Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
General Guidelines for Scoring:
• The FSS-ICU score should be used to grade a patient’s physical
performance only. The evaluator may assist with managing medical
devices and/or equipment, as well as supervising patient monitoring
systems. Such assistance from the evaluator should not be considered
when grading the patient’s physical performance.
• Unless otherwise stated (i.e. for ambulation and wheelchair mobility where
scoring allows for 2 evaluators), scoring of the FSS-ICU should be based
on only one evaluator physically assisting or supervising the patient with
each given task. Scoring of the FSS-ICU must be performed without the
use of a patient lift device to assist the patient.
• Scoring should be based on what is performed in the session where
testing occurs, not what the evaluator has witnessed the patient complete
in the past or anticipates that the patient should be able to perform.
Specific Instructions for Scoring:
For each task on the subsequent pages, transpose the score to the table below.
For each task, the minimum and maximum score is 0 and 7, respectively. The
“Total Score” is the sum of items 1 through 5, and has a minimum and maximum
of 0 and 35, respectively.
If task(s) were not performed for any other reason other than weakness (e.g.,
patient declines or patient’s medical equipment prevents performance of the
task), then use the following method for scoring:
1) If <2 tasks were not performed for such reasons, use the average score
from the remaining completed items to score the 1 or 2 missing tasks.
2) If >2 tasks were not performed for such reasons, only the completed tasks
can be scored and a total FSS-ICU total score cannot be calculated.
Task Score
1. Rolling
2. Supine to Sit Transfer
3. Sit to Stand Transfer
4. Sitting Edge of Bed
5. Walking
TOTAL SCORE (sum of scores)
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
1
Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
Descriptions
1. Rolling
Does the patient need assistance to roll in the bed?
[Testing Note: Place the bed as flat as safely possible for the patient]
No:
Does the patient perform rolling by themselves without the use
of a bed rail or other object to pull on? If yes, score 7.
Does the patient require a use of a rail or object to pull on in
order to roll themselves in bed? If yes, score 6.
Yes:
Does the patient require cueing or coaxing in order to roll, but
physically can perform rolling without assistance (the patient
may use a bed rail or object to pull self if needed)? If yes, score
5.
Does the patient require minimal assistance to perform rolling
(defined as the patient performing 75% or more of the amount of
the work)? If yes, score 4.
Does the patient require moderate assistance to perform rolling
(defined as the patient performing between 26%-74% of the
amount of work)? If yes, score 3.
Does the patient require maximum assistance to perform rolling
(defined as the patient performing 25% or less of the amount of
work)? If yes, score 2.
Is the patient completely dependent or unable to assist with
rolling (defined as rolling performed, but patient not being able
to assist at all)? If yes, score 1.
Is the patient unable to attempt or complete the task of rolling
due to weakness? If yes, score 0.
If task(s) were not performed for any other reason other than
weakness (e.g., patient declines, or patient’s medical equipment
prevents performance of the task), then do not score.
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
2
Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
2. Supine to Sit Transfers:
Does the patient require assistance to come to sitting from supine
position?
[Testing Note: Place the bed as flat as safely possible for the patient]
No:
Does the patient come to sitting from a lying down position by
themselves without the use of a bed rail or other object to pull
on for support? If yes, score 7.
Does the patient come to sitting from a lying down position by
themselves, but requires the use of a bed rail or other object to
pull on for support? If yes, score 6.
Yes:
Does the patient require cueing or coaxing in order to come to
sitting from a lying down position, but physically can perform
without assistance (the patient may use a bed rail or object to
assist themselves if needed)? If yes, score 5.
Does the patient require minimal assistance to come to sitting
from a lying down position (defined as the patient performing
75% or more of the amount of the work?) If yes, score 4.
Does the patient require moderate assistance to come to sitting
from a lying down position (defined as the patient performing
between 26%-74% of the amount of the work?) If yes, score 3.
Does the patient require maximum assistance to come to sitting
from a lying down position (defined as the patient performing
25% or less of the amount of the work?) If yes, score 2.
Is the patient completely dependent or unable to assist with
transferring to sitting from a lying down position (defined as
supine to sit transfer performed, but patient not being able to
assist at all)? If yes, score 1.
Is the patient unable to attempt or complete the task of
transferring from supine to sit due to weakness? If yes, score 0.
If task(s) were not performed for any other reason other than
weakness (e.g., patient declines, or patient’s medical equipment
prevents performance of the task), then do not score.
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
3
Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
3. Sit to Stand Transfers:
Does the patient require assistance to stand up from a sitting position?
[Testing Note: Transfers can occur from any surface of a reasonable and
customary height, including a bed, chair, etc.]
No:
Does the patient stand up or pull up from a seated position by
themselves without the use of bed rail/ armrests or other object
to push on or pull from? If yes, score 7.
Does the patient require the use of bed rail/armrests or other
object to push on or pull from in order to stand up? If yes- score
6.
Yes:
Does the patient require cueing or coaxing in order to stand
from a seated position, but physically can perform without
assistance (the patient may use a bed rail/armrests or other
objects to assist themselves if needed)? If yes, score 5.
Does the patient require minimal assistance to stand from a
seated position (defined as the patient performing 75% or more
of the amount of the work)? The patient may use armrests, if
needed. If yes, score 4.
Does the patient require moderate assistance to stand from a
seated position (defined as the patient performing between 26-
74% of the amount of work)? If yes, score 3.
