will include assessments of internal consistency, test-retest reliability, and criterion validity by comparison with established clinical scores such as the Functional Status Scale (FSS), Glasgow Coma Scale (GCS), and Pediatric Logistic Organ Dysfunction (PELOD) score. Feasibility and safety will be analyzed based on completion rate, administration time, and occurrence of adverse events.

The study population will include children aged 2-18 years who are admitted to the PICU and are clinically stable enough for bedside physical function assessment.

Inclusion criteria

• Children aged 2 to 18 years
• Admitted to the pediatric intensive care unit (PICU)
• Clinically stable for bedside assessment
• Parental or guardian informed consent obtained (and child assent when appropriate)
• Able to perform or be observed for at least one item of the cCPAx-TR
• Exclusion Criteria
• Unstable hemodynamics or severe hypoxemia that prevents safe assessment
• Deep sedation or neuromuscular blockade that prevents observation at both assessments
• Severe orthopedic or neurological conditions (for example, unstable fractures or acute paralysis) that prohibit safe mobilization
• Expected death or withdrawal of care within 24 hours
• Refusal of consent by parents or guardians