Does the patient require maximum assistance to stand from a
seated position (defined as the patient performing 25% or less
of the amount of work)? If yes, score 2.
Is the patient completely dependent or unable to assist with
going from a seated to standing position (defined as sit to stand
transfer performed, but patient not being able to assist at all)? If
yes, score 1.
Is the patient unable to attempt or complete the task of
transferring from sit to stand due to weakness? If yes, score 0.
If task(s) were not performed for any other reason other than
weakness (e.g., patient declines, or patient’s medical equipment
prevents performance of the task), then do not score.
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
4
Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
4. Sitting Edge of Bed:
Does the patient require assistance in order to sit up at the side of the bed?
[Testing Note: There is no time requirement for this task]
No:
Does the patient sit at the side of the bed by themselves with
hands free and not holding onto a bed rail or object for support?
If yes, score 7.
Does the patient require their hand(s) or a bed rail to balance
themselves while sitting up at the side of the bed by
themselves? If yes, score 6.
Yes:
Does the patient require cueing or coaxing in order to sit at the
side of the bed, but physically can perform without assistance
(may use hand to balance themselves if needed)? If yes, score
5.
Does the patient require minimal assistance to sit at the side of
the bed (defined the patient performing 75% or more of the
amount of the work)? If yes, score 4.
Does the patient require moderate assistance to sit at the side
of the bed (defined as the patient performing between 26-74%
of the amount of work)? If yes, score 3.
Does the patient require maximum assistance to sit at the side
of the bed (defined as the patient helping 25% or less of the
amount of work)? If yes, score 2.
Is the patient completely dependent or unable to assist with
sitting at the side of the bed (defined as sitting at the edge of the
bed performed, but patient not being able to assist at all)? If yes,
score 1.
Is the patient unable to attempt or complete the task of sitting at
the side of the bed due to weakness? If yes, score 0.
If task(s) were not performed for any other reason other than
weakness (e.g., patient declines, or patient’s medical equipment
prevents performance of the task), then do not score.
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
5
Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
5. Walking:
Does the patient need assistance to walk 150 feet (45 m)?
[Testing Note: Following the patient with a wheelchair or assisting with managing
medical equipment while ambulating should not be considered as a second
person assisting with the task]
No:
Can the patient walk 150 feet (45 m) without using an assistive
device such as a cane, walker, crutches, or use of a brace or
prosthesis? If yes, score 7.
Can the patient walk 150 feet (45 m) but requires the use of an
assistive device such as a cane, walker, crutches, or use of a
brace or prosthesis? If yes, score 6.
Yes:
Does the patient require only supervision or cueing in order to
walk 150 feet (45 m) without physical help (the patient may use
an assistive device as need)? If yes, score 5.
Can the patient walk a minimum of 150 feet (45 m) with
minimum assistance of only one person (defined as the patient
being able to perform 75% or more of the walking effort)? If
yes, score 4.
Can the patient walk a minimum of 150 feet (45 m) with
moderate assistance of only one person (defined as the patient
being able to perform between 50 to 74% of the walking effort)?
If yes, score 3.
Can the patient walk at least 50 feet (15 m) with the assistance
of only one person? If yes, score 2.
Can the patient walk less than 50 feet (15 m) with the
assistance of one person or requires the assistance of two
people to physically assist with any ambulation distance? If yes,
score 1.
Is the patient unable to attempt or complete the task of
ambulation due to weakness? If yes, score 0.
If task(s) were not performed for any other reason other than
weakness (e.g., patient declines, or patient’s medical equipment
prevents performance of the task), then do not score.
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
6
Functional Status Score for the Intensive Care Unit (FSS-ICU)
Version 8.11.15
Wheelchair Mobility:
Does the patient need assistance to propel a manual wheelchair on level
surfaces for 150 feet (45 m)?
[Testing Note: Assisting with managing medical equipment (i.e. IV poles, cardiac
monitoring, etc.) while the patient is performing wheelchair mobility should not be
considered as a second person assisting with the task]
No:
Can the patient safely propel a manual wheelchair 150 feet (45
m) without any supervision or physical assist? If yes, score 6.
Yes:
Does the patient require only supervision or cueing in order to
safely propel a manual wheelchair 150 feet (45 m) without
physical help? If yes, score 5.
Can the patient safely propel a wheelchair a minimum of 150
feet (45 m) with only occasional minimal assistance (defined as
the patient being able to perform more than 75% of the task) of
one person for help, such as with turning or negotiating
thresholds? If yes, score 4.
Can the patient safely propel a wheelchair for a minimum of 150
feet (45 m) with moderate assistance of only one person
(defined as the patient being able to perform between 50 to 74%
of the task)? If yes, score 3.
Can the patient safely propel a manual wheelchair at least 50
feet (15 m) with the assistance of only one person? If yes,
score 2.
Can the patient safely propel a manual wheelchair less than 50
feet (15 m) with the assist of one person or requires the
assistance of two people to physically assist with any
wheelchair mobility distance? If yes, score 1.
Is the patient unable to attempt or complete the task of
wheelchair mobility due to weakness? If yes, score 0.
If task(s) were not performed for any other reason other than
weakness (e.g., patient declines, or patient’s medical equipment
prevents performance of the task), then do not score.
This work, created by Dale M. Needham, MD, PhD, Jennifer Zanni, PT, DScPT, and the Johns Hopkins University Outcomes
After Critical Illness & Surgery (OACIS) Group, is licensed under the Attribution-NonCommercial-NoDerivs 4.0 International License. To
view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
